Fraud in Medical Research
Whilst thinking about homeopathy in the last post, the story of Andrew Wakefield was also in the news. If you type “Andrew Wakefield fraud” into Google, you get this story from Science-Based Medicine. Here is the first paragraph.
Pity poor Andrew Wakefield.
Actually, on second thought, Wakefield deserves no pity at all. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield’s work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.
Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result Wakefield has been frequently sarcastically “thanked” for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.
David Gorski then goes on to show how badly Wakefield conducted his research. Read the whole article and the comments that follow it.
I am of an age, where it seemed in every class at school, there was a someone who had suffered the effects of polio. So to all of these antivaccine Fascists, I ask if they want to go back to those times. I also have friends and relatives, who were damaged by measles and/or mumps, who would have been saved by the MMR vaccine.
Wakefield’s badly conducted research and the fact that it was not properly checked before publishing in the Lancet has left a terrible legacy.
But there are two troubles with medical research!
Suppose, a doctor notices a link between symptom A and disease B, which is outside the normal scheme of things. If he publishes honestly, saying that this might be correct and can anybody shed light on what he has seen, many sufferers will accept what he says has gospel. Tabloid headlines will proclaim a new cure for cancer, when the doctor was just postulating something that might be useful. We see this all the time.
On the other hand, suppose this link goes totally against the established thinking. His research may well destroy the reputations of the great and good in the field. Would they allow his research to be published? Of course not. Horizon, made a programme about the messenger of the body, which turned out to be completely different to established thinking, some years ago. A lot of the programme was taken up discussing the problems of the researcher getting his ideas published.
To return to Wakefield. He definitely was helped by the bandwagon that developed after his research was published. But supposing he had been refused the publication, as his results were against established thinking. I’m with him there as I really hate censorship. But then his research was flawed and shouldn’t have been published.
Was it fraud?
Probably not in the established sense, but I feel Wakefield might have suffered from a fault very common in doctors. They have a theory and try and prove it. I am an engineer and if have a problem then I try and solve it. So if he was guilty of anything, I suspect it was not being honest with himself, his patients and his research. But we’ve all done that. I know I’ve made mistakes by using information in the wrong way. But my research hasn’t been nearly so important.
If fraud was just an isolated event in medical research, we should not be seriously worried, provided that research is properly reviewed and published.
But I have written a piece of software called Daisy.
One of the things it can do is to check the integrity of a set of numbers. A medical professor, showed me how to check a set of observations were consistent. All you do is look at the last digit and plot them as a simple histogram. If they are genuine numbers they will have one pattern and if they are some that have been made up, then they will have a different one.
The professor showed me some research where it was obvious that the numbers had been made to fit the theory.
Another isolated case?
No! A relative of someone I know was struck off for doing something similar.
So it goes on.
To avoid other cases like Wakefield, we need to make sure that all papers, and not just in the medical field, are thoroughly reviewed before publishing. This alone would make sure that researchers used the best methods and the most exacting standards. We should also have a system in place, that would not allow the suppressing of controversial research that would upset the status quo.
Alzheimer’s Disease and Mobile Phones
I was sent an article about gluten-free food and this unrelated extract stood out.
Mobile phones and Alzheimer’s disease – Recent research suggests that mobile phone radiation may halt the progression of Alzheimer’s in mice but experts take issue with both the research methods and the report’s conclusions.
A summary of the research offers this explanation.
The researchers showed that exposing old Alzheimer’s mice to the electromagnetic waves generated by cell phones erased brain deposits of beta-amyloid, a protein strongly associated with Alzheimer’s disease. Clumps of beta-amyloid form so-called brain plaques that are a hallmark of the disease.
As an engineer, I’m not surprised if this happens. Irradiating things has all sorts of effects. Some are positive and some are downright dangerous.
Now, it has also been shown that low-levels of B12 may lead to Azheimer’s and other brain problems.
It would strike me as an engineer that these two areas of research are perhaps some of first pieces of a jigsaw, that if we can solve it, will lead to ways of possibly delaying the onset of what is a very nasty disease.
I hope so.
Cadbury
I’m sad that that iconic British company, Cadbury, is being sold to the Americans.
There are two main reasons and both are selfish.
I buy a lot of Green and Black‘s chocolate because I know it’s provenance and can trust that what they say on the packet. I really don’t trust Kraft to keep the standards of this brand and hope that someone buys it from them.
But the main reason is that Cadbury are very correct about which products are gluten-free and it is just a quick check on the web site. In fact over the last few years, more products have gone that way. Can I trust Kraft, from the country of gluten-in-everything to not put the evil maltodextrin in everything to save money?
I doubt it.
So yet again, coeliacs may well have less and less chance to buy something sensible to eat on the move.
Dr. Chris Steele
Dr. Chris Steele is a TV doctor. I’ll admit I’d never heard of him before, as he’s on ITV and I try not to watch any program with adverts.
