Farce – British Medical Journal – Undeclared Competing Interests

By John Stone

Nearly three weeks after BMJ editor-in-chief Fiona Godlee’s flimsy “it didn’t occur to us” apology for failing to disclose links with Merck and GSK in regard to its publication of Brian Deer’s allegations against Andrew Wakefield (HERE) only the most token and near-invisible gestures have been made to rectify matters.

While a correction notice (HERE) has been placed on line in regard to the original editorial signed by Godlee and fellow editors Jane Smith and Harvey Marcovitch (who doubles as chair of panels at the General Medical Council), there is no link to it on the article itself or the several other related articles in the journal, including those by Brian Deer himself. So, having admitted they were wrong they have done almost nothing to visibly correct it, continuing to leave at a disadvantage everyone who read, heard or saw the story reported, not to mention a great many of their own readers. It is a very disappointing result from Godlee and Marcovitch who have long purported to be experts on journal ethics, and are both former chairs of the Committee on Publication Ethics (COPE) (HERE). If BMJ and its distinguished editors were really interested in rectifying the problem they would have published on-line links above the relevant articles, as for example in this instance  (HERE).

The notice itself reads:

“The BMJ should have declared competing interests in relation to this editorial by Fiona Godlee and colleagues (BMJ 2011;342:c7452, doi:10.1136/bmj.c7452). The BMJ Group receives advertising and sponsorship revenue from vaccine manufacturers, and specifically from Merck and GSK, which both manufacture MMR vaccines. For further information see the rapid response from Godlee (www.bmj.com/content/342/bmj.d1335.full/reply#bmj_el_251470). The same omission also affected two related Editor’s Choice articles (BMJ 2011;342:d22 and BMJ 2011;342:d378). “

However, this also still fails to mention the most glaring conflict of all, which started all this, which is BMJ’s business partnership with Merck through their “information” arm, Univadis (HERE ). Furthermore, Marcovitch has remarked elsewhere on the double standards of the big journals (HERE ) .

“It is a paradox that the professional medical association that owns JAMA was less than open and transparent with Lundh and colleagues about potential financial conflicts (such as their income from industry sources) as they expect their authors to be.”

Admittedly, BMJ have also not been very demanding of Deer in this respect. They refused for months last year to acknowledge that he was the undisclosed complainant against Wakefield at the GMC (HERE ) and now publish the abstruse disclosure from him:“BD’s investigation led to the GMC proceedings referred to in this report, including the charges. He made many submissions of information but was not a party or witness in the case, nor involved in its conduct.”

Or, in other words, he reported on the matter for several years as a professional journalist without telling anybody he had himself made formal complaints to the GMC against Andrew Wakefield, John Walker-Smith and Simon Murch.

But while this is now after many representations opaquely acknowledged, they continue to baulk at requiring Deer to acknowledge that he accepted hospitality at conference last November, sponsored by the pharmaceutical industry including MMR manufacturers (and former defendants) GlaxoSmithKline (HERE ).

Or perhaps the message is that if you work for the pharmaceutical industry “anything goes”.

Posted by Age of Autism at March 29, 2011 at 7:34 PM in Dr. Andrew Wakefield, John Stone | Permalink | Comments (7)

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Some Readers’ Comments From Age of Autism

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Thank you everyone for your appreciation. I just wanted to pose the question why the BMJ Group’s partnership with Merck through its “information” service Univadis is so sensitive that it could not even be mentioned in their “correction”?

Posted by: John Stone | March 30, 2011 at 10:36 AM

 

People who live in glass houses shouldn’t mess with John Stone.

Posted by: Madvocate | March 30, 2011 at 09:02 AM

 

We all challenge the sacred cow of vaccine we must all pay..well they would like to think so…

Great John

P.S. Were never going away ..

Posted by: Angus Files | March 30, 2011 at 07:27 AM

 

Excellent John (and Jake).
It seems that AoA is performing an important social service in continuing to relentlessly expose all these webs of ‘conflicts of interest’ which also ‘infect’ our politicians press and media. We live in very ‘Orwellian’ times these days with plenty of examples of SOME people being ‘more equal than others’.

