The antivaccine movement and conspiracy theories go together like beer and Buffalo wings, except that neither are as good as, yes, beer and Buffalo wings. (Maybe it’s more like manure and compost.) In any case, the antivaccine movement is rife with conspiracy theories. I’ve heard and written about more than I can remember right now, and I’m under no illusion that I’ve heard anywhere near all of them. Indeed, it seems that every month I see a new one.
There is, however, a granddaddy of conspiracy theories among antivaccinationists, or, as it’s been called, the central conspiracy theory of the antivaccine movement. That conspiracy theory postulates that “they” (in the U.S, the CDC) have known for a long time that vaccines cause autism, but “they” are covering it up. In other words, the CDC has, according to this conspiracy theory, been intentionally hiding and suppressing evidence that antivaccinationists were right all along and vaccines do cause autism. Never mind what the science really says (that vaccines do work don’t cause autism)! To the antivaccine contingent, that science is “fraudulent” and the CDC knew it! Why do you think that the antivaccine movement, in particular Robert F. Kennedy, Jr., went full mental jacket when Poul Thorsen was accused of financial shenanigans (i.e., fraud) with grant money from the federal government? It was a perfect story to distract from the inconvenient lack of science supporting the antivaccine view that vaccines cause autism. More importantly, from the antivaccine standpoint, it was seen as “validation” that the CDC studies failing to find a link between autism and vaccines were either fraudulent or incompetently performed. Why? Because Thorsen was co-investigator on a couple of the key studies that failed to find a link between the MMR and autism, antivaccinationists thought that his apparent financial fraud must mean that he committed scientific fraud. They’re the same thing, right? Well, not really. There were a lot of co-investigators, and Thorsen was only a middle author on those studies.
As the time came to do my usual weekly post for this blog, I was torn over what to write about. Regular readers might have noticed that a certain dubious cancer doctor about whom I’ve written twice before has been agitating in the comments for me to pay attention to him, after having sent more e-mails to me and various deans at my medical school “challenging” me to publish a link to his results and threatening to go to the local press to see if he can drum up interest in this “battle.” I’ve been assiduously ignoring him, but over time the irritation factor made me want to tell him, “Be very careful what you ask for. You might just get it.” Then I’d make this week’s post about him, even though I wasn’t thrilled with the idea of giving in to his harassment and giving him what he wants.
That’s why I have to thank the ever-intrepid investigative reporter Brian Deer for providing me an alternative topic that is way more important than some self-important little quack and a compelling topic to blog about in its own right. Brian Deer, as you might recall, remains the one journalist who was able to crack the facade of seeming scientific legitimacy built up by antivaccine guru Andrew Wakefield and demonstrate that (1) Wakefield’s work concluding that the MMR vaccine was associated with “autistic enterocolitis” was bought and paid for by a solicitor named Richard Barr, who represented British parents looking to sue vaccine manufacturers, to the tune of over £400,000; (2) Wakefield expected to make over £72 million a year selling a test for which Wakefield had filed a patent application in March 1995 claiming that “Crohn’s disease or ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids”; and Wakefield’s case series published in The Lancet in 1998 was fraudulent, the equivalent of what Deer correctly characterized as “Piltdown medicine.” Ultimately, these revelations led to Wakefield’s being completely discredited to the point where The Lancet retracted his paper and even Thoughtful House, the autism quackery clinic in Austin, TX where Wakefield had a cushy, well-paid position as scientific director, had to give him the boot. Yes, Wakefield is a fraud, and it’s only a shame that it took over a decade for it to be demonstrated.
As much as I hate how it took discrediting Wakefield the man as a fraud rather than just discrediting his bogus science to really begin to turn the tide against the annoying propensity of journalists to look to Wakefield or his acolytes for “equal time” and “balance” whenever stories about autism and vaccines reared their ugly heads, I can’t argue with the results. Wakefield is well and truly discredited now, so much so that, as I noted, his prominent involvement probably ruined any chance promoters of the “CDC whistleblower” scam ever had to get any traction from the mainstream press.
