A misguided "chalkboard talk"

Sometimes I feel like Dug, the talking dog in the movie Up, in that when it comes to blogging I'm often easily distracted. The reason I say this is because there's been a "viral" (if you can call it that) video floating around the antivaccine quackery blogosphere that antivaccinationists are passing around as though it's slam-dunk evidence that vaccines aren't safe. It's called the Chalkboard Campaign:

Basically, it's one long series of chalkboard images touting pseudoscience and antivaccine misinformation over and over again, all over a sappy pop music soundtrack, using the tag line from the song throughout the video, "We need to talk." The video is popping up all over the antivaccine blogosphere, and it's being touted on—where else?—the antivaccine propaganda blog Age of Autism.

Indeed we do need to talk, but not in the manner that the creator of this video, Rebecca Ferguson, a mother who claims to have "recovered" her child Caroline using all manner of "biomedical" pseudoscience thinks we do. We need to talk about the sheer quantity of rank misinformation, that Ms. Ferguson has packed into a single four and a half minute video. I was half-tempted to put the video up and leave its deconstruction as an exercise for my readers, and, to some extent, I still like that idea. Unfortunately, the new ScienceBlogs layout does not permit me to control where the "fold" appears, so that I could just put all of my take on this video "below the fold" So what I'll suggest is that anyone who wants to do that watch the video now and then comment without reading my discussion. Alternatively, you can watch the video now, see how many antivaccine canards you can spot, and then compare your take on the video with mine. Ready? Here we go.

The first thing you need to know about this video is that it's made by a newly minted board member of VaxTruth.org for this express purpose:

When I do address vaccines, I try to put myself in my own shoes. The shoes I was wearing in 2006 – when our daughter was injured and we listened to her pediatrician for far too long - and I ask, “What would it have taken to reach ME?”

What might a friend have sent me that would’ve saved our family’s life as we knew it?

To that end, I recently made a half-dozen chalkboard images. Reducing vaccine controversy to simple black and white messages captured people’s attention.

But I knew there needed to be more. And as a newly appointed board member at VaxTruth.org, the topic weighed heavily on my mind. How can we expand beyond the “choir?” How can we reach new parents?

She concludes, addressing AoA readers:

Today, it’s here. But not just for you. You already know everything it says and more. It’s for your mainstream friends.

Also, this is not her first foray into video. She's known for making "recovery videos" of her daughter, like this one:

It's basically one long testimonial that confuses correlation with causation, blaming vaccines for every setback, even though autism can be detected as early as six months, and crediting biomedical quackery with every improvement. In it, it's assumed that autism is a condition of developmental stasis, so that when Caroline shows signs of improvement, such as developing language or having her sensory issues about various textures abate, the assumption behind the video is that none of these developments would have happened without the antivirals, gluten-free diet, chelation therapy, hyperbaric oxygen chamber, and, of course, homeopathic remedies Rebecca subjected her daughter to. On the other hand, I suppose the homeopathic remedies, at least, serve a purpose. Because most homeopathic remedies are nothing more than water, one can say that any improvement observed after they were administered to Caroline is certainly not due to the homeopathic remedy (homeopathic remedies more "potent" than 12C are, after all, the ultimate placebo), but rather to normal development and/or confirmation bias on the part of the parents. It's just too bad that the rest of the quackery is not so benign.

Those who know anything about vaccines will know that the "chalk talk" video is cleverly manipulated propaganda mixing half-truths and misinformation in a toxic stew designed to frighten parents. But is it effective? Damned if I know, because the only places I've seen this video thus far are on known antivaccine websites, such as AoA and various "alternative health" websites. Personally, I think the video is too simple, so simple as to be insulting to the intelligence of the average person, but that doesn't necessarily mean that it's ineffective. Certainly Ferguson has mastered the repetition thing.

It begins by looking at a classroom of 30 children and points out the number who will have various diseases and conditions, such as learning disabilities, food allergies, respiratory allergies, skin allergies, asthma, and attention disorders. She also says that one will have autism, although a one in thirty prevalence rate for autism is far higher than anything I've ever heard before, with the exception of one South Korean study. If she wanted to be correct, she'd say that approximately one child out of the children in three such classrooms has autism. One also notes that, despite the huge male preponderance of autism and autism spectrum disorder diagnoses, Ferguson chooses to use a picture of a girl to illustrate her point.

Be that as it may, after the collage of images and chalk font, the next message is, "Too many children are suffering," followed by a demand, "As their parents, we needed answers. What is causing all the neurological disorders?" Unfortunately, the "answers" Ferguson proceeds to supply are completely wrong. Certainly, Ferguson's claim that "we dug deep into the science" is risible at best. I'll show you the "science" she dug into. It's all on this page.

I must say, I'm impressed at the utter lack of research chops Ferguson shows. If this, as one must assume, is the best that she can come up with, it's pretty pathetic indeed. For instance, there's a typically fallacy-laden article by all-purpose quack and crank Russell Blaylock, for whom there apparently is no quackery too quacky for him to embrace. There's also another article by Andreas Moritz. Remember him? I do. He's a cancer quack who thinks that chemotherapy doesn't work, claims that cancer is not a disease but rather the "wisdom of the body," and is also known for using legal threats to intimidate into silence critics who point out his cancer quackery. In the article cited by Ferguson, Moritz claims that vaccines suppress the immune system, which is so demonstrably not true that I didn't know whether to laugh or cry when I read his article. Another article cited by Ferguson is a scary-sounding list of vaccine ingredients. Yes, indeed, her "evidence" is the "toxins" gambit here, the very same gambit that our old friend Dr. Jay Gordon used when he did a bit of fear mongering about formaldehyde. The list of "references" goes on, being made up mostly of articles from antivaccine sources, such as Ginger Taylor and Fourteen Studies, nearly all not published in the peer-reviewed literature. Sure, there are a couple of exceptions, one of which is mentioned through the antivaccine propagandist reporter Sharyl Attkisson (who is well known not just for her execrable journalism about vaccines but for her ties to Generation Rescue), namely Helen Ratajczak’s hideously wrong "review" of the literature about vaccines and autism.

Yes. This is the "research" Ferguson has done.

The result is a series of scientific claims regarding vaccines and autism that are so wrong they're, as we say, "not even wrong." She begins by asking "What has the power to change our immune system?" I bet you know the answer to that one. Yup, it's the dreaded vaccines! She even claims, apparently based on Moritz's nonsense, that vaccines decrease immune reactivity to viruses and increase immune reactivity to allergens. This is next followed by the "toxins" gambit, in which fear is brought to bear about how "even the smallest amounts of heavy metals and toxins in vaccines" can "bypass all natural defenses" because they're, you know, injected directly into the body, "further impare the immune system, increasing unbalanced reactivity," leading to "gut-brain encephalopathy," whatever that is. Of course, doctors won't tell you this because (of course!) according to Ferguson they rely on pharmaceutical reps for their information and are, of course, "pharma shills."

In contrast (and please, swallow any drink you might have in your mouth and put your glass or cup down now before you read this), the parents "scour the scientific studies and published research and have an unbiased interest in finding the truth." Really? Everybody has biases. Everybody. Where people go drastically wrong is when they think that they, alone among all humans, are "unbiased." There is no such thing. The best we can do is to admit our biases, make sure they're transparent, and try to compensate for them. In fact, the scientific method wouldn't need to exist if there were truly "unbiased" people. It exists largely to try to correct for biases in observation and interpretation that we all have. In the case of Ms. Ferguson, it's clear that her bias is that "something" caused her daughter's autism and that "something" can cure it. That might or might not be true, but her bias leads her to latch on to vaccines as the cause of her daughter's condition and quackery like homeopathy and chelation therapy as the cure. Her bias has completely short-circuited her critical thinking skills, and now she's functioning mainly in the realm of motivated reasoning, cherry picking information sources (not even scientific studies) that support her bias. She believes there must be a reason, even when there isn't always.

Ferguson's last major claim is that "there has never been a single study of the current vaccine schedule":

This is, of course, silly. One might first ask: Which schedule? Every country has different vaccine schedules, designed to meet the needs of its children according to the diseases most prevalent in each country. Moreover, every new vaccine that is introduced is tested in the context of the the entire vaccine schedule as it currently exists. Then there are epidemiological studies looking at different vaccines, vaccinated versus less vaccinated populations. It's hard to do an epidemiological study looking at vaccinated versus unvaccinated populations, at least in the U.S., because there are, fortunately, relatively few completely unvaccinated children. Particularly hilarious, attempts at "studies" of unvaccinated versus vaccinated children have been made by the antivaccine movement; if anything, they suggest that vaccines are protective against autism. Of course, they're utter crap as science; so I don't seriously say that they show this. I do say that even the antivaccine movement hasn't been able to link vaccines to autism or any other condition in a convincing fashion. Unfortunately, that doesn't keep antivaccine propagandists from demanding a "vaccinated versus unvaccinated study," even though there isn't really any good evidence to suspect that vaccines cause autism (or all the other conditions Ferguson attributes to them) given that the existing evidence is negative. That evidence comes from multiple countries over several decades, too.

After looking at Ferguson's website and video, I have to conclude that its simplistic message just might work to persuade some parents that vaccines cause autism. However, its message is undermined by conspiracy mongering and just how over-the-top its claims are. Even parents predisposed to believe might have a hard time believing that there hasn't ever been a "single study" of vaccinated and unvaccinated children, which is why I suspect that this video will probably mainly resonate with true believers, rather than serving as a tool to convert large numbers of undecided parents. (If you don't believe me, take a look at the copious praise the denizens of AoA have heaped upon this video in the comments after Ferguson's post.) On the other hand, one of the favorite canards of quacks and pseudoscience supporters is to demand "one study" that shows them everything they want to see. Science and medicine don't work that way. Conclusions in medical science are built up based on many studies from multiple different sources, and it requires a background in the relevant science and medicine to be able to interpret the totality of the medical literature on the subject.

It takes a lot of arrogance of ignorance to believe otherwise and that you can interpret the medical literature better than real scientists, and that's what Ferguson demonstrates in abundance: The arrogance of ignorance.