I was particularly angry and distressed by the recent ‘Science Betrayed’ Radio 4 BBC programme.
http://www.bbc.co.uk/programmes/b00znb98
This programme, used the recent Deer BMJ articles as 100% source material for the programme presented by Dr Mark Rutherford as part of a series. He described the Wakefield et al research as the “biggest medical scandal in living memory”. This is just sensationalist rubbish!! As Jake points out, the Lancet 1998 Wakefield et al paper was a simple little observation exercise involving 12 children apparently symptomatic of a novel bowel and associated neurological syndrome.

The minutiae of the childrens’ medical histories, picked apart by Brian Deer’ is completely irrelevant. Without all Brian Deer’s ‘”we can reveal media muck-raking”, the public would have long forgotten all about THAT Lancet 1998 article. (This was Deer’s OWN terminology from his Guardian blog, 11-01-11):-
“The medical establishment shielded Andrew Wakefield from fraud claims”
http://www.guardian.co.uk/science/blog/2011/jan/12/andrew-wakefield-fraud-mmr-autism?INTCMP=SRCH
http://www.guardian.co.uk/science/blog/2011/jan/12/andrew-wakefield-fraud-mmr-autism
(I enclose BOTH urls because the Guardian has been playing ‘ducks and drakes’ with this link. Could it be they are embarrassed by this outrageous Deer blog? After all, Deer not only attacks his ‘allies’ Goldacre and Offit, but he apparently also displays an innate resentment against all doctors and scientists!! Deer also seems to see the demise of both the BMJ and the Lancet amongst his ‘wish list’. Amen to that!!)

Brian Deer has NO medical, scientific or legal qualifications whatsoever, and he should never have been allowed to write articles for the BMJ in the first place. The BBC is funded by licences which we all have to pay in the UK if we own a television set. For Dr Mark Rutherford to use the utterings of Brian Deer as a basis for his ‘science betrayed’ programme is outrageous. The GMC DID NOT find Wakefield et al guilty of fraud. The Wakefield et al ‘fraud’ has been commissioned by the BMJ and ‘manufactured’ by Brian Deer. Deer’s so called ‘evidence’ is nothing more than a series of scurrilous unproven allegations. These ‘Secrets of the MMR scare’ articles by Brian Deer have been shunned by the UK press. This is because the slanderous content of these articles could result in expensive litigation proceedings. The Paul Offit Book ‘Deadly Choices’ has had to be pulped in the UK. Offit unwisely used the Deer BMJ articles as ‘source’ material for this book.

Professor Walker-Smith is appealing the GMC decision in the High Court. Professor Murch was previously cleared of all charges by the GMC. Dr Wakefield was employed by the Royal Free Hospital as a research scientist, not a clinician. The GMC could not prosecute Dr Wakefield without ‘dragging in’ the doctors who were involved with diagnosing and treating these children. If Professor Walker Smith is exonerated by the High Court, the GMC verdict against Dr Wakefield will become unsustainable.

The BMJ articles and the BBC ‘Science Betrayed’ programme are quite blatant ‘sub judice’ attempts to prejudice the forthcoming Walker-Smith High Court verdict. If the GMC was a REAL court of law this would be regarded as contempt of court in the UK.

Posted by: Jenny Allan | March 30, 2011 at 06:07 AM

 

“BMJ responses damaging to Dr Godlee’s reputation and the standing of the BMJ on facts and science have been censored by remaining unpublished. These relate to the BMJ claims of fraud against Andrew Wakefield.

The facts remaining unpublished include facts showing the BMJ allegations of fraud against Andrew Wakefield are themselves fraudulent.

Using the same source Brian Deer, Godlee and her BMJ colleagues claim to have used for Child 8 [and NOT those used for the Lancet paper] we find that six weeks before MMR Child 8 [at 18 months old] was developing within the normal range for that age [precisely as reported in the 1998 Lancet paper].

Three weeks after MMR at age 20 months she was globally developmentally delayed functioning at the age of a 12 month baby. [See more below for the details].

Godlee and BMJ cannot bring themselves to publish in open communication [so necessary to scientific truth] the unwelcome facts showing their deeply held beliefs are not true [assuming they are "beliefs" and not worse].

BMJ – scientific peer reviewed journal?

Nah. Don’t think so.

Dr Andrew Wakefield faithfully reported in the 1998 Lancet paper “early report” on autistic conditions and bowel disease in children the information provided to him by the other 12 expert specialist medical professionals at the Royal Free.

If you want to accuse someone of fraudulently reporting results you need the original results they were given to compare against what they reported. BMJ and Brian Deer did not do that.

