Research - Peer Review: A Slippery Slope

[Sheri Nakken]

http://www.redflagsdaily.com/yazbak/2006_feb08.php
(articles viewed with subscription only - but well worth it! - please
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Dr. Yazbak, a pediatrician, now devotes his time to the research of
autoimmune regressive autism and vaccine injury.

Peer Review: A Slippery Slope

By Red Flags Columnist, F. Edward Yazbak, MD, FAAP
(tlautstudy@aol.com)

“When looking for health information on the Internet, don't believe
everything you see. Articles published in peer-reviewed medical journals
are checked for accuracy, but anyone can put information on the Internet,
so there's no guarantee that the information you find is accurate or
up-to-date.”

This statement made last month (1) by someone at the National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is obviously not
always true. The accuracy of peer-reviewed studies about arthritis drugs,
specifically, has been in question lately in the news and in the courts.

The Lancet is a well-known and respected medical publication not only in
the U.K., but the world over. In its Oct. 15, 2005 issue, the journal
featured an article entitled “Non-steroidal anti-inflammatory drugs and the
risk of oral cancer: a nested case-control study.” The first sentence of
the Medline summary (2) was certainly an attention-getter: “Non-steroidal
anti-inflammatory drugs (NSAIDs) seem to prevent several types of cancer….”

The authors, all from the department of medical oncology and radiotherapy
at the prestigious Norwegian Radium Hospital in Oslo, described in the
methods section how they undertook “… a nested case-control study to
analyze data from a population-based database, which consisted of
prospectively obtained health data from all regions of Norway.” Patients
with oral cancer were identified among heavy smokers and their matched
controls were selected from the remaining heavy smokers, who were cancer-free.

Under findings, the authors reported, “We identified and analyzed 454 (5%)
people with oral cancer (279 men, 175 women, mean [SD] age at diagnosis
63.3 [13.2] years) and 454 matched controls (n=908); 263 (29%) had used
NSAIDs, 83 (9%) had used paracetamol (for a minimum of 6 months), and 562
(62%) had used neither drug. NSAID use (but not paracetamol use) was
associated with a reduced risk of oral cancer (including in active smokers;
hazard ratio 0.47, 95% CI 0.37-0.60, p35 months.

These rates are all above the overall rate of 11.0 for the reference group
of no vaccination over all ages. It is then somewhat implausible for the
adjusted rate ratio to fall below 1, unless the risk profile by age in the
unvaccinated is vastly different than in the vaccinated
(effect-modification). In this case, the adjustment for age could have been
artificial. It would be useful then to present rates on subjects 24-29
months since vaccination and on the unvaccinated (crude rate ratio 2.5)
stratified by age. Otherwise, one could be tempted to conclude that the
figure is in fact suggestive of an association between MMR vaccination and
the risk of autism.”

Suissa’s letter was never published in the journal and was only made public
two years later in a commentary by Carol Stott et al (11) that was
published in the same issue of Journal of American Physicians and Surgeons
as our response.

Not only had the peer-review process at the NEJM missed the inaccuracy in
Madsen’s calculations, but the editor’s refusal to publish Suissa’s
critique prevented the world from learning that there had, indeed, been a
statistically significant 45 percent excess risk of autism in recipients of
the MMR vaccine and, therefore, an association between MMR and autism in
the studied Danish population. (11)

One can only wonder whether Horton would have allowed recent comments by a
noted British physician and scientist to be printed in The Lancet, even as
a letter to the editor. In The Mail on Sunday on Feb. 5, 2006 was a long
article by Sue Corrigan, “Former science chief: ‘MMR fears coming true’.”

In it, Peter Fletcher, former chief scientific officer at the U.K.
Department of Health, suggested that the government had shown "utterly
inexplicable complacency" over the MMR vaccine.

According to Corrigan, Fletcher had also said that there was a steady
accumulation of evidence from scientists worldwide that the measles, mumps
and rubella jab is causing brain damage in certain children and that some
very powerful people in positions of great authority in Britain and
elsewhere had staked their reputations and careers on the safety of MMR and
were willing to do almost anything to protect themselves.

Having agreed to be an expert witness for parents’ lawyers, Fletcher had
examined thousands of documents that had never been made public. His
informed opinion is, "Clinical and scientific data is steadily accumulating
that the live measles virus in MMR can cause brain, gut and immune system
damage in a subset of vulnerable children."