More like this

There's a new feature article by Liza Gross [1] up at PLoS Biology. Titled "A Broken Trust: Lessons from the Vaccine-Autism Wars," the article does a nice job illuminating how the themes of trust and accountability play out in interactions between researchers, physicians, patients, parents,…
Dear Pa, I know you care deeply about many issues, especially social justice. You're tired of wars, you're ashamed of the attempts to destroy social programs in this country, you hate seeing the unions that helped you as a worker provide for our family get dismantled by wealthy CEOs whose only goal…
Dear Jenny, Jenny, Jenny, Jenny. Oh, Jenny. Look, I realize I might have been somewhat less than kind in the past, but I'm hoping you haven't written me off. I've been told you catch a lot more flies with honey than with vinegar, so please take this letter in the spirit it was intended---…
Welcome to my latest "liberation bibliography" project. This time around I'm gathering resources concerning the recent rather worrying trend towards people not vaccinating their children. In particular the last couple of months have seen multiple cases where vaccination has been in the news, from…

The song in the video is 'How to Save a Life' by The Fray, from the album of the same name.

I was nice enough to let them know the song was probably being used without permission at

http://www.thefray.com/us/wall

Throughout anti-vaxx's and alt med's irrevocably contaminated roiling sea of mis-informational websites, I discern a common item floating amongst the refuse there: don't trust doctors. TMR's denizens blame them for stealing/ destroying their children; Adams and Null declare them tyrants and call for revolution; AoA dismisses medical sources as irresponsible and as perpetrators of malfeasance

The simple question I then ask is how do they then function in a world where authorities are all corrupt and unworthy of trust.. who do you then listen to or go to for advice? Someone who shares your blather on the 'net? What if someone gets hurt or has a really serious illness? Thumb through a Guide to Natural Health for herbal/ supplement cures? See if MIkey has a Special Report about it?

Julie Obradovic writes about those horrible bloggers ( guess) who DARE to criticise AutismOne's conference and MMS while applauding presenters at the conference like Montagnier, Lewis and Herbert.

Although I do truly feel sorry for the women who write about their disappointments and stressful lives @ AoA or TMR, I also believe with all my heart that they are also contributing to their own miseries as well as misguiding other parents.

Fortunately- due to the unlimited mercy of universal probabilty- I cannot view videos at this computer. Lucky me!

By Denice Walter (not verified) on 08 Jun 2012 #permalink

So many laughable lies, so little time. Given that I must pick and choose, I pick:

"Ferguson’s last major claim is that “there has never been a single study of the current vaccine schedule”:"

If Ms. Ferguson knew as much about the science of vaccines as she claimed, she would know that the "current vaccine schedule" has been tested every time a new childhood vaccine was tested. Whenever a new vaccine is tested, the treatment group consists of children (for childhood vaccines) who are "up to date" on the currently recommended vaccines. Thus, the "current vaccine schedule" has been tested one vaccine at a time, just as she (and so many others" have insisted.

The other part of this issue - and one that shows another lacuna in Ms. Ferguson's knowledge base - is the question of what one would test the "current vaccine schedule" against. If the proposal (which I've heard repeatedly) is to compare the current recommended vaccine schedule to no vaccines, we (in a global sense) have already done that study.

First, we have the historical study comparing children today who have received the recommended vaccines to those 100 years ago who received none of the current vaccines. The data (some of which are available in older cemeteries everywhere) indicate that the current vaccine schedule leads to fewer deaths in childhood and also fewer long-term and permanent disabilities (deafness, blindness, paralysis, cardiomyopathy, etc.).

Another study - although a bit more "apples and oranges" than the first - is the comparison of children in the "Western World" (i.e. countries with modern medical care) and those from countries where childhood vaccines are not given or are unavailable. Granted, we have to acknowledge the confounding variables of nutrition and hygeine, but the data certainly suggest that the current vaccination schedule - even when it is administered in countries with widespread starvation and poor hygeine - saves children's lives and prevents disability.

I think what Ms. Ferguson really wants is a study that will "prove" what she already "knows" to be true. Unfortunately, reality hasn't been kind to her, which is why she has to resort to a fantasy-based "chalk-talk".

Thanks, Orac, for providing another wonderful example of the perils of fantasy-based reasoning.

Prometheus

By Prometheus (not verified) on 08 Jun 2012 #permalink

Squirrel!!

By Composer99 (not verified) on 08 Jun 2012 #permalink

"the parents “scour the scientific studies and published research and have an unbiased interest in finding the truth.”"

Yeah, I'm sure that they'll only accept "the truth" if it has deep enough pockets to sue the hell out of.

For my response to this, I refer to Joe Pesci*ks opening statement in My Cousin Vinny:

"Everything that guy just said is bullshit. Thank you."

Seriously, what else can you say?

By Marry Me, Mindy (not verified) on 08 Jun 2012 #permalink

“the parents “scour the scientific studies and published research and have an unbiased interest in finding the Truth.””

(fixing JohnV's transcription error (-:)

Unbiased. I don't think that word means what Ms. Ferguson thinks it means.

By Eric Lund (not verified) on 08 Jun 2012 #permalink

Are those people complaining about dangerous chemicals in vaccins the same who are administeringbleach to their autistic children?

As far as I know they idea that tobacco was not good for ones health was known before 1958. At least my aunt learned it when she did some course to be able to take care of her dads tobacco-shop. And this was a long time ago, I suppose before her marriage.

I would suggest Ms. Ferguson, in chasing her own tail, has firmly embedded herself in the Cone of Shame.

By Scottynuke (not verified) on 08 Jun 2012 #permalink

Okay, I "cheated" and found Rebecca Fergusson's e-book:

http://www.scribd.com/doc/91473446/Breaking-Through-Journey-Out-of-Auti…

Throughout this short (19 page) e-book, Rebecca wows us with her "credentials" (She went to college and "built bridges", then went to law school.

Page 3...Caroline, at 12 months of age stopped speaking and avoided eye contact.

Page 7...Rebecca, after all her "research" comes to the conclusion "it all comes down to vaccines and immunity".

Thereafter, she starts "treating" her child, based on her "research" with every bogus treatment modality *known to cure autism*.

Supplements, vitamins, omegas and "more"

Gluten and Casein-Free diets

"Specific Carbohydrate Diet"

Diflucan...to combat the yeast

MB-12 injections to improve the methylation cycle

Hyperbaric Chamber Oxygen Treatments ("to supply oxygen to her brain and strengthen connections")

Submitted her child to testing for "leaky gut"...which was positive

Testing for "elevated levels of metals" (which were 3X normal) that "were killing her immune system".

(According to her "research"), "the only way to remove the excess metals was through chelation"

Dosed her child with oral chelation every 3 hours around-the-clock for three days each week for 2 years duration.

Later her child was diagnosed with PANDAS ("an autoimmune reaction to bacteria that creates antibodies that attack the brain including the basal ganglia, which control motor control, learning behaviors, sleep/awake cycles, cognitive and emotional functions")

PANDAS experts prescribe antibiotics for her child.

After speaking with other "parents who cured their children" she discontinues the use of antibiotics, in favor of "natural treatments". "The antibiotics were destroying her gut", according to Rebecca.

One of the (unknown) natural treatments is camel's milk.

Possibly the only "treatment" that Rebecca did not subject her child to is stem cell transplants.

Oh my goodness! I looked at Rebecca Ferguson’s webpage because I wondered if it would tell me how old she is (why is explained in my next comment). Is there any type of treatment fad this woman will not embrace?

Her daughter is a beautiful child and it sounds like she has a lot of potential. I sincerely hope she allows her daughter to develop into her own person.

I thought that the slide titled "Do you trust the CDC?" was a bit odd; it seems to imply that the CDC claimed smoking was "safe" in 1958. So, I did a little library "research".

As I suspected, I could find no evidence that the CDC (then known as the "Communicable Disease Center" - it wasn't named "Centers for Disease Control" until 1970) issued any statement about the safety of smoking in 1958. In fact, I can't find any official statement from the CDC about smoking until well after the 1964 US Surgeon General's report , which stated: “cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.” - not exactly a ringing endorsement of smoking's safety.

This isn't surprising because in 1958 the CDC's mandate didn't cover smoking (hint: it was primarily interested in communicable diseases - the name gives it away). Now, some government agency might have issued a statement that smoking was "safe", but the medical literature of the time show that - even in 1958 - there was little doubt among the medical and scientific community that tobacco smoking was linked to a variety of lung diseases (the link to vascular diseases was discovered later).

In contrast, the medical and biological literature of today show no evidence that childhood vaccinations cause autism, SIDS, "immune dysfunction" or anything other than a significant reduction in childhood morbidity and mortality.

What Ms. Ferguson seems to be claiming is that since the CDC - in her Universe, apparently, not ours - issued recommendations ("smoking is safe") in 1958 that contradicted then-current medical data, that the CDC should do the same today and contradict now-current medical data (i.e. that vaccines haven't been shown to cause autism, SIDS, etc.) by claiming that vaccines cause autism.

Even if we accept Ms. Ferguson's "alternative" Universe history, what she's asking is essentially that the CDC atone for one wrong (which, as far I can tell, it never actually committed) by doing another. Even my mother - no scientist - knew that two wrongs don't make a right.

Prometheus

By Prometheus (not verified) on 08 Jun 2012 #permalink

It was easy to debunk. Even I managed to do it, and I’m a just a chemist. Here’s just some of my take.

My first complaint: what’s with all the 3’s? Just coincidence? Her repeating that number makes me think she’s making it all up! And with all those conditions – how many of them overlap within the same child? Oh, but there’s only 1 diagnosis of autism – what, she didn’t think we’d believe that there were 3 in one classroom?

Thinking about the classroom numbers makes me wonder how old she is – I have to assume she’s younger (of course, I am an AMA mother, so that would not be a surprise). It’s very difficult to compare the classrooms of the young generation (i.e., my kids and her kid), to my own generation’s elementary schools in the 1970s.

We didn’t have classrooms with 30 kids – we never went over the low 20s. We didn’t have learning disabilities in our classrooms because they went to “special” rooms, and institutions. As for all of those allergies – I don’t know about the food allergies, but there rest of them were all there. Are there more of them now? Maybe. Or maybe we’re just paying more attention.

I find her arrogance in presenting herself as more knowledgeable that professionals who spent years studying for medical degrees and were trained in hospital simply astounding.

And finally, we have this: she superimposes the words

[(from the previous slide) we the parents] have an unbiased interest in finding the TRUTH

over a picture of a mother hugging a child!

