Roger Bohn's Blog

The Lancet retracts paper linking MMR vaccines and autism By Matt Ford | Last updated February 3, 2010 9:27 AM

This week, after receiving the conclusions of a multiyear ethics investigation of UK doctor Andrew Wakefield performed by the General Medical Counsel GMC, the editors of British medical journal The Lancet formally retracted a study which purported to find a link between the childhood MMR vaccine, gastrointestinal disease, and autism. It was published in 1998 and has been a source of controversy ever since.

via The Lancet retracts paper linking MMR vaccines and autism.

This article is tale of greed and incompetence.  But the harm it did lives on. Here’s a site that claims to present “all sides,” but clearly thinks Wakefield is a hero. There are many like it – conspiracy theories flourish better than scientific analysis on the web. (More fun  and much easier to write, after all.)  For a good article on these hysterias, see an article by Amy Wallace in Wired.  As best I can tell, some  parents cannot handle the concepts of bad luck or Acts of God. If their child gets sick, someone is responsible! And it’s part of a widespread plot!

A second problem, much more widespread than the vaccine phobias, is that people have trouble dealing with small probabilities. (This observation goes back at least to research by Kahneman and Tversky on how humans have systematic cognitive biases.) So you can find nonsensical statements like “If screening for disease X [breast cancer screening under age 50 is the current example] saves even a single life, than not doing it is manslaughter.” What’s the problem? Screening itself causes difficulties, such as unnecessary biopsies. Not to mention that more lives might be saved by spending the same amount of money on something else. So deciding whether/when to get screened is a balancing act; it’s not all one way or the other.

One interesting bit of sociology (which to me is further proof that these health-scare controversies almost never have factual basis): most countries have phobias about vaccines and medicines, but the specific phobia varies by country. For example, the smallpox-eradication effort fell apart at the last moment when smallpox vaccine was rumored to cause infertility. (I’m looking for more specifics on the nation-specific fears of vaccines – I’ve forgotten where I came across it.)

Yet,  there are a LOT of problems with modern medicine, and with drugs in particular. But in an environment where any half-baked theory gets taken seriously, it’s very hard to separate the fear-mongering from the real problems.

The Lancet retracts paper linking MMR vaccines and autism By Matt Ford | Last updated February 3, 2010 9:27 AM

This week, after receiving the conclusions of a multiyear ethics investigation of UK doctor Andrew Wakefield performed by the General Medical Counsel GMC, the editors of British medical journal The Lancet formally retracted a study which purported to find a link between the childhood MMR vaccine, gastrointestinal disease, and autism. It was published in 1998 and has been a source of controversy ever since.

via The Lancet retracts paper linking MMR vaccines and autism.

This article is tale of greed and incompetence.  But the harm it did lives on. Here’s a site that claims to present “all sides,” but clearly thinks Wakefield is a hero. There are many like it – conspiracy theories flourish better than scientific analysis on the web. (More fun  and much easier to write, after all.)  For a good article on these hysterias, see an article by Amy Wallace in Wired.  As best I can tell, some  parents cannot handle the concepts of bad luck or Acts of God. If their child gets sick, someone is responsible! And it’s part of a widespread plot!

A second problem, much more widespread than the vaccine phobias, is that people have trouble dealing with small probabilities. (This observation goes back at least to research by Kahneman and Tversky on how humans have systematic cognitive biases.) So you can find nonsensical statements like “If screening for disease X [breast cancer screening under age 50 is the current example] saves even a single life, than not doing it is manslaughter.” What’s the problem? Screening itself causes difficulties, such as unnecessary biopsies. Not to mention that more lives might be saved by spending the same amount of money on something else. So deciding whether/when to get screened is a balancing act; it’s not all one way or the other.

One interesting bit of sociology (which to me is further proof that these health-scare controversies almost never have factual basis): most countries have phobias about vaccines and medicines, but the specific phobia varies by country. For example, the smallpox-eradication effort fell apart at the last moment when smallpox vaccine was rumored to cause infertility. (I’m looking for more specifics on the nation-specific fears of vaccines – I’ve forgotten where I came across it.)

Yet,  there are a LOT of problems with modern medicine, and with drugs in particular. But in an environment where any half-baked theory gets taken seriously, it’s very hard to separate the fear-mongering from the real problems.

(This presentation discusses the “car-parts neonatal incubator” in more detail, which  the NY Times profiled recently.  This is an example of appropriate technology. It would make a good takeoff point for projects in several of my courses.)

Many multinational companies manufacturing medical devices for developing countries focus their efforts on high-end products too expensive to be used in most healthcare settings. Unable to afford their own equipment, healthcare providers in areas with few resources often receive donated equipment from international organizations. Unfortunately, while this donated equipment is usually state-of-the-art, it often ends up falling into disrepair and eventually disuse. Donors with the best of intentions fall into the trap of donating equipment that the recipient cannot afford to maintain. Just as most of us would like to own a Ferrari but would be unable to pay for its upkeep, most clinics in resource-poor areas cannot afford to maintain expensive devices, such as incubators, designed for use in developed countries.

via CIMIT Forum: Medical Devices in Global Health: Idea to Implementation, Successes and Challenges.