Wednesday July 18, 2007
Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media. Just one week before his GMC hearing, yet another factless “MMR causes autism” news story appeared: and even though it ran on the front page of our very own Observer, I am dismantling it on this page. We’re all grown-ups around here.
The story made three key points: that new research has found an increase in the prevalence of autism to one in 58; that the lead academic on this study was so concerned he suggested raising the finding with public heath officials; and that two “leading researchers” on the team believe that the rise was due to MMR. Within a week the story had been recycled in several national newspapers, and the news pages of at least one academic journal.
But where did the facts come from? I contacted the Autism Research Centre in Cambridge: the study the Observer reported is not finished, and not published. The data has been collected, but it has not been analysed. Unpublished data is the antithesis of what science is about: transparency, where anyone can appraise the methods, and the results, and draw their own conclusions.
This study is the perfect example of why this is important: it was specifically designed to look at how different methods of assessing prevalence affected the final figure. So it is no surprise that one of the results from an early analysis is high, “one in 58”, using techniques which deliberately cast the widest net. But even other figures in the initial analysis were less dramatic, and similar to current estimates, and the Observer admits it was aware of them. It seems it simply cherry picked the single most extreme number and made it a front page splash story.
The Observer is unrepentant: it says it has the “final report”, from 2005. I can’t get it to show it to me but the Cambridge team suspect the paper has seen the last of the quarterly progress reports to the funders. So how did the Observer manage to crowbar MMR into this story?
First, it claimed that the lead researcher, Professor Simon Baron Cohen, “was so concerned by the one in 58 figure that last year he proposed informing public health officials in the county.” Prof Cohen is clear: this is inaccurate and scaremongering.
And the meat? The Observer claims that “two of the academics, leaders in their field, privately believe that the surprisingly high figure [one in 58] may be linked to the use of the controversial MMR vaccine.” This point is repeatedly reiterated, with a couple of other scientists disagreeing to create that familiar, illusory equipoise of scientific opinion which has fuelled the MMR scare in the media for almost a decade now.
But in fact, the two “leading experts” who were concerned about MMR, the “experts”, the “leaders in their field”, were not professors, or fellows, or lecturers: they were research associates. I rang both, and both were very clear that they wouldn’t describe themselves as “leading experts”. One is Fiona Scott, a psychologist and very competent researcher at Cambridge. She said to me: “I absolutely do not think that the rise in autism is related to MMR.” And: “My own daughter is getting vaccinated with the MMR jab on July 17.”
She also said, astonishingly, that the Observer never even spoke to her. And in the Observer’s “readers’ editor” column one whole week later, where the Observer half heartedly addressed some of the criticisms of its piece, the Observer persisted in claiming she believes MMR causes autism: it believes it knows the opinions of this woman better than she knows her own mind. Despite her public protestations. The only voice that Dr Scott could find – bizarrely – was in the online comments underneath the readers’ editor piece, where the Observer continued to call her an MMR “dissenter”, and where she posted an impassioned and slightly desperate message, protesting her support of MMR, and threatening legal action.
That’s one of the leading experts. The other is Carol Stott. She does believe that MMR causes autism (at last). However, she is no longer even a “research associate” at the Autism Research Centre.
Carol Stott works in Dr Andrew Wakefield’s private autism clinic in America, which the Observer failed to mention, and she was also an adviser to the legal team which failed in seeking compensation for parents who believed that MMR caused their child’s autism, which the Observer failed to mention. She was paid £100,000 of public money for her services. She says her objectivity was not affected by the sum, but even so this seems an astonishing pair of facts for the Observer to leave out.
And were Stott’s views private, or secret, or new? Hardly. Stott is so committed to the cause against MMR that when the investigative journalist Brian Deer exposed the legal payouts in 2004, although she had no prior contact with him, she spontaneously fired off a long series of sweary emails titled “game on”: “Try me, shit head … Believe me, you will lose … so go fuck yourself. Got it yet shit head. Try me … Twathead … waiting … oh yes … Stick that where it feels good. Shit head … well, ur a bit slow on the uptake … Give it time I s’pose. Twat.” And so on.
On the phone I genuinely warmed to her, and she regrets that many people have fallen into entrenched positions on MMR on both sides. But she’s not a leading expert (as she herself agrees); she’s not a sombre Cambridge academic suddenly expressing a fresh concern (her views are very public); and in any case, even she is very clear that this new research reported in the Observer would tell us nothing whatsoever about MMR causing autism.
Nothing has changed, and this scare will never be allowed to die. If we had the right regulatory structures, almost every section of the media would be in the dock, alongside Wakefield.
Please send your bad science to firstname.lastname@example.org
I think we should recognise that criticising a paper within the same stable is a very unusual thing, and I think it shows phenomenal integrity that the Guardian was willing to give me the opportunity to write about this as I would about any other newspaper story that was so wrong, even if it took some time. I honestly don’t think it could happen anywhere else, especially as I was criticising the central facts of a news story, not a comment or opinion piece.
On the other hand I might be completely wide of the mark and this is a non-event. I don’t know, I don’t know much about media politics generally, and I don’t go into the building much (I’d be scared of getting a wedgie in the back staircase off the Observer people now).
Either way the most important thing is that the Observer’s was a very prominent story, it was picked up all over the place (can you believe the BMJ quoted that one in 58 figure as fact in a news story?), and now there is something in the public domain that puts the facts a little straighter. I hope it doesn’t trigger, er, “reprisals” and I would be very surprised if there’s anything in there that doesn’t stand up.
Building a story out of scary unpublished data has been a recurring feature of the anti-MMR coverage (eg here, while newspapers ignore any reassuring negative risk findings like here and here) and to me that is really the central science- and risk-communication issue arising from this Observer piece. If there hadn’t been a need to get bogged down in the dreary details I would much have preferred to just write about that, but I was on a juggernaut of pulling the piece apart by then.
Mainly of course my indignation was simply a contrivance to get the words “shithead” “fuck” “twat” and “twathead” onto the pages of a national newspaper. The especially good news is that my very lengthy analysis of the Observer piece is being published in the British Medical Journal on Friday, which I am assured after the cut still features twat, fuck, and shithead action. After this has been published, I believe it will be the sweariest thing the BMJ has printed to date. The gauntlet is down.