Irony meter exploded! There is absolutely nothing more biased than a parent dealing with his or her own child.

This is self-evident. If this weren’t true, she wouldn’t be even be on her misguided crusade. We (all responsible parents) want to help and protect our own child. And she has the gall to try to pain herself as unbiased?

Possibly the only “treatment” that Rebecca did not subject her child to is stem cell transplants.

Actually, I couldn't find any evidence that she's subjected her child to bleach enemas. Yet.

pain should read "paint"

Remember, I'm only the messsenger:

I hate to be the bearer of bad tidings BUT-
it appears to me that material resembling the aforementioned tripe is multiplying exponentially, Malthusianly because the readers of AoA, TMR *et les autres* think of themselves as being bold, hard-arsed rebel freedom fighters and thus loudly proclaim THE MESSAGE via blogs, videos, facebook, twitter in an endless, sickening, mind-numbing tsunami of terrible prose, outright lies and misplaced paranoia. Many have just returned jived up from the conference : a health freedom one is upcoming next week ; there'll be a Canary Party in August, IIRC.

It ain't gonna stop anytime soon. I have scanned the facebook numbers of most of these sites and see thousands of likely suspects who are itching to get into the game.

Fortunately, we're prepared.

By Denice Walter (not verified) on 08 Jun 2012 #permalink

My evidence is totally anecdotal. But in a world of anecdotes whose trumps whose? I was a child with skin allergies, asthma, respiratory allergies and attention problems ( guess I was four different children-that could explain...oh never mind). That was over 50 years ago. Thirty years ago my children were the ones in the classroom with those same problems. There are other adult family members with autism spectrum disorders. None of us had the "too many too soon" vaccine schedule. As the mother of 3 children who were hospitalized with asthma attacks. (Teenaged boys don't think they need maintenance medication) I am perfectly willing to say that there was a genetic component to their asthma, which at times has been life threatening and their attention problems which also are life long challenges. These parents need to learn to accept the child they have. Guilt should not be an issue.

I noticed in the beginning the child with the asthma MDI is using it wrong. It all went down hill from there.

@Rob
I didn't notice. I was busy counting up how many of those problems I had and my dad before me, back in the day before the evil vaccine schedule.

Wow, another video of the same misinformation that been said by every single antivaxer throughout the world. As for the allergies. If I remember allergies are associated with IgE, which is usually involved with the immune response to various parasites. In areas where parasites are very common allergies are much less common, then in the areas where they have now become uncommon such as the US. Though I could be remembering this wrong. So, if they want less allergies go bring back all the parasites that used to be common in the US.

because the readers of AoA, TMR *et les autres* think of themselves as being bold, hard-arsed rebel freedom fighters

And scream like wounded rabbits when anyone is mean enough to correct them.

Lilady, You're back!

@ Shay:

I'm wondering when they'll start suing people like their patron saint does.
The warriors/ revolutionaries are role-playing fancy dress notions of societal transformation based upon an obviously deranged conception which is heard all-too-frequently @ AoA, TMR, Natural News, Progressive Radio Network ( political actions to change scientific data?). I suspect that many of them have been somewhat privileged and have never had to deal with harsh reality UNTIL they discovered that they had a child with ASD so now they're shrieking holy, bloody murder and blaming the hard, cruel, corrupt establishment for their woes. Wake up ladies, the world is not necessarily your oyster.

@ Autismum:

I believe that Ms Obradovic ( AoA) may be writing about your take on MMS

@ lilady:

Please don't tell me that you did not spend some euros *chez* Signora Prada, ...

By Denice Walter (not verified) on 08 Jun 2012 #permalink

Lilady, I thoroughly jealous and mightily hungry after reading those posts.
Back on topic, I've had this awful vid sent to me a couple of times now. The whiny music and the text effects are almost as bad as the BS.

Lilady if I want clear I apologize. I remember reading something in one of my bio text books the takes about fewer alergies in areas where parasitic infections are still a problem. Yet you don't see them calling for that even though it would be right of their alley. So the allergies are just a sign of progress we made, and they a always view that as bad.

I've posted twice on this thread within the last two hours and am having difficulty getting through.
When my post doesn't appear and I resubmit, I get this message

"Duplicate comment detected; it looks as though you’ve already said that!"

What gives?

"1958: Smoking has been studied" (by big tobacco)"

As people have said, this is untrue on multiple levels. From "Autism's Failed Prophets":

In 1953, tobacco companies hired the most powerful public relations firm in the United States, Hill and Knowlton. The firm's job was to seed doubt about the validity of epidemiological studies that clearly showed cigarette smoking caused lung cancer -- to make the public believe the case against tobacco was a medical controversy.

So when Generation Rescue hired Fenton Communications (the contemporary counterpart of Hill & Knowlton) to launch a similar campaign against the evidence in the autism / vaccines context, naturally they used the same tactics. They have a new tactic, though, where the now-recognised dishonesty of anti-science lobbyists in the tobacco war is used to claim that scientists are dishonest.

Naturally Ferguson goes along with it. You can't fix stupid.

By herr doktor bimler (not verified) on 08 Jun 2012 #permalink

@ Matt F:

Those I survey attribute illnesses like arthritis, asthma, MS, Alzheimer's, allergies, Crohn's as well as ASDs, LDs, SMI to medical interventions like vaccines and pharmaceuticals and the advent of modernity including pesticides, metals, non-organic fertilisers, fluoridated, chlorinated water, pollution et al: I believe paradise was lost sometime c.1900.
- see esp. the Canary Party.

By Denice Walter (not verified) on 08 Jun 2012 #permalink

Before I finish reading the deconstruction as a writer, musician and artist my first thought was, "Did she ask The Fray or The Goo Goo Dolls for permission to use their music in her "public service announcements"?" Because they may not WANT to be "attached" to antivaccine rants.

Another thing, as I listened to her classroom lists - the incidence of autism (1 in 30) seems to be a bit high, and MANY of those could very easily be comorbid - i.e., the child who has respiratory allergies has asthma, etc., etc.

Further, I always thought that vaccines were to INCREASE reactivity of the immune system to the disease by "letting it know how to recognize the disease" and having antibodies already in place to help fight the illness (in layman's terms). She says that the purpose of vaccine is to REDUCE immune response to viruses and it accidentally increases reactivity to everything else as an unwanted side effect.

WBBM Newsradio here in Chicago reported this morning that a study done by Northwestern University found that urban kids had a higher incidence of allergy to shellfish and tuna than farm kids. I call BS (bad science) - farm kids are a whole lot less likely to ever eat shellfish or tuna. Duh.

Here is a link to the study. Not to take allergies/asthma lightly, but this was a self-reported survey.

I love it how the video says that doctors get their info from med reps while they, the parents, actually rely on scientific evidence.

The level of arrogance of ignorance is too damn high!!!

By FilipinoMDstudent (not verified) on 08 Jun 2012 #permalink

Chemmomo @12:39

I am afraid that most of these parents are raising a generation of Jake Crosbys,not a pleasant thought.

I think Ms.Ferguson may possibly be onto something,in suspecting her daughter might have PANDAS,or a related disorder,but from what I have read,her daughter seems kind of mild even for PANDAS.Like all of these diseases, PANDAS does have a spectrum,and has all kinds of psychiatric,and behavioral diagnoses attached to it.But chelation is the last thing you want to do for PANDAS.

I have met a lot of people in internet groups over the last decade or so,one was this man,who,like me,had a lot of weird,and serious medical issues.This was 2007,if I recall.I think he had a combination of ADHD,tics,and Asperger's.He went to NIH,and had a full week-long workup,.He was diagnosed with PANDAS in his early 30s.No one knew what was wrong with him as a child,because the diagnosis didn't exist.

These are the cases you never hear about from the likes of Ferguson,and AoA.

By Roger Kulp (not verified) on 08 Jun 2012 #permalink

bad poet -- I live in the middle of the upland Illinois corn prairie. Tuna fish casserole is practically our national dish (right up there with Herman Munster-green jello with marshmallows and fruit cocktail in it).

Shellfish, now, you may have a point.

But shay, what about shrimp?

We had a lot of shrimp growing up. Imagine Bubba Blue reciting the litany...

"You got fried shrimp, and fried shrimp, and fried shrimp. There's shrimp that's fried, and shrimp that's fried....etc"

Yep, we had a lot of shrimp.

By Marry Me, Mindy (not verified) on 08 Jun 2012 #permalink

I have a question for anti-vaxxers; are you sure autism is something you develop instead of something you grow out of?

By Alan Kellogg (not verified) on 08 Jun 2012 #permalink

I live in the middle of the upland Illinois corn prairie. Tuna fish casserole is practically our national dish

One word: tarragon.

Just watched the video and read the comments. No one commented about their incredibly poor synopsis of the immune system yet, probably because it was too easy of a target. The classic divide between Th1 and Th2 helper T cells that I learned in immunology class was that Th1 cells were involved in cell-mediated immunity while Th2 cells were involved in humoral immunity, NOT "acute reactions vs. autoimmune/allergic reactions". For example, Type IV or delayed type hypersensitivity reactions are cell mediated, not antibody mediated. Also, antibodies (humoral immunity) are definitely involved in acute reactions, often appearing within days to an infection. Anyways, that misinterpretation and oversimplification of the immune system would be expected in a video like the one above.

Then they tried to split Th1 vs Th2 into inside vs outside cells, however, bacteria can be both intracellular and extracellular pathogens and yeast is facultatively intracellular, but hey, they dug deep into the science, right? Oh and antibodies (Herceptin) can be used against cancer.

Of course an obligatory misrepresentation of vaccines as "lowering immunity to viruses and increasing it to allergens" with no regard for the fact that there are vaccines that increase the humoral response and also vaccines that target the host cell mediated response (eg many live-attenuated vaccines). Oh and of course zero references to back up any of their wild statements otherwise.

Gratuitous metal-toxin gambit, which "impairs the immune system and unbalances reactivity". Of course, the metal adjuvants in vaccines actually increase the immune response, but that must have just been a little deeper into the science than the makers of the video thought to dig. The stupid burns indeed.

I also liked how "digging deep into the science" involved a textbook page with a picture of a mitochondrion. I personally would have chosen a screenshot of Pubmed, but to each their own.