But he has now been diagnosed with coeliac disease as the Daily Mail reports.
I’ve tried to put a comment on the web site, but I can’t seem to get registered. So I’ll post it here for now.
Dr. Steele’s case is typical. For some reason, doctors miss diagnosing coeliac disease all of the time. I know of a GP with coeliac children, whose husband family have coeliac history, who missed her own coeliac disease. So it is not easy to get right.
In my case, I was not diagnosed until 55, seven years ago. My symptoms were joint pains, chronic dandruff, extreme tiredness, gall stones, migraines, depression, wind, diarrhoea, mood swings etc. etc. But if you trace my family tree and those who probably had coeliac disease, you will notice that no women in the family have had any children. Could it be that the low B12 levels associated with coeliac disease, mean that it is difficult to conceive or carry a baby to full term?
As to eating out, Dr. Steele should try Italy. Just say you are a coeliachai and you get gluten-free pasta in many restaurants. We should follow the Italians and treat the disease very seriously, as how much does the misdiagnosis cost the NHS.
I very pleased of this for two reasons.
- Every celebrity who is diagnosed with coeliac disease helps publicise the disease.
- His experience shows that when you have been diagnosed the cure is simple and you get better pretty quickly.
So my advice would be if you think you have any of the symptoms of coeliac disease, try a gluten-free diet. It might not work, but it wouldn’t do you any harm.
How Can We Improve Security?
Over the years the security services and the police all over the world have made many basic mistakes which have meant that people have lost their lives. I should also add that there have been lots of cases of domestic violence and child abuse which were not picked up, which also resulted in death. I could also add in things like misdiagnosis in hospitals.
It’s all part of the same problem.
The evidence in many cases is there, but no-one can put it together to find the correct or even deadly link.
So the first thing that must be done to improve security or in the NHS’s case patient diagnosis is to make sure that all computers can talk properly to each other.
As an example of this, the DVLA can check quickly that vehicles are taxed, insured and MOT’ed instantly. The benefit to the general public is that it is now a simple process to retax a vehicle over the Internet. But to the police it is a valuable tool to check whether vehicles are legal. I suspect that the number of untaxed vehicles has also reduced and the tax take has increased. The only downside of this linking of databases is that because of the on-line purchase of road tax, Post Offices are getting less revenue and this doesn’t help their financial situation.
We still are nowhere near getting a decent patients’ record computer system and I’ve also heard stories about how police computer systems are all different and sometimes need the same data to be entered more than once. I hope most of the stories I’ve heard are wrong. But I doubt it!
All my life I’ve been a maverick kicking against complacency and the status quo.
Any organisation handling data should employ people like me. Well not me, as I’m too old and well past my sell-by date.
But I know that some of my software and other similar systems have been used in very sensitive applications to link data together so that police and others can target criminals, problems or epidemics. This type of software is used outside of the computer mainstream and to many so-called computer managers it is a pain. I can understand their point, but they should see that these analysts are on their side. It could be argued that the collapse of several of the banks in recent months was because senior managers knew better and ignored the well-researched facts and opinions of analysts with minds much sharper than their own.
So every organisation should have a group of people, whose job is to analyse and question the data in every way possible. Unfortunately, these type of groups are the first to be got rid of in times of financial restraint. They are always a pain in the arse to so-called managers.
I should put a bit of history in here. Years ago in ICI, I worked in a Computer Techniques section, that had free rein to poke its nose into problems in the Division. It was very successful, but had it not been for the diplomacy of those that ran it, it would have been very unpopular. I was at one time, when I told a chemist that he was barking up the wrong tree. But then he wasn’t using any mathematics for his reactions and I was!
I also believe that we rely too much on conservative techniques. I sometimes think that some of the problems with the banks were caused because too many people looked at them all in the same way, with the same software.
So if the maverick groups are to be effective, they need to be able to purchase software and services, that may not fit the policy of the organisation. They also need to have access to specialist programming resources. I would say that wouldn’t I!
I would also make the watch lists much more publicly available.
Let’s say that you are a check-in clerk for an airline. Someone turns up and there is something you don’t like about them. You should be able to flag the guy quickly with just a single key stroke. Perhaps, you can now, but if you can’t then you should be able to. If the watch list was able to be checked at that moment, then it would help airport security ascertain if the person was just nervous of flying or a bomber.
But the key to better security is that everyone should be on watch for anything suspicious. After all one of the biggest failures in the Umar Farouk Abdulmutallab case, is the fact that his father reported him and no-one did anything about it. We need a system that allows the public to contribute to the data, when they have suspicions.
But our biggest problem is that all of these security services are closed and secretive organisations, so they tend to believe all their own methods, publicity and hype. I am reminded of a friend, who in the 1950s needed to be cleared to work on top-secret radar systems. The fact that he was a member of CND should have precluded this, but the security services never knew, as they never asked him.
