The threat of bad science

No parent wants to make his or her own child sick. So when Andrew Wakefield's 1998 study indicated that the combined measles, mumps and rubella vaccine (MMR) could cause children to develop autism, an entire industry developed to prevent the vaccine from being given. Along with scares that Thimerosal — a mercury preservative previously used in childhood vaccines — was a culprit in autism rates, anti-vaccine fury spread throughout the country.

Media coverage was widespread. Grass-roots organizations sprouted. School systems revised vaccine regulations. All this for a study on 12 children that has now been proven false. And all occurring in spite of the consistent recommendations of physicians' groups urging parents to vaccinate their children.

The Wakefield study had been repudiated for years with dozens of follow-up studies that never found a linkage between the vaccine and autism. The comprehensive new report from the editors of the British Medical Journal flatly accused Dr. Wakefield of using fraudulent data to "prove" his theory. Yet health decisions were based on research conducted with this tiny sample, which by research standards is a clearly flawed practice. Regardless of the strength of the findings or their original publication in a prestigious medical journal, there is no way one can control all of the variables in just 12 subjects.

The unfortunate result of the fear generated by this study has been that millions of parents avoided the vaccine. Large numbers of children were no longer given the MMR vaccine, and some of these unvaccinated children came down with these previously rare childhood illnesses, whose risks are associated with serious complications, and in some cases, death.

How findings such as those in Dr. Wakefield's study are able to enjoy wide public acceptance must be examined so that we can avoid following the next baseless medical trend. First, the influence of media coverage — along with the appearances of celebrity proponents espousing one scientist's point of view — should not be underestimated. Actress Jenny McCarthy, a parent of a child with autism, has received significant media attention for her anti-vaccine views and advocacy of nonproven methods for "curing" autism. Quack cures and medical advice are bad enough when found on paid ads in the middle of the night. They should not be the content of legitimate news programs.

Second, many people, especially minorities, are understandably suspicious of the scientific community. The abusive and unethical syphilis research conducted in Tuskegee, Ala. from 1932 to 1972 on 400 African-Americans has lingered for decades as a stain on scientific research. The unearthing of numerous other high-profile cases has only increased the fear that legitimate researchers are often unethical.

Finally, the general public lacks scientific knowledge; many people also sense that scientists, including physicians, cling to prevailing scientific dogma. Without the full incorporation of teaching research ethics in graduate and professional schools, and the adoption of routine standards for the responsible conduct of research, the public's trust is diminished.

Misconduct happens rarely, but its impact can be extremely high. From fraudulent stem cell research to the abuse of research subjects, the need for strict standards is evident. In the Wakefield case, it took a journalist, not a research team, to decipher the data and demonstrate the fraud. If the scientific community were more attuned to misconduct, a routine investigation of Dr. Wakefield's study could have been conducted, and more children would have been spared the serious consequences of these childhood illnesses.

The irony of the Wakefield case is that in an effort to spare their children from a dreaded disorder, parents exposed those children to other horrendous childhood illnesses that had been considered remnants of the past. This troubling experience should reveal lessons for those who are supposed to inform and protect the public. Careless researchers will always pose a threat to those who report results to the public. But until all members of the media and scientific communities become more responsible to the public, we will be subject to following potentially dangerous advice.

Dr. Adil E. Shamoo, the editor-in-chief of the journal Accountability in Research, writes on ethics and public policy. He is a professor at the University of Maryland School of Medicine. His e-mail is ashamoo@umaryland.edu. Bonnie Bricker is a special education teacher in Howard County.

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