Final point: even if you do have an unbiased interest in finding the truth, if you don't have the skills to find the truth (scientific literacy), there is no reason to believe you will find it. Of course, when you are emotionally invested with an affected child, your fervor to find the truth may also bias you to overly simplified solutions as a way to comfort yourself and gain control over the uncaring universe. <--nothing that hasn't been said here many times before, but with particular application to the video.

Oh and how on earth did this study make it into Clinical Reviews of Allergy and Immunology?? (saw it while refreshing my memory on Th1 vs Th2 cells)
http://www.ncbi.nlm.nih.gov/pubmed/22669752

Can't reach the full study because I'm on my home computer and it's behind a paywall, but just the abstract makes me cringe. Appeal to antiquity much?

Can't reach the full study because I'm on my home computer and it's behind a paywall, but just the abstract makes me cringe.

Firstly, this song by The Fray was used to better effect in that Scrubs episode where the transplant patients were dying of rabies, and Dr. Cox was losing it.

Secondly, I'd just like to say hello. As someone who has only been reading this blog for a few weeks, I can't tell you how much it warms my heart to see that the position based in reality has at least some web presence. Say what you will about these homeopaths and pseudo scientists, but damned if they aren't all over the internet getting their ridiculous message out (and selling supplements!)

I'm currently a medical resident and perhaps had been surrounded by logical folks for too long to notice which way the wind is blowing in some circles. I recently had some time off and got to speaking to a family member who is a newly minted chiropractor. I was talking about some bizarre parenting strategies I'd recently heard of some old friends practicing, and to drive my opinion of these ideas home, I stated, "They don't even believe in vaccinating their children, can you imagine?"
This 6 months post graduate chiropractor who insists everyone call him "doctor" looked me dead in the eye and said, "Well yeah, I tell all my patients not to vaccinate their kids."
Felt like someone had punched me in the gut. A medical practitioner, a relative I'd known since we were children to be fairly intelligent, starts talking about Wakefield's study, toxins, too many too soon, and on and on. This person gives medical advice! He went to school for 3 years after college to learn what? How can you call yourself a doctor and not "believe" in vaccines? It's like a NASA engineer being a moon landing denier...

It only got worse from there. He's indoctrinated and believes I'm in the pocket of big pharm, while I'm just as broke as every resident in the country. No amount of evidence, data, or reasoning will ever persuade this person.

Orac, you're doing wonderful work. For days after that conversation, all I could think about was starting some sort of physician edited skeptic's blog, but you've already done it in a magnificent way better than I ever could have.

But this being the internet, you have to wonder, is this just a polarizing echo chamber like AoA and the others? Are the only visitors to this site people who want to hear how correct they are and how stupid the other side is? The hardcore believers in woo will never be swayed, but I sure hope that at least every now and then you convince an open-minded person or two...

One reaction to tarragon: ewww! Yuck!

Now we need to talk about those Midwestern fish fries.

Fresh water fish fully battered and deep fried was a staple on Friday in near by Wisconsin! They were yummy if the fish was good, the batter had good beer and the oil was less than a month old!

Yeah, I was not a fan. But I do enjoy fishies done right. It is sad when I can take a piece of individually wrapped piece of frozen fish from Costco and make it more edible than a MidWestern Friday night fish fry.

I would like to know why there is so much "Autism" in the US compared to other countries in the world.
My two cents is that Autism is used as a too broad diagnosys.
I agreed with Alan up, I believe it is possible that some "Autism" diagnosys aren't autism at all, and as such the child grow out it.
And this thing about vaccines? Honestly how can people be so stupid? I learnt something about it at 14 and then believe it. I grew up it by 16.
I don't get people.

The runoff election for US Senator from California will include incumbent Diane Feinstein and her Republican challenger Elizabeth Emken, who has been associated with Autism Speaks. According to Wikipedia, Emken is the former Vice President for Government Relations at AS.

I think it's sad the lengths people will go to to try to 'cure' their child of something which isn't 'curable' in that manner.

All that time and money could be better spent on enriching their child's life and understanding what their child needs to thrive, rather than subjecting them to unproven, dangerous 'cures' that they're chasing from the internet.

Some kids do 'grow out' some aspects of autistic behavior. They've taught themselves (or adapted to) how to 'read' other people and what is (more or less) acceptable social behavior. Are they still autistic? Yep. They're not cured - they've adapted.

Chemmomo @ 12:46
I don't know if schools still have Special Ed,or if budget cuts killed it off in most states,but when I was in school Special ed was a disaster.You did have children with autism,severe learning disabilities,or who were mildly retarded,but often it was also a dumping ground for students who were budding felons,and caused all sorts of problems in school.

I wear one of these with pride,and for all I know,maybe a lot of other disabled people do too.

http://www.bewild.com/irishbusho.html

Speaking of fish...

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032917

By Roger Kulp (not verified) on 09 Jun 2012 #permalink

Oh GRichard - sorry to hear about your family tragedy, chiropracty is incurable. Be brave eh? You can get through this.

Lord Draconis is the space-monarch in charge of distributing payment to Ebil Pharma Shills. I've triggered the Minionator to let him know there's a new EPS in the ranks. He should see the signal on his next flyby part the Milky Way,with the fleet.

Ooh. and check out http://www.sciencebasedmedicine.org/

It will gladden your poor chirot-saddened heart!

Welcome to the ranks.

@GRichard

I know that feeling, bro. I, myself, have a family member who believes almost any unscientific therapy. Magnet therapy, TCM, acupuncture, supplements, alkalinization, chiropractic etc. When I point out to this family member that all of these are nonsense, she played the "close-minded" card on me. Explanations of epidemiology, clinical trials and medical science don't work. She even told me that I'd be a horrible doctor in the future when she found out that I was skeptical of a lecture on acupuncture in my medical school. She acts as though being a skeptic is a bad thing! When she told me that cancer can be cured by "alkalinizing", I told her that it is nonsense, and that cancer isn't caused by acidic blood or that "alkalinizing" will cure it. She angrily looks at me and asks me how the hell I can come to that conclusion.

The consolation is that she isn't anti-vaccine. Although, when she watched Jenny McCarthy on Oprah, she got slightly convinced that maybe it’s possible. When I told her that the vaccine-autism link has been refuted, she looked at me angrily and asked me how the hell I could come to that conclusion when we don't know what causes autism. Explanations of the power of epidemiology didn't work. At least she still believes vaccines are important.

By FilipinoMDstudent (not verified) on 09 Jun 2012 #permalink

She even claims, apparently based on Moritz’s nonsense, that vaccines decrease immune reactivity to viruses and increase immune reactivity to allergens.

"Neonatal and early life immune responses to various forms of vaccine antigens qualitatively differ from adult responses: predominance of a Th2-biased pattern which persists after adult boosting." [9711791]

We need to talk, squirrel.

She even claims, apparently based on Moritz’s nonsense, that vaccines decrease immune reactivity to viruses and increase immune reactivity to allergens.

Orac, the misguided infection-promoting squirrel.

"Overcoming dendritic cell tardiness to triumph over IL-13 receptor: a strategy for the development of effective pediatric vaccines."

Neonatal exposure to antigen gives rise to a primary response comprising both T helper 1 (Th1) and T helper 2 (Th2) lymphocytes. However, re-encounter with the same antigen yields an indubitably biased response with minimal Th1 but excessive Th2 cells. Since Th1 cells combat microbes while Th2 cells react to allergens, the neonate faces susceptibility to both microbial infections and allergic reactions. The Th1/Th2 imbalance of neonatal immunity stems from a delayed maturation of dendritic cells that yields limited IL-12 cytokine during the neonatal stage. Th1 cells developing under these circumstances up-regulate the IL-13Ralpha1 chain that physically associates with the IL-4Ralpha chain, forming a potentially hazardous heteroreceptor. During re-challenge with antigen, IL-4 from Th2 cells utilizes the heteroreceptor to signal the death of Th1 cells, leading to the Th2 bias of neonatal immunity. Our view to overcome Th1 deficiency is to supplement neonatal immunizations with toll-like receptor ligands that could stimulate maturation of dendritic cells and augment IL-12 production to counter IL-13Ralpha1 up-regulation. This regimen would yield Th1 cells devoid of the heteroreceptor and resistant to IL-4-induced apoptosis. Accordingly, the neonate would have balanced Th1/Th2 immunity and withstand both microbes and allergens. Such approaches could open new avenues for better pediatric vaccines and allergy therapies.

PMID 20587345

GRichard:

We try not being an echo chambre: you'll notice that our esteemed host alllows dissenting comments - we sometimes are critical of the so-called establishment as well. But we is not perfect.

I have been running into the most egregious nonsense spread far and wide- like organic manure- since about 2000 : I try to use whatever i've learned via formal education and real-world experience to expose how this garbage - being both products and ideas- gets sold to the unsuspecting, how woo-meisters capitalise on fear and how they will say ANYTHiNG to get a sale AND their audience's adulation. We need to have people start seeing these websites as being COMMERCIALS, advertisments- not the informational sources that they spuriously masquerade as.

Here's an old strategy from tennis: when you play, you need to 'cover' your opponent's shots- you can't be everywhere at once and cover every possible entry so you learn what is most likely and work on that: if you are met with an impossibly good shot, you let them have it.

Translating this to our situation: the die-hards are the impossible shot, so we try to seek out the reasonable people - the 'most likelies" and speak to them If you imagine a bell curve: we talk to the middle sections - one extreme is already on our side, the other is un-reachable.

And yes, I sometimes feel badly that I single out nonsensical information perpetrated by hurt parents who have kids with ASD but they spread information which can harm others.

Keep up the good work at school.

By Denice Walter (not verified) on 09 Jun 2012 #permalink

GRichard: You've ARRIVED!!! You have attracted the attention of Th1Th2, a/k/a "Thingy" our resident insane troll.

Best to just ignore Thingy. It is germ-phobic, it hates children, it "claims" to have been a licensed Registered Nurse and it has been banned from websites which are known for tolerating alternative theories and alternative medical treatments.

Just another health care professional wannabe nasty troll who craves attention.

On a more positive note, we have turned people around who a fence-sitters about immunizations and other medical topics. This blog is highly regarded in the medical community and the wider "civilian" community as well.

> This blog is highly regarded in the medical community and the wider “civilian” community as well.

Damn right it is.