What is sometimes forgotten is the effect Wakefield’s message has had on parents. These are the sorts of parents who tend to congregate into groups designed to promote the idea that vaccines are dangerous and cause autism, such as the bloggers at the antivaccine crank blog Age of Autism, the equally cranky blog The Thinking Moms’ Revolution, or groups like The Canary Party. It is Wakefield’s message and the “autism biomed” quackery that it spawned that have led to unknown numbers of autistic children being subjected to the rankest form of quackery in order to “recover” them, up to and including dubious stem cell therapies and bleach enemas.
Ed. Note: Today we present a guest post from Josh Cuevas, a cognitive psychologist and assistant professor in the College of Education at the University of North Georgia. Enjoy!
Breaking the cycle
Since early on in graduate school when I began studying cognition, I’ve followed the learning styles movement because it was such a powerful phenomenon. It took hold rapidly, seemingly overnight, at all levels of education. And, like so many fads in education and science, it created a big-money industry involving conferences, training seminars, paid speakers, how-to manuals, and a variety of other mediums, inevitably linked to a profit in some way. Yet in the peer reviewed studies I was sifting through, evidence for learning styles was nowhere to be found. And more than a decade later I’m still looking for it.
Today when I suggest to students that learning styles are no more than a myth, I can hear their collective jaws drop, regardless of whether they’re undergraduates or graduate students, because learning styles have been preached to them the entire time they’ve been in school. The graduate students concern me the most because they’re supposed to know the research. And I used the term “preached” because these students have been convinced via no more than word of mouth, are asked to accept the information based on faith, and many come to hold a strange religious-like fervor for the concept. That’s not how science works and it shouldn’t be how education works.
It has been no easy task combating this common misconception in college classrooms, particularly when it is reinforced in textbooks, by other professors (who are also supposed to know the research), and in public schools where students do their internships. The research we’re doing at the University of North Georgia on learning styles has two purposes – it allows us to collect data on the effects of learning styles and contrast it to a stronger model, dual coding, but it also lets us demonstrate, in real time, to students who will one day be teachers how what they’ve long believed to be true simply does not work when put to the test. (more…)
In April 2013 President Obama announced the BRAIN initiative – Brain Research through Advancing Innovative Neurotechnologies – committing 100 million dollars to brain research. The goal of this initiative is to accomplish with the brain what the Human Genome Project accomplished with the human genome.
The BRAIN project came after a similar, and larger, initiative in Europe – the European Union’s Human Brain Project (HBP), which was given 1.3 billion dollars in funding. The HBP came under some controversy this summer when neuroscientists complained about how the money was being awarded.
The serious commitment to brain research on both sides of the Atlantic reflects the general recognition that the brain is an important and complex organ (arguably the most complex thing we know about in the universe) and there is tremendous opportunity to reap benefits from new research.
The comparison to the Human Genome Project is quite deliberate. The HGP is generally perceived to have been incredibly successful, the biological equivalent of announcing that we will send people to the moon by the end of the decade, then doing it.
It looks like we can file this one under “here we go again.” A small town in Colombia, El Carmen de Bolivar, has seen more than 200 girls hospitalized with a mysterious illness since May of this year. The symptoms include dizziness, headaches, and fainting. So far, all of the girls hospitalized have been found to be healthy and were quickly released from the hospital without discovering any specific disease or pathology.
Unfortunately I have to depend on news outlets to provide information about this case, and most are skimpy on details. However, taking what is being reported, the case has all the features of mass psychogenic illness. Specifically, the cases are clustering in a small community, which is typical for typical for episodes of mass delusions. The symptoms being reported are all subjective and the kinds of symptoms that can result entirely from psychological stress. I have seen no reports of objective clinical findings, such as fever, rash, abnormal laboratory findings, strange lesions, or objective findings on exam.
Doctors who have examined the patient feel that the presentation is consistent with psychogenic illness. I have discussed this at length previously. A psychogenic illness results from the physical manifestation of psychological stress. This is always partly a diagnosis of exclusion, meaning that other causes of the presenting symptoms need to be ruled out. However, it is more than just a diagnosis of exclusion, as there are sometimes clinical features that can be positively demonstrated to be psychological rather than physical. The ultimate test of the psychogenic diagnosis is that patients should improve with support and encouragement.
