Tuesday, May 29, 2007

Journal Integrity

It happens from time to time that I will run across two separate sources of information that somehow relate to one another, and the combination prompts additional thought. Today, one of these circumstances occurred.
First was Kev's post titled "On Media, Neurodiversity, and Science". In it, Kev refers to the value of the scientific method and the value it has for ongoing progress in autism research. And, what's more, how those who espouse acceptance of Autism differ in their approach to information dissemination from those who espouse a cure for autism.

Then, a few hours later, I came across an interesting opinion piece in The Wall Street Journal. It was authored by Dr. Scott Gottlieb, former Deputy Commissioner of the FDA here in the U.S. Titled "Journalistic Malpractice", the article discusses the politicization of once-respected Medical Journals. He opens:

"As medical information is exploding and becoming more accessible, all of
us, particularly physicians, need objective sources to interpret data and
present a balanced view. Unfortunately, major medical journals that should
be filling this role often put more weight on pushing political agendas."

Which, of course, leads to the point - not dissimilar from that made by either of my two cited sources named above. That is - the proponents of the mercury/autism connection consistently cross the boundary between rational thought and self-delusion. They arbitrarily assign validity to various positions based not on truth, reality, or data, but instead based on what most closely matches their accepted world-view. They apply their efforts more towards propaganda than towards analysis of existing information. Their weapons of choice in the ongoing debates are public relations, political pressure groups, media blitzes (witness Generation Rescue's notorious full-page newspaper ad or, most recently, the United Methodist Church-Women's Division Simpsonwood Rally to be held next week), and tort litigation. And one battleground of choice is the medical journal.

The value of medical journals lie in their mission of "informing clinical practice and maintaining standards for how rigorous clinical research ought to be conducted." (from Journalistic Malpractice, Gottlieb). In other words, commonly accepted standards are assumed to be in place, so that when one reads information in a journal of science, it can be safely assumed that the information has been objectively and critically reviewed by a panel of expert peers. Since the peers are doing the "heavy lifting" in terms of critiquing the methodology and conclusions, the reader (and eventual applicator of findings) can "trust" that the information is good.

But wait! Even this vehicle is utilized by the mercury militia in their efforts to promulgate the ongoing, and harmful, myth about childhood vaccines and autism. An excellent description of the types of journals the maverick researchers who play in this sandbox subscribe to is found here. This article by Kathleen Seidel illustrates that lowest of the low in medical journals - JAPandS (Journal of American Physicians and Surgeons). This journal makes no bones about its position on vaccines, stating on its website (excerpted from Neurodiversity Weblog, referenced above):

"AAPS opposes “mandated vaccination,” calls for its members to
“insist upon truly informed consent for the use of vaccines,” persistently
questions the safety and efficacy of immunization to prevent infectious
diseases, and offers dire scenarios of supposed threats posed to children by
vaccination requirements for public school entry."

So, basically, the editors have taken the position that they intend on publishing research that conforms to this standard, reality be damned. This is where one can look to find the research of such doctors as Jeffrey Bradstreet or the Geiers (well, at least the senior Geier is a doctor).

In contrast, the Gottlieb piece is referring to to the New England Journal of Medicine (sister publication to The Lancet), known as a reliable, stand-up publication with strong ethical fiber. Gottlieb's article focuses mainly on last week's fiasco involving misleading conclusions published in the NEJM regarding the diabetes drug Avandia. It highlights the point that, even in the best ethical climate, politicization can and will frequently occur. It follows that in an environment such as JAPandS, editorial bias is almost assured.

One interesting aspect of this article is its discussion of drug-safety testing conducted by the FDA, which is a primary target of mercury militia spite and ridicule. In Gottlieb's words:

"When it comes to the issue du jour, drug safety, no description of
medical research in a medical journal comes close to the detail level or
scrutiny imposed by the FDA on study results before approval."
This statement jibes with a conversation I had a while back with a friend of mine who is a clinical trial director for a pharmaceutical testing company. I explained to her the theories advanced by those who believe in the whole FDA/CDC/Thimerosal conspiracy. She was astounded that anyone could believe that such a coverup was even possible. As she explained, drug testing and approval involves hundreds, sometimes thousands of people, and extremely rigorous standards of testing. If even one person of these hundreds decided to blow the whistle, the proverbial game would be over for any conspiracy.

Yet, as has been shown time and time again, when the radical views of the mercury militia are contrasted to virtually any mainstream standard of epidemiology, biology, or even logic, the folly of their position is exposed. Of course, whenever the slippery supporters of this so-called theory come close to having a showdown with reality, they can (and will) easily reinvent their positions. And therefore the debate rages on and on and on, ad nauseum.


Ms. Clark said...

Thanks. I appreciate the way you packaged this topic. I'm not sure if that's a peer review or not, but I can say you didn't pay me to give it a good review. :-) Neither did "Big Pharma".

Prometheus said...

Seeing how even reputable journals (Nature, Science, Lancet, etc.) end up bowing to the political winds of their editors, think how much more so it is for the bottom tier journals like JAP&S and the Journal of Toxicology and Environmental Health. It simply boggles the mind.

Thank you for also addressing the "conspiracy" issue. I've often been astounded to hear seemingly rational adults prattle on about "government conspiracies", knowing that such a "conspiracy" would have to involve hundreds - if not thousands - of people. If any one of them talked, the game - as you so aptly put it - would be up.

Large conspiracies only work when every member has more to lose from revealing the secret than they have to gain. This is how the mafia keeps secrets - "squealing" is punished by death. That's a lot to lose!

In contrast, the FDA does not have "enforcers" who mercilessly gun down any would-be informants; this is painfully apparent to anyone who is able to read a newspaper (or watch news on the telly). If even one of the under-paid, underappreciated civil servants at the FDA or CDC were to decide to "rat out" this alleged conspiracy, they would be instant celebrities - and would probably make more in a week from TV appearances than they currently make in several years.

So, why hasn't someone "blown the whistle" on the big "vaccine conspiracy"?

Because there isn't one.


Niksmom said...

Oh Prometheus, don't you know? "They" must be drugging them with their own vaccines! (Snerk!) Yeah, I always roll my eyes whenever I read any of the conspiracy junk. It *is* disconcerting though to think that such reputable journals are now falling prey to "the poliical winds."

Club 166 said...

Thanks for blogging on what I consider an important subject, Steve.

I think that publishing junk science in junk journals is part of a concerted effort to "muddy the waters" of what is really true. The "junk articles", once published, can then be referenced by their "junk expert witnesses" in court cases, as well as by their "junk practitioners" of woo.

It's a never ending circle that feeds itself, and serves anything but the truth.


pickel said...

Coming to a blog near you, Autism is not mercury poisoning...June 2

Anonymous said...

Thanks for posting on this topic. Check out Dr. Blaylock's views.