Publication Bias - Antidepressants and Autism

Publication bias: It has long been a problem with medical studies. Studies with outcomes that are positive are more likely to be published than those that are negative.  As a result, the medical literature that establish how diseases and disorders are treated often provides doctors and other healthcare providers a flawed picture of the evidence presented.

Antidepressants are not FDA approved for treating some of autism's symptoms:  hoarding, tapping, head banging and strict adherence to routine.
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Integrity is Lost in Wakefield

Hypothesis testing and the outcome, all part of the scientific process, shows integrity whether positive OR negative. In the Wakefield study, he focused his attention on 12 children who had been referred to for GI problems. Dr. Wakefield had already been toying with the idea of a connection between bowel problems and the MMR vaccine. At the same time Dr. Wakefield was paid to find out if children who had already had the MMR vaccine and a corresponding decline had a case. Some of these children were in both studies. That in itself is called "conflict of interest." Dr. Wakefield did admit that more research was needed but that he insisted on the MMR being administered individually rather than the 3-in-1 jab. Today, this study has been retracted as an elaborate fraud with Dr. Wakefield vehemently denying such an accusation. The British medical journal BMJ, which published the results of its investigation, concluded Dr. Andrew Wakefield misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study - and that there was "no doubt" Wakefield was responsible. The journalist who wrote the BMJ articles said Thursday he believes Wakefield should face criminal charges.

Is this an example of a doctor who wanted recognition and to be the pariah in the medical community for autism OR is this an example of Big Pharma winning out and going on a witch hunt?

Because of this article, I have personally witnessed the attitude toward vaccinations shift from lifesaving to poison even so far as one parent telling me that she would not vaccinate her three children because it was wrong and if I did the same I was a bad parent. Tell that to the parents of the infants, babies, and children who have died since 1998 when Dr. Wakefield's study appeared.

In the prevaccination era, pertussis (ie, whooping cough) was a leading cause of infant death. The number of cases reported had decreased by more than 99% from the 1930s to the 1980s. However, because of many local outbreaks, the number cases reported in the United States increased by more than 2300% between 1976 and 2005, when the recent peak of 25,616 cases were reported.1 The disease is still a significant cause of morbidity and mortality in infants younger than 2 years. Pertussis should be included in the differential diagnosis of protracted cough with cyanosis or vomiting, persistent rhinorrhea, and marked lymphocytosis. (link)

In the prevaccination era, pertussis caused more than 270,000 cases and nearly 10,000 deaths annually. This rate reached a low of 4 reported deaths in the United States in 1982 and has recently risen to an average of about 25 deaths annually, with 39 being reported in 2005.

It's not so much that if you don't vaccinate your child that your child will die. It's that you are now taking advantage of herd immunity. You are taking advantage of a scenerio where most follow the rules and thus pertussis was on the decline. You are saying, "I don't have to vaccinate my child because pertussis isn't here." It is here. You are helping to carry it along. I am grateful for the recent push to booster dTaP in the adult community.

MMR was the focus of the study, though. I did cringe as both my children received the MMR and watched them like a hawk for the next six months wondering if "the light bulb would turn off suddenly." It did not. I do feel relieved that I don't have to worry about mumps. Mumps is back, folks. Ask those who are deaf now how THEY feel about those parents that will not vaccinate their children.

Read this post from back in May. Exactly. I couldn't have written it any better.

Please, for the love of God, stop putting our children at risk. Vaccinate your children. I truly believe that those that don't are negligent.

From the AP regarding vaccine and autism link

I'm sure there are a lot of people reading this one today. 

ATLANTA (AP) — The parents of the 9-year-old girl who won a government settlement described how their hearts were broken as they watched their bright, red-haired daughter deteriorate into an irritable, odd-behaving toddler after she got several childhood shots.

"Suddenly my daughter was no longer there," said Terry Poling, the girl's mother, in a news conference Thursday. She and her husband Jon said their daughter, Hannah, has been diagnosed with autism.

The government has agreed to pay the Polings from a federal fund that compensates people injured by vaccines. U.S. officials reject the idea that the vaccines cause autism, but they say that in this case the shots worsened an underlying disorder that led to autism-like symptoms.

The Polings said five simultaneous vaccinations in July 2000 led to Hannah's autistic behavior. She was about 18 months at the time.

U.S. health officials have consistently maintained that vaccines are safe, and a lawyer representing them said this week that there was no change in that position.

"Nothing in any of this is going to change any of our recommendations" about the importance of vaccines for children, said Dr. Julie Gerberding, who heads the Centers for Disease Control and Prevention. "Our message to parents is that immunization is life-saving."

In Polings' first appearance since the case became public this week, the Athens, Ga., couple acknowledged their legal case never got to the point where evidence was introduced or argued.

They called on the government to remove thimerosal — a mercury-based vaccine preservative — from all flu shots. Thimerosal has already been removed from other vaccinations given to children.

"Why take a chance?" asked Jon Poling, a 37-year-old neurologist.

The Polings, accompanied by Hannah, said their daughter was a bright child who could whistle on command. But almost immediately after the vaccinations nearly eight years ago, she because feverish and irritable. Then, her behavior gradually changed so she would stare at fans and lights and run in circles.

"It wasn't like a switch being turned off. It was more like a dimmer switch being turned down," Jon Poling said.

Government health officials conceded that the vaccines worsened an underlying condition and that she should be paid from the federal vaccine-injury fund.

Autism advocates called Hannah's case a "landmark decision," although the Polings' own attorney disputes that.

"This was not a court decision," said Clifford Shoemaker, who is based in Vienna, Va. The U.S. Department of Health and Human Services conceded the case before the court was asked to make a determination, he added.

Government officials wouldn't discuss why they conceded this particular case, but said people with pre-existing injuries can obtain compensation under the program if they establish that their underlying condition was "significantly aggravated" by a vaccine.

Medical and legal experts say the narrow wording and circumstances probably make the case an exception — not a precedent for thousands of other pending claims.

Hannah has a disorder involving her mitochondria, the energy factories of cells. The disorder — which can be present at birth from an inherited gene or acquired later in life — impairs cells' ability to use nutrients. It often causes problems in brain functioning and can lead to delays in walking and talking.

The Polings were exploring two theories about what happened to Hannah. One is that she was born with the mitochondria disorder and the vaccines caused a stress to the body that worsened the condition. The other was that the ingredient thimerosal caused the mitochondrial dysfunction, Jon Poling said.

Since 2002, the preservative thimerosal has been removed from shots recommended for young children, except for some flu shots.