Have they got any better?
But what will we get?
Probably a lot more restrictions on our lives.
How to Encourage Binge Drinking
This story from the Telegraph shows how those in charge of the nanny state haven’t a clue.
The “app”, which measures drinks in alcoholic units, has sparked something of a craze among drinkers to get the highest score.
The NHS drinks tracker was launched at the start of December and is designed to help people avoid overindulging.
It works by converting drinks into units to show drinkers when they have gone over the recommended daily limit.
But within days of the tracker being released it was being described on the internet as an “awesome game” and users were boasting about trying to beat their “top score”.
If you produce a drink-o-meter for an iPhone, you could have bet your life that people will attempt to create a record score. Someone should be fired for being stupid. But I doubt they will be.
Keeping Your Brain Healthy
Look at any list of symptoms for coeliac disease and you’ll find a lot of them are concerned with brain or mental problems.
- Mild Depression
- Feelings of Inadequacy
- Gait Ataxia/Apraxia
- Lightheadness and Fainting
- Migraine or Persistent Headaches
- Mood Swings
- Sleep Disturbance
I used to suffer from most of these except for sleep disturbance.
Once I went on a gluten-free diet all of these symptoms cleared up. Now I know that I am a special case in that I’m a coeliac, but once the B12 levels were back up to normal, all of the symptoms disappeared. Research at Oxford University has indicated that higher B12 levels may help brain health.
It would be interesting to repeat their experiments with coeliacs. When a hospital diagnoses a coeliac, they should immediately undergo the tests before starting a gluten-free diet. And then they should be tested at intervals after starting the diet. My body actually reacted quite quickly in that my dandruff cleared up after about two weeks.
Now I know several people who have MS. One has sent me a link to an article about a new treatment for the disease called The Liberation Treatment. Here are the first couple of paragraphs.
Amid the centuries-old castles of the ancient city of Ferrara is a doctor who has come upon an entirely new idea about how to treat multiple sclerosis, one that may profoundly change the lives of patients.
Dr. Paolo Zamboni, a former vascular surgeon and professor at the University of Ferrara in northern Italy, began asking questions about the debilitating condition a decade ago, when his wife Elena, now 51, was diagnosed with MS.
He found that in some patients, the blood flow to the head was restricted and by improving this using standard surgical procedures, their health improved. Here’s a couple of paragraphs from the article.
One of those patients was Buffalo resident Kevin Lipp. Lipp had MS for over a decade, and as part of the study, discovered he had five blocked veins in his neck. After undergoing the Liberation Treatment 10 months ago, he says he hasn’t had a single new MS attack.
Zamboni emphasizes that the Liberation Treatment does not make people in wheelchairs walk again. Rather, it seems to stop the development of further MS attacks, and in some cases, improves movement and decreases the debilitating fatigue that are the hallmarks of MS.
It may not cure MS, but it is all very interesting.
I tend to look on the body, as an engineer would look on a machine or a car. Machines don’t work well if they don’t have all of the things they need like fuel, electric power, oil, water and all the other necessities.
Is the body any different to my car in that respect?
And now today, it has been reported that those who develop Alzheimer’s are less likely to get cancer.
This would appear to push things in another direction, as research at Nottingham University has shown that coeliacs are less likely to get breast cancer. Diagnosed coeliacs have on the whole healthy brains because they eat well, so this research might show the opposite.
We need to do a lot more research to find all of these links.
Sometimes I Go Over the Top
Friends sometimes accuse me of being a bit boring as I keep banging on about gluten.
But then I read this at Gluten Connection, which advertises a new book. This is an extract.
Millions of Americans are enduring painful and chronic conditions. Most doctors are mystified. Drugs usually offer little help. Most of these conditions have one thing in common… It’s called gluten sensitivity. It’s caused by a widely used food ingredient. It can lead to a wide range of serious health conditions and…it can affect up to 81% OF ALL AMERICANS!
If you are gluten sensitive, your body does not have the ability to break down and digest gluten, a protein found in wheat, barley, and rye. Your body reacts to gluten as if it were a virus. It launches an immune reaction that can cause or worsen a wide range of chronic health problems.
So perhaps I’m a bit understated.
Michael Obiora
It helps me and many other coeliacs, when a celebrity, an actor or anybody in the public eye, says that they are coeliac.
So three cheers for Michael Obiora, who has said he’s a coeliac.
He actually seems to have suffered from a multitude of problems, that I didn’t have. So I’ve been lucky! I wish him all the best.
Ignorance of Asbestos
There is an article on BBC Breakfast this morning about asbestos. There just seems to be a lot of if we don’t think about it, then it’ll be alright.
But!
Between 1968 and 1972, I worked for ICI. I seemed to remember that they had banned it then and were removing it whenever they had found it. This was some years before bans started to be introduced in the mid-1980s.
So I’m rather surprised that there is still so much of it about.