That there is an “autism epidemic” is taken as a given by those who feel autism has a dominant environmental cause. The Age of Autism blog, for example, bills itself as a, “Daily Web Newspaper of the Autism Epidemic.” The term “epidemic” also implies an environmental factor, such as an infection.
The epidemiology of autism and autism spectrum disorder (ASD) has never supported the conclusion that there is an autism epidemic. There is no doubt that the number of autism diagnoses has increased in the last two decades, but the evidence strongly suggests this increase in an artifact of how autism diagnoses are made, and not representative of a true increase.
Adding to this data, a newly published study looks at autism and ASD prevalence worldwide: “The epidemiology and global burden of autism spectrum disorders“. They found:
In 2010 there were an estimated 52 million cases of ASDs, equating to a prevalence of 7.6 per 1000 or one in 132 persons. After accounting for methodological variations, there was no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs.
A recent editorial entitled “CAM in the Real World: You May Practice Evidence-Based Medicine, But Your Patients Don’t” published in Headache: The Journal of Head and Face Pain by Robert Cowan, a headache specialist, addresses the use of complementary and alternative medicine (CAM) in the treatment of headaches. Unfortunately he propagates many common misconceptions about CAM in the article.
I do agree with one point – physicians need to be more aware of CAM treatments and their patients’ use of them. We should be directly asking our patients about such use, in a non-judgmental way, and we should be familiar enough with common CAM treatments so that we can provide knowledgeable guidance to our patients.
Cowan begins by, in my opinion, grossly exaggerating the current popularity of CAM. He writes:
As much as 82% of headache sufferers use complementary and alternative approaches.
The reference he cites, however, states:
Adults with migraines/severe headaches used CAM more frequently than those without (49.5% vs 33.9%, P < .0001); differences persisted after adjustment (adjusted odds ratio = 1.29, 95% confidence interval [1.15, 1.45]). Mind–body therapies (eg, deep breathing exercises, meditation, yoga) were used most commonly.
Only 4.5% of adults with migraines/severe headaches reported using CAM to specifically treat their migraines/severe headaches.
The American Heart Association and the American Stroke Association recently published in the journal Stroke a thorough analysis of the evidence for an association between cervical manipulative therapy (CMT) and both vertebral artery dissection (VAD) and internal carotid artery dissection (ICAD). The full article is online: “Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.” For background, an arterial dissection is essentially a tear in the inner lining of the artery. This tear disrupts the normal flow of blood, and also causes platelets to gather at the site of injury. This can result in a blood clot at the site of the dissection. This blood clot can block flow through the artery, or it can break off and lodge downstream, blocking flow at that point. Dissections, therefore, can result in a stroke (a lack of blood flow to a portion of the brain causing damage). There are four arteries in the neck that bring blood from the heart to the brain, two carotid arteries in the front, and two vertebral arteries in the back. A dissection in one or more of these arteries is associated with 2% of all strokes, but with 8-25% of strokes in patients <45 years old. This is mostly because strokes associated with processes like atherosclerosis are much less common in the younger population. Arterial dissections are classified as either spontaneous or traumatic. Trauma can be either severe, such as whiplash injury from a car accident, or subtle, such as from yoga or simply turning one’s neck to look past the shoulder. (more…)
Years of analyzing popular but dubious claims leads to the impression that just about all knowledge that filters down to the popular consciousness is essentially wrong, at least as a first approximation. This may sound cynical, but think about any area in which you have specialized knowledge and compare that to what the average person believes about that area. Now extrapolate that to every other area of specialized knowledge.
I may be skeptical, but I am not a nihilist. I do think the situation can be and is being improved by popularizing science and other areas of knowledge. Experts need to be directly involved in teaching the public about their area, and when they are, popular beliefs can be corrected.
One example is the myth that we only use 10% of our brain. This is still fairly popular, and was recently a central plot element to the blockbuster movie, Lucy. However, Google “10% brain” and you will find nothing but links to sites debunking this myth, at least in the first few pages.