Fletcher went on to say, “It is the steady accumulation of evidence, from a
number of respected universities, teaching hospitals and laboratories
around the world that matters here. There's far too much to ignore. Yet
government health authorities are, it seems, more than happy to do so.” He
added that there is “a very strong clinical signal that some children are
immunologically at risk from MMR…. Why is the government not investigating
it further — diverting some of the millions of pounds spent on advertising
and PR campaigns to promote MMR uptake into detailed clinical research
instead?" (12)

* * * *

There obviously is a lot of misinformation on the Internet and people
should be careful and selective. There is also wonderful medical and
scientific information available.

Most universities and medical centers have first-class web sites and
excellent information available to the public.

In the field of continuing medical education, specifically, the material
available on the Internet is consistently of the highest quality and of
great clinical relevance; it is also free. I would dare say that a
practicing physician who only reads “peer-reviewed” medical journals would
be less generally informed about the latest developments than a colleague
who also looks at the enormous good material on the Internet. This is
particularly true when it comes to vaccine-related problems including
regressive autism and shaken baby syndrome … and indeed any information
that could be perceived as likely to “rock the boat.”

Probably the best-kept secret in medicine is the fact that many doctors do
not even open the “peer-reviewed” medical journals that they receive and
have paid for. They simply let them pile up on their desks or on the
shelves of their bookcases, for effect.

Sometimes, that may be a good idea.

References

1. Don't Believe Everything You Read
http://www.niams.nih.gov/hi/topics/howto/howto.htm#how3
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIH Publication No. 05–4745
January 2005
2. Sudbo J, Lee JJ, Lippman SM, Mork J, Sagen S, Flatner N, Ristimaki A,
Sudbo A, Mao L, Zhou X, Kildal W, Evensen JF, Reith A, Dannenberg AJ.
Non-steroidal anti-inflammatory drugs and the risk of oral cancer: a nested
case-control study. The Lancet. 2005 Oct 15-21;366(9494):1359-66.

case-control study. The Lancet. 2005 Oct 15-21;366(9494):1359-66.

http://www.ncbi.nlm.nih.gov/entrez/quer ... ed&dopt=Ab
stract&list_uids=16226613&query_hl=4&itool=pubmed_docsum
3. Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen
P, Olsen J, Melbye M. A population-based study of measles, mumps, and
rubella vaccination and autism. N Engl J Med. 2002 Nov 7;347(19):1477-82
4. An Investigation of the Association between MMR Vaccination and
Autism in Denmark. Goldman GS, Yazbak FE. J .Am Phys Surg
2004;9(3):70-75http://www.jpands.org/vol9no3/goldman.pdf
5.
http://clio.stanford.edu:7080/cocoon/cl ... ign/nested
Case-Control/
6. http://news.bbc.co.uk/1/hi/health/3510721.stm
7. http://www.alertnet.org/thenews/newsdesk/SEO165628.htm
8.
http://www.time.com/time/asia/2004/pers ... o_suk.html
9. http://times.hankooki.com/lpage/nation/ ... 752920.htm
10. The CDC finances, writes and helps publish Danish research.
Another useless CDC-supported autism study
http://www.redflagsdaily.com/yazbak/fil ... _jun26.pdf
11. http://www.jpands.org/vol9no3/stott.pdf
12.
http://www.mailonsunday.co.uk/pages/liv ... in.html?in_
article_id=376203&in_page_id=1774

Online Conference Center

Also by F. Edward Yazbak

January 23, 2006
Shaken Baby Syndrome And Multiple Vaccinations: An Investigation

January 18, 2006
Kicking It Up A Notch, CDC Style

December 30, 2005
Those Lucky Dogs

December 21, 2005
Vaccines — Like Apple Pies On A Conveyor Belt

December 9, 2005
Shaken Or Not: That Is The Question

December 2, 2005
MMR, Autism and Thanksgiving

November 9, 2005
Combination and Multiple Vaccinations: A Mixed Reaction
3 and [1 +1] ? 5

October 31, 2005
The Flu Shot — Or Not

October 28, 2005
Alive and Well: The MMR-Autism Connection
A critique of the Cochrane MMR Review

October 12, 2005
Nothing New about Lack of Effectiveness of Influenza Vaccination in Babies

October 5, 2005
Could Thimerosal Be Worse Than We Thought?