@elburto
Thanks for the link, and I'm sure my bank account will thank you soon too. 'Bout time I get a cut of these huge vaccine profit margins.

@FilipinoMDstudent
I'd say fight the good fight, but it's just so frustrating. People back in my home town ask me how school is going (hint: residents draw a salary and are licensed to practice medicine, school's over) while they ask the chiropractor for adjustments and medical advice. I will admit I am a little jealous I can't treat healthy 20-somethings for a living though, they're almost impossible to break, of course you get better outcomes than the trainwrecks we see at the charity hospital.
My current strategy is to become a walking anecdote, since that's what these people seem to value more than data. What I mean is that I do my very best to present a picture of health to patients and acquaintances without touching any of this nonsense. Then when asked about what supplements I'm taking or how long I've been gluten-free or some other such BS, I can laugh and say, "Eat what you want, but not too much. Throw in some vegetables. Get up and move more, and have a drink every now and then if you want. See a doctor if you're sick, and get it taken care of. The end. Oh, and don't smoke, for the love of whatever god you may believe in, just don't." This might not be the best approach, but if you've even seen how these hucksters market themselves, it seems to be effective. Basically, "look at how great he looks/feels/is, if I listen to him, I can have it all too." It's nonsense - no two people are the same, results not typical, etc... But if these folks can use themselves as "proof," so will I.

@Denice Walter
I see the dissenting opinion just above yours, and I went ahead and followed up on it by reading the actual paper. It's a review article which makes some interesting assertions and postulates, and if correct could lead to better vaccines. It certainly doesn't support the video though.
I like your tennis analogy. I less like the idea that my views are as extreme as the other side's, but I have noticed myself becoming somewhat fanatical about issues like this. Best to remind ourselves very frequently that we can be, and often are, wrong.
But not about vaccines ;)

@lilady
Troll or no, presenting a published article is light years better than just making crazy unfounded claims. I didn't mind chasing down the link and reading it. Something I really credit my med school for was being very interested in teaching its students critical appraisal. Lies, damn lies, and statistics and whatnot. In this case, there weren't statistics, just commentary, so whatever. I'm not sure what it was supposed to disprove anyway; it's just looking for avenues to improve vaccine durability, so um, keep up the good work I guess?

Glad to be here though, thanks for the welcome.

@Narad - Two words: Soy sauce.

@GRichard - Welcome!

@Lilady - Welcome back!

And for all Pharma Shills and Minions in the Chicago area, there's a "health freedom expo" this weekend. Woo warriors wanted to ward off wackaloonery and master money mindfulness. Lord Draconis, if you and your lovely Lady have any powerful PharmaStink™ bombs, please let me know so I can target them alternately.

Roger Kulp
@Jun 8: I agree with you – and I’m afraid that whatever real medical issues the girl has are going to end up untreated in favor of using all that other stuff.
@Jun 9: I think Special Ed in all its forms has improved a lot since when we were kids, but that’s based just on teachers I know. I don't have any first hand experience.

@ GRichard:

Extreme alright- extreme sanity.

A recent focus group by Gardner et al showed that parents were more likely to accept information about vaccines when the source was other parents than if the information came from authorities, thus illustrating the dangerous power of anti-vax groups run by parents.
-btw- those who listen to hucksters and buy their products and line of bull may wind up ill or even worse.. some settle out of court but others hang on.

Altho' I 'm on my way out the door, I will warn you that His Lordship will not pay you in currency- it's purely luxury goods, autos, expensive trips. Hope you enjoy that sort of thing.

By Denice Walter (not verified) on 09 Jun 2012 #permalink

Health Freedom?
How about building freedom? People should be able to make buildings or bridges without safety-rules and regulations. And if it fails, we just say: "Building freedom".

@Narad – Two words: Soy sauce.

That's a horrifying thing to suggest doing to a tuna casserole. Seriously, it would be like adding raisins.

Renate -- you're absolutely right! After all, it worked so well in Port au Prince.

Narad: I brought pesto with linguine to my very first potluck shortly after I moved here. I overheard one of the church basement ladies asking who made the green spaghetti. Tarragon is a non-starter. After all, this is a part of the country where Jello technically is a vegetable.

MESSAGE BEGINS----------------------

Shills and Minions:

You must forgive me for my innatention of late. Astra and I are returning from a three day music festival on GV-238. It was to be a trip to escape the pressures of planetary subjugation, the daily hatchling induced mayhem and the constant sniping and whinging of the Rothschild and Windsor clans. Well, this trip brings to mind two of your primate proverbs, "you can't go home again" and "I'm too old for this shit." Wise words from endotherms.

The music was "rad" as the hatchlings say, but honestly, rekindling one's youth is hardly worth the effort on the high side of 100 terran years. My ears ring like a wailing V'maach and although our Obsidian Unit was comfortable enough, my back and dorsal spines long for the sublime comfort of the low-gee sleep chambers back at PharmaCOM Orbital and Terrabase DIA. And three days of Klevk, M'vasct Opera, Sleemot and Durr performed by more than three score groups? My nervous system is simply not up to it any more.

In any case, we welcome our latest warrior Gritchard. What shall it be sir, Shill or Minion? Betrayal of one's species is never undertaken lightly and while the rewards are great, there's always that gnawing "loyalty" thing you people have. Well, not to worry, we, your Reptiloid Pharma Overlords, really do know best. You were ruining the place anyway, why not go out in style? In closing, we know you have your choice of marauding species to serve in the subjugation of your homeworld, we thank you for choosing to serve the Glaxxon Corpus!

Back to work.

Lord Draconis Zeneca VH7iHL
Pharmaca Magna of Terra, Foreward Mavoon of the Great Fleet, Monkey Master of Mars, Requester of "Free Bird"

In Transit
0001110101101010111110101010

------------------------MESSAGE ENDS

By Glaxxon Pharma… (not verified) on 09 Jun 2012 #permalink

Danged WP ate my last comment. Because I was "commenting too fast". Not.

Welcome, GRichard! I too have a chiropractor-relative. He's anti-vax. In the name of family peace, we confine our conversations to sports. But I have to say, his anti-vaccine nonsense is one of the things that's prompted my pro-vax advocacy.

There are a number of skeptical medical or health-related sites in addition to RI and Science-Based Medicine, such as Skewed Distribution, The Poxes Blog, Harpocrates Speaks, Neurologica (for starters).

If you want to read science-based articles on autism, The Thinking Person's Guide to Autism*, LeftBrain/RightBrain, Photon in the Darkness** and Cracking the Enigma come to mind. But you should really be reading blogs by autistics. One place to start is The Autism Hub; another is ThAutCast.

Herr Doktor Bimler, this is the best comment on the silly fish paper yet, from Sullivan on twitter: "with a great deal of therapy, can they make the ssri'd fish indistinguishable from peers?"

More seriously, Neuroskeptic thrashed the study here Antidepressants in Water Cause Autism Study, and Dorothy Bishop (@deevybee) at PLOS Blog Network went at it with Fish, Antidepressants, Autism, and a Problematic Research Premise.

Deborah Blum, at the Knight Science Journalism Tracker, focused more on the news coverage: Taking the Bait: A Fish (and Autism) Story.

@ herr doctor bimler: Just what the world needs now...a study by fresh water ichthyologists that links SSRIs to fish autism.

The study is sure to be picked up by AoA, Safe Minds and Babs at the NVIC. Too bad though, that none of the fish received vaccines.

After all, this is a part of the country where Jello technically is a vegetable.

Now, now, my great aunt, of similar location and descended from noteworthy Lutherans, was famous for her orange Jell-O with shredded carrots, served on a bed of iceburg lettuce with a dollop of homemade mayo. You just have to sell it. I promise, a pinch of tarragon will make that tuna casserole stand out. Using cream of celery is also a nice change from cream of mushroom. And tricolor rotini.

(Also: canned pear halves in lime Jell-O. Makes for an elegant presentation if set in ramekins, but you might want to switch to red cabbage or radicchio for the base.)

GRichard:

"But this being the internet, you have to wonder, is this just a polarizing echo chamber like AoA and the others? Are the only visitors to this site people who want to hear how correct they are and how stupid the other side is? The hardcore believers in woo will never be swayed, but I sure hope that at least every now and then you convince an open-minded person or two…"

I was one of the fence sitters. I have a daughter who was diagnosed with Autistic Disorder just before her second birthday (she got re-evaluated two years latter with a dx of PDD-NOS). I got on the biomed wagon and was wary of vaccines. (My daughter was fully vaccinated, except for chicken pox, up till her autism diagnosis. I freaked out and she didn't receive any boosters from that point on).

I've been reading this blog for almost two years. It's been my experience that all commenters have their concerns and questions addressed patiently and thoroughly...until they prove to be rude and/or impenetrable to reason. It's this blog, among many others, that convinced me to accept my daughter for who she is and to get her vaccines up to date. Welcome!

By tangentgirl (not verified) on 09 Jun 2012 #permalink

a study by fresh water ichthyologists that links SSRIs to fish autism.

I read into the paper as far as the point where they state:
In that study, Croen and colleagues found a 2-fold increase in ASD risk associated with SSRIs, with the strongest effect occurring in the first trimester.

-- which is where I threw up my hands in disgust. In fact Croen &c measured the adjusted odds ratio which is not the same as risk In their words,
mothers of children subsequently diagnosed with ASD were twice as likely to have at least 1 antidepressant prescription in the year prior to delivery of the study child
-- the increase in *risk* works out to much smaller.

Now to be fair, Croen &c made the same mistake in their press release, where the massive overstatement of an increased risk is more sensational and more important than telling the truth; and the Fish Autism study is merely quoting the press release. But I really think the authors should have read the *paper* before citing it.

By herr doktor bimler (not verified) on 09 Jun 2012 #permalink

One day I would love to be good enough to be a minion. I'll never make it to shill status.

I read something rather horrifying in a book by a former hygienist (though she insisted she cured several people of cancer, she died of it in her 50s; her loving husband published the book posthumously in her honor):

"The AMA has a stranglehold on the sick. There is no effective competition for its methods. Alternatives are suppressed. In my version of a better world, if anyone that wanted to could hang out a shingle and offer to diagnose, treat and cure disease, a few quacks would really hurt a few people. But many genuine therapies would appear and the public would be exposed to workable alternatives. If anyone that wanted to market it could put a label on a bottle of pills, power or tincture that said its contents would heal or cure disease, yes, a few people would be poisoned. And a few would die needlessly by failing to get the right treatment. But on the positive side, all this liberty would result in countless new therapies being rediscovered and many new uses for existing substances would appear."

