Last Sunday the Observer published a really shoddy piece of journalism about the increase in autism and the possible connection with MMR. I fired off a letter to the editor and persuaded some colleagues to add their signatures. Unfortunately I sent it to the Readers editor and not the Letters editor. Therefore my letter did not get to stand alongside the epistles of Professors Simon Baron-Cohen and Stephen A Bustin. But it did get to feature in the response of the Readers Editor, printed on the same page.
I thought his defence of the story was quite weak and fired of another letter to him. Here is my original letter
Dear Sir, We were surprised to read your headline, “New health fears over big surge in autism” (Sunday July 8, 2007) as we are unaware of any recent studies that would support such a claim. Our surprise turned to concern when we read the subheading, “Questions over triple jab for children.” Had the Observer discovered evidence of a dramatic increase in autism linked to the MMR vaccine? That was the clear implication of your headlining this on your front page. It was also misleading in the extreme as there was nothing in the article to justify this impression.
The study that forms the basis of the article is unpublished and therefore unread and unavailable for peer review. That means that nobody apart from the authors has access to the methodology or the data that supports the figure of 1 in 58. You name Fiona Scott as one of the researchers who “privately believe that the surprisingly high figure may be linked to the use of the controversial MMR vaccine.” If your reporter had spoken to Dr Scott she would have told him what she told the Daily Telegraph (Monday, July 9 2007), that the study had absolutely nothing to do with MMR or causation. “One of the elements of the research was how different methodologies can affect the result. One of the figures was one in 58. The other figures were lower than that. I absolutely do not think that the rise in autism is related to MMR. My own daughter is getting vaccinated with the MMR jab on July 17.”
The other researcher named in support of the MMR connection is Carol Stott. Carol Stott has left the Cambridge Autism Research Centre to work for Andrew Wakefield, the originator of the MMR scare, at his clinic in Texas. Prior to that, she was an advisor to the legal team seeking compensation for parents who believed that MMR caused their child’s autism. She was paid £100,000 for her services. These details, which were omitted from your report, might have helped your readers to draw their own conclusions about Dr Stott’s private belief “that the surprisingly high figure may be linked to the use of the controversial MMR vaccine.”Dr Scott has also categorically denied your claim that 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.”
On closer examination every claim in your story proves to be false. This is bad enough in itself. But the potential impact on public health makes it even worse. There is an overwhelming body of evidence that refutes Dr Wakefield’s claim that the MMR vaccine is responsible for a new and preventable form of autism. Much of it was presented at a recent hearing of the case of Michelle Cedillo before the US Court of Federal Claims. Despite their elevated status in the Observer as “leading experts in their field” neither Dr Scott nor Dr Stott were called as witnesses for the claim that MMR was responsible for Michelle Cedillo’s autistic condition.
MMR vaccination rates are beginning to recover in the UK as scientific evidence mounts to allay the natural, albeit erroneous, fears of parents. These fears have been reinforced by irresponsible media reporting that ignores the overwhelming evidence that MMR is safe and does not contribute to autism. Your article helps to stoke those fears. Finally, it has not escaped our notice that this story coincided with your exclusive interview with Andrew Wakefield, the architect of the whole MMR/autism debacle and the subject of a GMC disciplinary hearing that is due to start next week. In the interests of balance can we look forward to equally prominent coverage of the views of Wakefield’s critics in next Sunday’s edition?
Simon Pritchard in the Observer
The Observer reported last week on a ‘big surge’ in the number of children in Britain with autism and included the claim that the rise might be linked to the use of the MMR vaccine. This caused an immediate outcry within the scientific and medical community. An unpublished report leaked to the paper showed that the number of children in Britain with autism could be as many as one in 58. The document had been the work of seven academics at Cambridge University, two of whom, the paper said, believed privately that the surprisingly high figure ‘could be linked to the controversial MMR vaccine’.
Our story caused considerable controversy. Some said it would stir up alarm on the eve of the General Medical Council’s disciplinary hearing into the case of Dr Andrew Wakefield, who faces charges relating to his conduct during an MMR research project in the 1990s, and, it was suggested, the two ‘dissenters’ quoted in the piece were not ‘leaders in their field’ as claimed by the paper.
Furthermore, both had received payments for expert evidence offered at a now-abandoned court case against MMR manufacturers and one was currently working for a US clinic associated with Dr Wakefield, who had given an exclusive interview in the same issue of the paper to the same reporter.