So what did Godlee of BMJ do? She and BMJ colleagues published allegations of fraud when they did not even have the key medical records and developmental records the 1998 Lancet paper was based on. Even Brian Deer has admitted that.

Instead they relied on a hotch-pot of inaccurate family doctor records which no one at the Royal Free had and which in many cases were a brief note here and there of a visit to the child’s doctor which are often compiled over time by different family doctors, practice nurses and suchlike. These records are so bad that some had the wrong vaccine recorded and the wrong dates of vaccination – key points when assessing exactly when an adverse reaction to the vaccine occurred.

For Child 8 we find from the family doctor records – used in the GMC hearings:

May 1994 age 10.5 months:

Specialist independent developmental pediatrician reports:

“There were no neurological abnormalities and I felt that her development was within normal limits”

23 December 1994 (aged approx 18 months) – specialist developmental pediatrician wrote:

“I felt that her abilities, although delayed on the average age of attainment were not outside the range of normal. Her growth has been satisfactory.”

17 February 1995: The developmental pediatrician writes three weeks after MMR:

“When I reviewed her in clinic recently I confirmed that she is globally developmentally delayed, functioning at about a one year level on Denver Developmental Assessment. …… General examination is unremarkable. There were no neurological abnormalities other than the developmental delay.”

So what is troubling about this?

1) we can see that something serious happened to Child 8 immediately associated with the MMR vaccine – but the BMJ covering up the facts means that this will continue to happen to children around the world and has been doing;

2) Godlee and BMJ refuse to publish these facts – which demonstrates complicity in covering this up – in simple terms “Godlee is Guilty”;

3) Andrew Wakefield was not a treating physician at the Royal Free – all the information from the 1998 Lancet Early Report came from the other 12 doctors.

4) Godlee and BMJ have thereby actually accused all the other 12 Royal Free specialists of fraud;

5) Godlee and BMJ have made these allegations when they did not have the evidence to justify them but did have evidence which cast doubt on them – like Child 8;

6) is this crooked? Or is it criminal? Either way it is evil – and the “evil” word is much underused these days.

Posted by: ChildHealthSafety | March 30, 2011 at 05:59 AM

 

Thanks Jake

I just woke up in London with a thought (and indeed a memory) regarding the issue of pharmaceutical hospitality and conferences. Back in to 2007-8 I kicked up a fuss about well-known psychiatrist/journalist Ben Goldacre’s article about pharmaceutical hospitality at conferences and award ceremonies:

http://www.bmj.com/content/335/7618/480/reply

However, when I tried to mention the issue again in August 2008 I got this interesting and disturbing message from another senior BMJ editor Tony Delamothe:

“I can see why you think the sponsorship of his award is relevant, but it’s hardly Goldacre’s fault that an outfit that has made the award has pharma sponsorship. The BMJ Group is about to start an awards programme of its own and some of the awards will be sponsored by pharma companies. If we were to give you the Medical Communicator of the Year Award (let’s say, for the point of argument, sponsored by Novartis) it wouldn’t bring everything you’ve said into question.”

(email 2.14pm 10 August 2008)

Interestingly, the first award in 2009 went ahead without pharmaceutical sponsors:

http://groupawards.bmj.com/previous-awards

but Godlee & co were already negotiating to expand the awards with pharmaceutical sponsorship for 2010 so it had suddenly become politically inexpedient to mention pharmaceutical sponsorship of events at all, and indeed anyone who attended their own ceremony in 2010 or the next one in 2011 will have also had their record spoilt.

I think this shows just how important business association with the pharmaceutical industry has become under Godlee’s directorship, and why they can’t talk about it, or perhaps why certain things just “don’t occur” to them now.

John

Posted by: John Stone | March 30, 2011 at 01:16 AM

Isn’t it funny how conflict of interest disclosure is a joke to people like Brian Deer, Seth Mnookin, Chris Mooney, David Gorski, Gardiner Harris, John Stossel, Alison Singer, and the editors at BMJ and The New York Times: all of whom are tied to – as well as staunch defenders of – the vaccine industry.

Yet to these same people, the issue of so-called conflict of interest disclosure warrants revoking Andrew Wakefield’s medical license and calling him a fraud when all he did was write up the case reports of a few children.

Posted by: Jake Crosby | March 29, 2011 at 10:00 PM

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