This is from "How and When to be Your Own Doctor" by Isabel Moser.

In her book during rants about some treatments (she was an RN and supposedly had a PhD in psych) she would talk about the 'first do no harm" ethic required in medicine.

When I read her closing comments (sorry, the book had all of the rubber-necking appeal of a train wreck - I just wanted to understand how they think this stuff up!) I was absolutely horrified.

"Sure, people might get poisoned by "medicine" someone concocts in their basement, and others might die because they go to someone with absolutely no training who is sure that they can heal people (or just wants to pretend to and make lots of money), but it is worth it so we can have "health freedom."

I know that sometimes there are failures in our current system that lets that happen, but there are also processes in place to watch and if there is the possibility that at treatment or drug is causing injury, the drug is pulled. I can't imagine the horror of living in a world where you would have no idea what treatment was safe, what doctor was qualified, etc.

Then again, it's kind of what a lot of these parents of autistic children do - they throw away all reason and assurances and chase after anything that "promises" (no matter how flimsy the theory behind it) to give them back their child.

The rant mentioned earlier by the one blogger at AofA made me sad - I don't think any of us think the parents are stupid - we think they are desperate and being taken advantage of by people who should not be allowed to. That's not the same as stupid. They're being victimized and it hurts their pride to hear it.

@tangentgirl -

I am so happy you shared that. I have been reading this blog for a few years now, and occasionally even bravely commenting. I have often wondered, with how firmly entrenched some can be in woo (I'm married to one, thus the nickname), if all of the deconstruction of faulty logic, etc., ever actually helped anyone begin to ask questions about their fears and look for better answers. It is good to hear that some actually listen!

Dear Lord Draconis Zeneca VH7iHL,

Your consort Lady Astra, She Who Must Be Obeyed, ran into me at the local Starbucks and asked me to inform you that the new mammal pet, Zeta Puppis, escaped his newspaper-lined potty-training capsule and somehow got into her lingerie drawer. The Lady Astra suggests that this might require her to make a few trips to Cadolle.

By Phoenix Woman (not verified) on 09 Jun 2012 #permalink

Ah, memories of a cylinder of green jello with pineapple rings. Though i much preferred the pineapple upside down cake made in the big cast iron skillet.

a study by fresh water ichthyologists that links SSRIs to fish autism.

Disappointingly, and unlike certain other papers in the autism literature, there is no mention of "social morays".

By herr doktor bimler (not verified) on 10 Jun 2012 #permalink

a study by fresh water ichthyologists that links SSRIs to fish autism.

Disappointingly, and unlike certain other papers in the autism literature, there is no mention of "social morays".

By herr doktor bimler (not verified) on 10 Jun 2012 #permalink

@GRichard

Well, that's sad. People there actually think of a chiropractor higher than a medical resident. Perhaps those people ought to learn what real doctors are.

About trying to convince others, your proposed approach is actually quite thought-provoking. I will keep that in mind when I start to get clinical experience. Nevertheless, I will explain science first. After all, that should be the basis. When people start telling anecdotes, I will also use counter-anecdotes (based on real experiences, of course). When they are still unconvinced, then it would be the time to let go because that person would be too close-minded.

So far, here in the Philippines, the nonsense in medicine does not appear to be as prevalent compared to the US. I am really, really glad that antivaccine lunacy is not prevalent here at all. It seems as if the main reason why vaccination rates are low here is because of socio-economic reasons instead of the nonsense by antivaxxers. Nevertheless, I'm not letting my guard down. After all, our school already gave us one class on acupuncture. Who knows how long it will take before nonsense will suddenly flood into med schools here?

By FilipinoMDstudent (not verified) on 10 Jun 2012 #permalink

Ah, memories of a cylinder of green jello with pineapple rings.

Now, wait one second. That's supposed to be impossible. The bromelain from the pineapple should prevent the gelatin from setting.

@ Mrs Woo:

Her nonsense sounds like the nonsense I survey: the medical establishment has too much power; it's corrupt; it's frightened of bold maverick innovators; it kills 'hundreds of thousands a year'. Now interestingly, I have run across a new item that sheds some revealing light on these health freedom fighters:

in late April,2010, a well-known woo-meister was poisoned by his own product ( see Orac's "Too deliciously Ironic for words..."). Six of his trusting customers were harmed enough to require hospitalisation; two of them ( a couple and another woman) sued and both were settled out of court for UNDISCLOSED amounts. However, late in 2011, a fellow sued on behalf of the estate of his mother, who died. Barrett's Quackwatch article links to the suits.

Of course, we can say that it was faulty manufacturing, or surveillance et al , HOWEVER ( and it's a big however) the idiot teaches his followers to avoid and mistrust doctors and to take his own doltish advice on health.

-btw- we often use 'shill' and 'minion' interchangeably or 'shills' for boys/ 'minions' for girls as well as 'minion' for the sluttier ones, regardless of gender. And I think that you're already a 'prentice.

By Denice Walter (not verified) on 10 Jun 2012 #permalink

@ Narad:
My exact thought!

-btw- I have to say that all of you brilliant chefs and cooks and brewers have made me aware of my own extremely limited capacities in that area of endeavor. My repetoire consists of faux-restaurant Franglo-Indian-Thai, i.e. semi-prepared store-bought plus curry.

I am thoroughly jealous. But, I AM descended from someone who was well-known for producing gin. So there!

By Denice Walter (not verified) on 10 Jun 2012 #permalink

@ herr doktor bimler: Thanks for the chuckle by mentioning "social morays". I'm trying to remember which troll used that phrase.

Meanwhile, over at LB/RB on the MMS thread, a brainless twit mentioned the FDA and its link to Monsanto. She claimed to not be affiliated with the Canary Party, but stated she is anti-vaccine and a libertarian.

I was in a snarky mood and provided her with this link:

http://www.snopes.com/politics/business/organic.asp

(I don't think she will be posting again)

tangentgirl- I'm having a truly awful day, but your comment made me emit a happy squeak. Thanks for sharing.

Roger Kulp, the tomato aspic with olives is actually ridiculously easy to make. The one with lemon jello. But I prefer the more complicated one with gelatin.

I got into gelatine cuisine in a big way when the oldest stepson got his braces and was quite uncomfortable chewing for a couple of weeks. I was motivated by memories of my grandmother's perfection salad.

Back on topic, re vaccine rejection: see today's story at McClean's Fighting scary vaccine stories with scarier ones.

A bit off topic but I just saw an interesting youtube film on an interesting, almost miraculous, medical treatment. My apologies if it has been mentioned before and I missed it.

It treats all sorts of diseases. Perhaps it's a replacement for homeopathy?

23 and 1/2 hours: What is the single best thing we can do for our health?
http://www.youtube.com/watch?v=aUaInS6HIGo&feature=youtube_gdata_player

By jrkrideau (not verified) on 10 Jun 2012 #permalink

MESSAGE BEGINS-------------------------

Woman of Phoenix:

Our gender differentiation is, of course, entirely different from your species. Most humans find our ways . . . disturbing. For instance, our society is a aggro/plenary ovamatriarchy and though I wield great power, all authority from Corpus down through clade levels comes from Her Imperial Highness Clopidogra Invicta XXIII (may she feast on the subjugated for all time) and her sisters/daughters.

Our Great Egg Mother knows and decides all. As a male, mine is to seed, educate, defend, acquire and subjugate. If, as you report, my beloved/feared Astra wants soft, alluring human garments, be assured that they are hers to take by any means she chooses. As for the troublesome canine Zeta Puppis, it will cause no more mischief. After its ill-concieved garment shredding, it made the final mistake of its short, clumsy life by wandering into the hatchling creche where it was assumed to be a snack of some sort.

Human Mrs. Woo:

Your intellect, fortitude and ability to maintain a loving relationship with your mate despite your clearly superior grasp of reality might make you an excellent Agent of Conciliation and Subterfuge for the Corpus. Some of our "acquisitions" are carried out with a great deal more finesse than we have employed here on Terra. The great PharmaTeat™ isn't just for Shills and Minions anymore. Just ask Cadre Leader DW, she'll fill you in on the details.

Thank you for your interest in the Glaxxon Corpus™.

Lord Draconis Zeneca, VH7iHL
Foreward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Order of the Vengeful Egg

PharmaCOM Terrabase DIA
00101111101010101111010000101010101

--------------------------------MESSAGE ENDS

By Glaxxon Pharma… (not verified) on 10 Jun 2012 #permalink

Narad:

The bromelain from the pineapple should prevent the gelatin from setting.

The hint was the "cylinder." Canning pineapple cooks out the enzymes that prevent jelling. All you had to do was drain the juice from the can of pineapple rings and then pour in lime jello. You let it set, take off the bottom of the can and slip out the green cylinder with pineapple rings.

Canning pineapple cooks out the enzymes that prevent jelling. All you had to do was drain the juice from the can of pineapple rings and then pour in lime jello.

I should have realized. I will thus mortify myself by admitting that I enjoyed lime Jell-O made with half the liquid called for as a warm beverage as a lad. Then again, this came about after a long period of consumption of straight MSG from the shaker of meat tenderizer.

We at Illuminata Ltd create and manufacture quality information- both real and facsimile- for your every need. Should you require data, research, evidence or testimony, we can provide it to meet your specifications. Whether you are an individual, a corporation or a government, we can assist you in image maintainence as well as educational services.

We like to think of ourselves as being traditional with a cutting edge- like Burberry's. Modern without being modernistic: like Apple.

If you desire enlightenment, get lit with us. Don't be an Illuminata *non grata*.

Sincerely,
DW, CEO and CFO, Illuminata Ltd
Worldwide

for some reason- we are listed @ DAX- I have no idea why that is

To all the gelatin fans, if you have a Mexican market nearby (eg La Rosita), try gelatinas, which are made with milk and come in interesting flavors like coconut, vanilla, and pineapple. If you have an international fresh market nearby (eg Valli), look for micro curries, which come in all kinds of choices from bengan bharta to dal tarka.