Equally serious was the charge from the Science Media Centre that The Observer had conflated two issues: the apparent rise in autism figures and the MMR debate. The leaked document dealt in statistics, but not causes, as the story made clear, and yet the paper had reported the private views of two of its authors, both of whom were experts in autism, but were not vaccinologists.
I put these points to the reporter and to our head of news who began by denying absolutely a further accusation put to me by one correspondent: that there was a deal done to get the story on the front page in return for the exclusive interview.
The head of news said: ‘I believe it was legitimate to include the thoughts of two of the authors of the study. We didn’t conflate the two issues; the issues are already conflated.
‘We worked hard to give a non-incendiary, balanced view. I believe we had to give the readers all the information we had. After all, they would ask, “Could MMR be a factor?”‘
The document, which is entitled a ‘Final Report’ to the Shirley Foundation, the funding body which paid £300,000 for the research, is dated 15 November 2005 and showed the 1 in 58 figure to be the key headline finding.
The reporter said he knew of the payments made to the academics for the expert report they co-wrote for the court case in 2003.
He maintained that this report bore out what the paper had said: that they both believed that MMR could be a factor in autism emerging in small numbers of children.
He accepted that he should have made that plain in the story, along with the current links to Dr Wakefield. He also agreed that lower, less alarming figures of one in 74 and one in 94 found in the report should also have been in the text.
And the central point, in my view, is that the leaked story of the apparent rise in the prevalence of autism was a perfectly legitimate and accurate story in its own right, which did not need the introduction of the MMR theory.
in today’s Observer you responded to criticism of last week’s coverage of autism and MMR by suggesting that, “that the leaked story of the apparent rise in the prevalence of autism was a perfectly legitimate and accurate story in its own right, which did not need the introduction of the MMR theory.”
While it may be legitimate for a newspaper to use leaked documents to reveal truths that powerful, vested interests are trying to hide, to apply the same criteria to an unpublished scientific paper is to misunderstand the nature and purpose of academic publication. The authors submit the paper to a suitable academic journal. If it is accepted, the paper’s rationale, methodology and data are all subject to peer review prior to publication. Peer review does not guarantee that the paper is correct. It does indicate that it is a valid piece of research that merits serious discussion. If the subject of the paper is sufficiently newsworthy coverage in the non-specialist press will bring it to the attention of the general public.
This process serves two purposes. It helps to drive science forward by promoting accurate reporting of research and encouraging informed debate within the research community. It also acts to filter out weak or spurious research that might otherwise mislead the public. When scientists choose to circumvent this process and newspapers aid and abet them, both are guilty of subverting the scientific process and potentially creating another unjustified health scare amongst a lay public that will remember the headline long after the details have been forgotten.
As regards accuracy, Professor Baron-Cohen obviously disagrees. See his public statement http://www.admin.cam.ac.uk/news/dp/2007071305 that refers to your report as “inappropriate … premature … alarmist.” Or there is the report in Thursday’s Times http://www.timesonline.co.uk/tol/life_and_style/health/article2060575.ece where the reporter actually spoke to Professor Baron-Cohen before writing the story. Then there his letter, in similar vein in today’s Observer. http://observer.guardian.co.uk/letters/story/0,,2126633,00.html
You claim that it “did not need the introduction of the MMR theory.” The point is that it did revive the connection between MMR and autism. And it is no use to argue, as your news editor did, that, “We didn’t conflate the two issues; the issues are already conflated. ‘We worked hard to give a non-incendiary, balanced view. I believe we had to give the readers all the information we had. After all, they would ask, “Could MMR be a factor?”"
Let us be clear. The only people conflating MMR and autism in the minds of the public are the media who continue to publicize the views of a minority of parents and professionals despite the total lack of credible scientific evidence in support of their claim. Your attempt to give a “balanced view” actually lends credence to MMR. Balance implies that both views have equal weight in the scientific community. You should strive for accuracy not balance when reporting on these matters.
And just how accurate is a report that quotes people without interviewing them; that attributes thoughts and actions to them that are subsequently denied; that, by your reporter’s own admission, omitted facts known to him that should have been made plain in his report?
And finally, why oh why is today’s letters page headlined, “the big issue: vaccination. Reasons why autism could be on the rise.” Vaccination is only an issue because you make it so. Please stop.