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Archive for September 2nd, 2009

Vaccines and the Media: No Room for Balance

A Dose of Controversy
© 2009 msnbc.com

Matt Lauer and NBC have continued the ignominious media tradition of feigning to bring “balance” to the issue of vaccine safety. In the Dateline episode A Dose of Controversy, which aired on Sunday night, Matt Lauer interviewed Andrew Wakefield, the originator of the MMR-causes-autism myth, and highlighted his work at Thoughtful House, the autism treatment center he created in Texas after he was exiled from the U.K. He also interviewed (as “balance”) Dr. Paul Offit, a renowned expert on vaccines and pediatric infectious disease, and Brian Deer, the British journalist whose investigative reporting on Wakefield revealed the true, dark underbelly of the story. Of course, no balance was required to cover this story, since there is no balance from a scientific perspective. There is the evidence – that there is no causal association between the MMR vaccine and autism, and there is the myth, belief, and dogma (and a smattering of fraud) backing the notion that there is. A good piece of journalism covering this topic would have discussed Wakefield only as reference in the narrative of the story. But then that wouldn’t be nearly as good for ratings. Tension, controversy, personalities, that’s what makes for a good story. And that’s just what Dateline provided it’s viewers. Unfortunately, what it probably didn’t do was ease the fears of parents who have been thrown off course by misleading media stories and the speed-of-light trajectory that has characterized this myth. Worse, by simply shining light on the debonair Dr. Wakefield, the show may have misled even more parents into believing this dangerous myth. (more…)

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IVF and CAM Use

Perhaps the biggest hurdle to broader acceptance of the need for a consistent scientific basis for medical interventions is the attitude that worthless treatments are harmless. I often have the experience, after reviewing the evidence showing lack of efficacy for a specific intervention, of getting the head-tilt and shrug along with some variation of the dismissive attitude,  “Well, if people feel better, then what’s the harm?” In my opinion, ethics and intellectual honesty indicate that we have to do better than that.

The “what’s the harm” refrain is so tired and overused that it prompted a website by that name, documenting direct harm caused by unscientific treatment modalities. This is a helpful reminder that any intervention that actually does something (has biological activity) must also contain some risks. But this site also has significant limitations. First, it is anecdotal. But also it emphasizes direct harm, while the indirect harm of unscientific methods (for example by delaying definitive treatment) likely vastly outweighs the direct harm. However, indirect harm is extremely difficult to quantify.

Studies looking at the net clinical effects of using or relying upon unscientific methods is therefore desirable. Recently Danish researchers have published one such study:  Use of complementary and alternative medicines associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment.

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