I like tuna noodle casserole. No potato chips our anything non-standard. Just the canonical canned tuna, elbow macaroni, canned cream of mushroom or celery soup, and LandOLakes bulk sliced American cheese on top.

The only "food snob" place I've ever lived in is around Kyoto/Osaka, famous for takoyaki, tonkatsu, and other sort of working class dishes. I love sushi, but not soy sauce. I've seen people eat rice in their bowls of soy sauce. That's disgusting.

In a place famous for pizza, Italian beef, Maxwell style Polish and Vienna beef hot dogs, I can't complain about my food choices. Just don't force me to eat fast food, unless it's Culver's or Portillo's.

Just the canonical canned tuna, elbow macaroni, canned cream of mushroom or celery soup, and LandOLakes bulk sliced American cheese on top.

WHAT? This is the "canon" of a perverted church.

I feel so privileged, having grown up in Brooklyn, New York where we shopped at the original Waldbaum's Super Market. Back then they catered to a primarily Jewish clientele. "Kojel" kosher gelatin was always available at the market, which I believe was parve (made with a vegetable gum).

I still make my own matzo balls...not strictly kosher...with melted butter, not margarine...for homemade chicken soup.

Dear hubby's lunch crony Geoff is from the U.K. and they make forays into neighboring towns to indulge in authentic Indian and Middle Eastern cuisines. They also visit and purchase exotic foods from the many food markets; we have large diverse ethnic populations in my County.

“Kojel” kosher gelatin was always available at the market, which I believe was parve (made with a vegetable gum).

KoJel switched to a parve formulation in 1986, according to their OU blurb.

@ Narad: Would you believe I was a kid growing up in Brooklyn in 1986? Nah, my "kid years" were the 1950s.

Here's the OU link for Kojel. Was it made free of pig products before that...similar to the halal gelatin link provided Roger Kulp?

Was it made free of pig products before that…

Probably cattle bones or hides, if the Rabbi Sheinkopf mentioned is this one. Allow me to emphasize that I am neither a competent halachic authority, nor do I play one on RI.

I made the mistake of introducing my son's friends to well-made pierogies. Now the normal box of them (I cheat and buy them frozen) isn't enough if anyone happens to catch me making them as a comfort food meal. Last time I got exactly two! LOL

Never heard of the tower of green jello trick before. When I was a girl there was something we called "yucky salad." I think it's real name was "Five Cup Salad." The first time we hated it, but it grew on us. It included lime jello, cottage cheese, celery, walnuts and pineapple chunks, I think. Once it grew on us we couldn't get enough of it. When my stepmom got tired of making it she finally started pulling the "you always called it yucky" card and refusing to make it anymore. I should email her for that recipe!

@Lord Draconis - I very humbly appreciate your invitation, and will have to ask DW for information regarding proper application background checks, etc. Thank you so much!

Fascinating - I typed my comment, was told I did too many comments, too soon (sorry, just had to) and when I refreshed on another page Narad had a very recent post - any chance the "commenting too fast" is actually ANY comments and the blog can't differentiate and if two are submitted nearly simultaneously it sends that message?

Actually, it looks as though it was that Rabbi Sheinkopf's father who originally gave KoJel his approval.

any chance the “commenting too fast” is actually ANY comments and the blog can’t differentiate and if two are submitted nearly simultaneously it sends that message?

The only thing it can't differentiate is its ass using both hands.

Mrs Woo @7:33 10 Jun

“yucky salad.”

That was my son’s reaction to his grandma’s green jello (and he had asked for a lot of it because he liked how it looked). After reminding him not to call his food “yucky,” I had to explain to grandma that’s he’s just not a fan of citrus (or anything acidic for that matter). It didn’t have as many things in it as the one you describe.

@7:34 the posting too fast thing seems to hit somewhat random.

At the risk of *revealing* my age...does anyone remember Junket desserts?:

http://www.junketdesserts.com/junketmemories.aspx

My mom used these Junket powders (Raspberry, as I recall), to make desserts. She was a great cook and a great baker, as well. We had homemade tapioca and bread puddings, in addition to the Junket desserts and made-from-scratch pies. (I should have been more attentive, when she prepared her yeast dough for rolls and yummy desserts).

Narad, I assumed you were Jewish...yet you had a Lutheran aunt. I was brought up as a Lutheran-Missouri Synod and was a "product" of a mixed marriage (Mom was Roman Catholic).

I am fascinated with dietary restrictions and religious customs of the various religions that my friends adhere to. Most of my Jewish friends were brought up in homes that "kept kosher". Some have continued those traditions and others have returned to the kosher traditions of their parents' homes.

I also have close friends who are Muslim and who are Hindu (born in Guyana, educated in the U.K. and who prepare food that is a mixture of Indian and Caribbean cuisine).

lilady: "mixed marriage"? I've heard the Lutheran church described as "Catholic Lite" and "Catholic without the guilt."

My comment @8:15 lost an "at" before random and I'm unsure if the correction went into moderation or into the ether.

Narad, I assumed you were Jewish…

No, but my best friend and fellow foodie, who passed far too young, was orthodox. I learned a fair amount simply as a matter of mutual respect. (And was given a rabbinical pass a couple of times to serve as a galley assistant for some large-scale, albeit vegan, cooking operations.)

OK, I can't resist; while I do not bake, I nevertheless manage to concoct desserts that people really like through the process of *assemblage*. I gather together mostly ready-made products that people like and arrange them together artfully.

One requires a deep glass bowl and involves cubes of sponge cake, custard or vanilla pudding, raspberries, jam, liquer ( Grand Marnier or Amaretto ) layered with mountains of whipped cream in layers.

The other makes use of sweet crumbs at the bottom of a pie plate and softened ice cream which then is layered with caramel sauce, ground almonds, chopped dried cherries, a liquer to match whatever ice cream you choose and mountains of whipped cream on top. You choose according to what your audience prefers- e.g. add semi-sweet chocolate pieces or toasted coconut.- candied orange peel.

People can be fooled into thinking you have culinary flair. Trust me on this.

By Denice Walter (not verified) on 10 Jun 2012 #permalink

People can be fooled into thinking you have culinary flair. Trust me on this.

It seems to have worked spectacularly for the sponge fishermen who (Wikipedia informs me) came up with Key lime pie.

I read an article some time ago about how/why there are more autism and other related developmental problems these days.

Part of it is because persons with certain gene traits are coming together more easily and frequently.

I'm going to make it sound bad, but I can't cite the original article or make it sound PC. But weak bodies, strong minded nerdy/geeky types are converging and breeding with one another. This brings more of those genotypes together and make it more likely to produce children with learning disabilities, etc.

If you even look at the groups of people affected and trying to "find a cure" you'll find that they are from more intellectual tech type communities.

Actually I thought they still sold them. They don't?

I remember them - couldn't it also be used as an ice cream mix? I swear there was a Junket ice cream mix back in the day...

@Denice - I think my sister has made that before... Then again, she gave us margaritas for breakfast one year on Christmas Eve morning. I found it slightly confusing...

Oh, man, I might even have the cookbook that goes with this Galloping Gourmet synchronicity bomb, as I was a collector for some time:

Episode Detail: Ate and Chongo - The Galloping Gourmet
Two desserts from Mexico are prepared, one a custard-style vanilla and sugar dessert, the other a gelatin pineapple confection.

The latter is indeed rennet-based, viz., junket.

"Former," sorry.

@ Chemmomo: Clever....Missouri Synod Lutherans especially, are close to Catholic. So what did I do? Why, I married a Catholic in a civil ceremony. Daughter, went to a private Catholic high school and the nuns were unaware that she wasn't Catholic, until she couldn't recite the rosary, at morning prayers. She quickly learned all the required prayers in Latin and in Spanish, as well as English. Gee, once she graduated, I missed the daily early AM telephone calls from the dean, Sr. Kathy. Kathy had my number on speed-dial because my daughter was always showing up with make-up or hoop earrings and always with her uniform skirt rolled up.

Narad, I make a not too shabby charoset and my potato pancakes are requested frequently for Chanukah parties.

Denice, it appears that you are serving up English trifle desserts...now if we could only find you a simple made-from-scratch custard...for your trifle.

Let's face it guys, we truly are foodies.

lilady: I can't take the credit. I'd hit "submit" before I realized I'd left out the fact that both statements were made by friends raised Lutheran (and at least one is definitely Missouri Synod). And with the slow down you're posting too quickly already operating I did not correct myself.

My own mother's marriage was a bit more mixed, as she is a Roman Catholic who married a Jew. And was widowed and remarried to someone nominally Lutheran (and they've been known to attend separate seriveces at Christmas and Easter).

I myself have gone through both RCIA and the Missouri Synod education class, and I have to say I agree with the statements I quoted. Which is all I'm going to say about it.

Your comments about your daughter makes dread me when my own gets to high school. She follow rules now. . . what am I in for later?

@ Chemmomo: Aside from the Anglican Church, the Lutheran church is the closest you can come to Catholicism. Looking back on my upbringing, I think my mother instilled in me and my siblings a humanist faith.

"Your comments about your daughter makes dread me when my own gets to high school. She follow rules now. . . what am I in for later?"

I didn't mean to scare you about your daughter's upbringing. My daughter was the "perfect child"...really...until she was ~13 years old. Why do you think I sent her to the nunnery?

As you know, I had a very disabled son and so much of my time and energy was devoted to his care and his medical crises, so it was a "healthy" natural reaction for my daughter to act out some of her frustrations. The high schools in my suburban school district were ultra liberal and permissive, which would fit right in with daughter's ability to knock down decent grades with little or no effort. I wanted her to be challenged intellectually and to have the academic discipline that I experienced in the New York City public high school that I attended years before. The private Catholic school was a "better fit" for my daughter.

Don't concern yourself with your daughter's future...just expect that she, like most kids, will have a period of acting out (now labeled as "oppositional behavior") It is a frustrating time for parents but an emotionally healthy time for teens who are just showing some independence in preparation for adulthood.

P.S. She still didn't "perform" up to her capabilities throughout high school and college, but managed to matriculate into a top tier engineering school for a MS-Computer Science/Global Technology with a 4.0 average. She's a V.P. at a major international bank.

Mrs Woo, don't sell yourself short. You are proving to be an excellent minion.