September 30, 2005
Influenza Vaccination of Infants: A Useless Risk

September 26, 2005
ProQuad: The new kid on the block

August 24, 2005
Vaccinate Johnny To Protect Grammy — And Other Wild Ideas

August 19, 2005
Mumps suddenly a serious problem
Ill-advised decisions by U.K. medical authorities may have put children in
harm’s way

August 17, 2005
Trust Me: I Have The Statistics To Prove It

August 3, 2005
Direct Individualized Funding for Autism: What is that?

July 27, 2005
The CDC, Autism and Elastic Statistics

July 22, 2005
Conflicting Reports on Autism Data

June 26, 2005
The CDC finances, writes and helps publish Danish research (pdf)
Another useless CDC-sponsored Autism Study

June 12, 2005
Post Mortem On A "Shaken Baby Syndrome" Autopsy (pdf file)

May 16, 2005
IMPORTANT LETTER REGARDING VACCINE SAFETY!
Letter to Harvey V. Fineberg, MD, PhD, President, Institute of Medicine

April 26, 2005
Concerns about the Infant Mortality Rate in the United States

The NON-Shaken Baby Syndrome: The rest of the cases

April 5, 2005
Thimerosal: The “safe” mercury!

March 31, 2005
The Mercury Memo

March 15, 2005
Neonatal Hepatitis B Vaccination: Acceptance in Israel

March 10, 2005
MMR – Autism Epidemiological Studies: Just a distraction.

February 25, 2005
The Flu Vaccine Saga: The Latest Twist - Apples and Oranges, Too

February 17, 2005
The Recent Flu Vaccine Crisis: A Review

January 17, 2005
The Latest Autism Study

December 3, 2004
FLU-46

November 22, 2004
VIOXX and Vaccines: Vive La Difference

November 17, 2004
THE FLU VACCINE CRISIS: DID WE MISS A RED FLAG?

May 16, 2004
FINLAND'S HEALTH PARADOX:
Did a National Vaccination Campaign Compromise Health?

January 25, 2004
AUTISM NUMBERS SKYROCKET IN QUEBEC

January 12, 2004
HYPING VACCINES: AN INVESTIGATION
Chickenpox, Lyme, Rotavirus, And A Highly Revealing Analysis Of Flu Statistics

December 22, 2003
DR. ANDREW WAKEFIELD IS BEING BLAMED FOR THE DECLINE IN MEASLES, MUMPS AND
RUBELLA VACCINATION IN THE UK. BUT THAT’S NOT WHAT REALLY HAPPENED. THE
TREND STARTED YEARS BEFORE HE PUBLISHED HIS INITIAL RESEARCH ON REGRESSIVE
AUTISM

December 4, 2003
A NOT-SO-PERFECT VACCINE: THE DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS
VACCINE: AN INVESTIGATION

November 4, 2003
VACCINATION, RUBELLA AND CONGENITAL RUBELLA SYNDROME
Separating Fact From Fiction

November 1, 2003
A DETAILED REPORT ON VACCINES AND AUTISM, INCLUDING THE CURRENT CONTROVERSY
BOILING OVER IN THE UK OVER THE MMR VACCINE

October 15, 2003
THE SAGA OF PEDIATRIC HEPATITIS B VACCINATION
When it comes to the Sad Saga of the mandated Pediatric Hepatitis B
Vaccination Program, there are still, twelve years later, more questions
than answers. Probably the most baffling question is: why was a new vaccine
recommended for a vulnerable infant without risk/benefit analysis and in
order to prevent a disease that was not an immediate threat and that had a
decreasing incidence?

October 10, 2003
SIDS, VACCINES AND VAERS: A FOLLOW-UP
On the basis of his investigation, a physician challenges statements made
by the U.S. Institute of Medicine about Sudden Infant Death Syndrome and
vaccines

September 22, 2003
SUDDEN INFANT DEATH SYNDROME AND THE VACCINE ADVERSE EVENT REPORTING
SYSTEM: A REVIEW
A Physician investigates sudden and unexpected deaths of apparently healthy
infants and the possible link of some of these deaths to vaccines

September 8, 2003
SHAKEN BABY SYNDROME AND VAERS: A REVIEW AND ANALYSIS
A physician investigates reports to the Vaccine Adverse Events Reporting
System and finds that some parents who were accused of causing “Shaken Baby
Syndrome” in their children were probably innocent

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Sheri Nakken, R.N., MA, Hahnemannian Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
Vaccination Information & Choice Network
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