By Sid Offit (not verified) on 10 Jun 2012 #permalink

Liz Ditz' comment was in moderation so I've only just seen it:
this is the best comment on the silly fish paper yet, from Sullivan on twitter

The main reason for exposing fish to SSRIs is to give them the peace of cod that passeth understanding.

By herr doktor bimler (not verified) on 10 Jun 2012 #permalink

MESSAGE BEGINS---------------------

SURRENDER SID:

Oh, silly, whimsical, bitter Sid, leave our freshly minted Minion Woo alone (the irony of that name is so delicious). Relax, loosen those polyester Sans-a-belts and come over to the winning side. We have the Sooper Seekritå™ Kures for cancer, we shower you with the finest lucre that pharma can buy, we throw the best parties (who do you think funds Burning Monkey?), the Rothschilds make sure we have the rarest of rare of wines, and you know we have the best drugs.

Peace, little man, resistance is feudal.

Lord Draconis Zeneca, VH7iHL
Foreward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Recipient of the Imperial Order of the Crossed Glow-Sticks

PharmaCOM Orbital
00000000000000100001000000010000000011

------------------------------MESSAGE ENDS

By Glaxxon Pharma… (not verified) on 11 Jun 2012 #permalink

The county just north of us hosts a fair number of farmers who are Apostolic Christians (I suppose one could call them Amish Lite). One of them owns a grocery store where you can still buy stuff like rennet, and samp. I think I remember seeing junket on their shelves; I'll have to check.

@Anthony:

I read an article some time ago about how/why there are more autism and other related developmental problems these days.
Part of it is because persons with certain gene traits are coming together more easily and frequently.

Was it the one written by Michael Hanlon? It was originally printed in the Daily Mail. The Star (Johannesburg's main daily newspaper) also ran it. I was so unhappy with it I wrote in and my letter was published.
The article mentioned Simon Baron-Cohen's hypothesis of "Assortative Mating". I criticised that in my letter as well.

By Julian frost (not verified) on 11 Jun 2012 #permalink

herr doktor bimler: "In fact Croen &c measured the adjusted odds ratio which is not the same as risk In their words,
mothers of children subsequently diagnosed with ASD were twice as likely to have at least 1 antidepressant prescription in the year prior to delivery of the study child
– the increase in *risk* works out to much smaller."

Are you referring to Croen et al, Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry 2011;68:1104-12? This case-control study reported prenatal exposure to antidepressants in 3.3% of the control children and 6.7% of the ASD children, or twice as many. But according to the abstract (available on PubMed), there was "a 2-fold increased risk of ASD" associated with SSRI use during the year before delivery (adjusted odds ratio, 2.2, with an adjusted odds ratio of 3.8 associated with use during the first trimester). No increase in risk was observed for mothers who had had mental health treatment but were not using SSRIs.

Since these authors claim a doubling of risk in their abstract, what is the basis for your claim that increased risk "works out to much smaller"?

Here's a link to Croen et al.:
http://archpsyc.jamanetwork.com/article.aspx?articleid=1107329

They calculate an odds ratio -- the likelihood, given an antecedent (autism), of observing a precedent (maternal consumption of SSRIs). This is not the same as the risk. This is not the same as "risk" (the probability, given a precedent, of observing an antecedent).

Since these authors claim a doubling of risk in their abstract
It is not my fault if they misrepresent their work in the Abstract and their press releases.

By herr doktor bimler (not verified) on 12 Jun 2012 #permalink

Wikipedia:

Odds ratios have often been confused with relative risk in medical literature. For non-statisticians, the odds ratio is a difficult concept to comprehend, and it gives a more impressive figure for the effect.[..] A study of papers published in two journals reported that 26% of the articles that used an odds ratio interpreted it as a risk ratio.[12]
This may reflect the simple process of uncomprehending authors choosing the most impressive-looking and publishable figure.[13] But its use may in some cases be deliberately deceptive.[14] It has been suggested that the odds ratio should only be presented as a measure of effect size when risk ratio can not be estimated directly

By herr doktor bimler (not verified) on 12 Jun 2012 #permalink

The only time you can use OR to estimate RR is if the outcome/disease/condition is very rare. That's because of the math. Other times, I suggest you look for other measures of association. But what the heck do I know?

As much as I loathed my epi class, it was invaluable in my studies.

Ren, you've got both my admiration and my sympathy for being an epidemiologist.

In Croen et al's methods, they claim: "Unconditional logistic regression analysis was conducted to estimate unadjusted and adjusted *relative risks* of ASD associated with antidepressant use..." [corrected for various factors]. In their results, they report: "When compared with women with no antidepressant prescription during this period, women with a prescription for an SSRI were more than twice as likely to have a child later diagnosed with ASD (any SSRI: adjusted odds ratio [AOR], 2.2 [95% confidence interval {CI}, 1.2-4.3]; SSRI only: AOR, 2.6 [95% CI, 1.3-5.4]); no association was seen for the small group of women who were prescribed a non-SSRI antidepressant only."

These authors explicitly state that they calculated relative risk and report that they found increased risk, as herr doktor bimler defines it above, i.e., that given that a woman takes an SSRI, the probability that she will then have an autistic child is higher. They do simultaneously throw in the term "odds ratio" as if it means the same thing. Almost all of us who are not statisticians assume that it does, since in common English "odds" means the probability that an event will happen ("antecedent" also has quite a different meaning in ordinary speech). It would have been nice had the journal made them clarify this language; perhaps the reviewers and editor didn't know any better than the authors?

That doesn't change the fact that (a) they claimed to find a doubling of risk, and (b) there are no numbers in the paper from which a reader could conclude that "the increase in 'risk' works out to much smaller." Ren tells us that if the outcome is rare, the odds ratio and relative risk will be similar. The Wikipedia example of very divergent odds ratios and relative risk is of one in which one group has a 90% probability of something, and the other a 20% probability. Seems to me that autism will be closer to the former category; if one's chances are, say, 0.8% without SSRI usage, that's relatively rare.

Jane notes that Croen et al (2011) report they found a "... a 2-fold increased risk of ASD associated with treatment with selective serotonin reuptake inhibitors by the mother during the year before delivery (adjusted odds ratio, 2.2 [95% confidence interval, 1.2-4.3])..." [from the abstract].

Not to pick nits, but what Croen et al actually found was that the risk of maternal use of SSRI's was higher in autistic children than in controls. This may seem a trivial difference, but it isn't. The cases in this case-control study were chosen not by maternal use of SSRI's but for a diagnosis of autism, so any results are predicated on this selection criterion.

If the authors had gone through the same Kaiser Permanente database looking for women who had taken SSRi's withing a year of delivery (a much harder search, it must be admitted), then they could have said that autism was a "risk" of SSRI use.

Although "Ren" would probably scream in horror at the thought, I decided to work backwards from the reported Croen et al results and get an estimate of what the relative risk (RR) would look like. To do so, I took the authors' reported percentages of maternal SSRI use and "Jane's" 0.8% autism prevalence to come up with a "first approximation" RR of 1.8, which admittedly isn't too far from the OR reported by Croen et al.

Another issue I see is that SSRI's are generally in pregnancy category "C" or "D", meaning they shouldn't be used unless there are compelling issues of maternal health. This suggests a confounding variable: the association of autism and a family history of depression or OCD (two conditions where SSRI's are commonly used).

By using autism as the selection criterion, the authors may have inadvertently selected for families with a higher risk of not only autism but also depression, OCD and - indirectly - SSRI use. In short, the study may have shown nothing more than the already known facts that autism, depression and OCD tend to be familial and that SSRI's are used to treat depression and OCD.

Food for thought?

Prometheus

By Prometheus (not verified) on 13 Jun 2012 #permalink

there are no numbers in the paper from which a reader could conclude that “the increase in ‘risk’ works out to much smaller.”

Point taken. I retract the word "much". We know that the risk ratio is smaller than the odds ratio that is calculated, but how much smaller it is depends on information not provided.

the authors may have inadvertently selected for families with a higher risk of not only autism but also depression, OCD and – indirectly – SSRI use.

They do acknowledge that possibility, and attempt to factor out psychiatric condition as a confound.

By herr doktor bimler (not verified) on 13 Jun 2012 #permalink

One of them owns a grocery store where you can still buy stuff like rennet, and samp.

It was a mere 15 years ago that I could get saltpeter from the local pharmacist.

And it was a mere 30 years ago that I was listening to (and forutnately not believing) the stories that everything we consumed in Marine chow halls was laced with saltpeter. I'm not sure why but I think it had something to do with preventing the dangers of propinquity.

What I don't understand is the extreme concern about polluting their children's bodies with the minuscule amount of anything that could be found in a vaccination. Are we not exposed to way more chemicals -- many of which are actually harmful -- just by breathing the air in our homes, walking around outside, eating food, and just going about our lives, every single day? Even breast milk -- something that you would think would be the most pure substance you could put into your infant's body -- is tainted with hundreds of industrial chemicals. I think their concern over vaccination chemicals is seriously misdirected.

@JessE

What I don’t understand is the extreme concern about polluting their children’s bodies with the minuscule amount of anything that could be found in a vaccination.

In part, I think it's a fear of needles. Second to that, it's that vaccination is a deliberate act. Much like people who are terrified of flying in planes but have no qualms about driving in a car, it's easy to be scared of something that is unusual and complacent about the familiar.

In part, I think it’s a fear of needles. Second to that, it’s that vaccination is a deliberate act.

I am sympathetic to the notion that it's just plain spooky. One is doing something in the hope that nothing will happen and also generally has no idea how this works.

I agree that it is "scary" is because you cannot know what is in the needle. If someone argues "you don't really know what is in the capsule, either," that is true, but we have a long history of putting things in our mouth and swallowing them and surviving the experience.

I have been very relieved - Mr Woo attempted to derail vaccination of most recent grandchildren after we were told one of the grandchildren might be on the spectrum. Very fortunate that the mother of the next grandchild born just happened to be a pediatric nurse with a level head. When he survived his vaccinations and remained a bright, fun and normal toddler Mr Woo quit trying so hard to save future generations from the needle...

Something happened to my old laptop that I use away from home. The cookies are gone, so the comments are from the past.

Though this seemed like an appropriate comment to post on, since I recently had this video used in another blog to show us the "errors of our ways." I had to ask why the youtube page deletes comments, and does approve others. Especially the ones that actually show the real data.