Wednesday, 31 December 2008

Pediatrics publishes a critique of an "anti-vaccine" book

I've tended not to write anything about vaccines, partly because it's a long way from my field of expertise, and partly because it brings out the internet loons in greater numbers than almost anything else. Still, I ran across this via Ben Goldacre's miniblog, and it overlaps with my interest in scientific publishing: Pediatrics, the official journal of the American Academy of Pediatrics, has published an article by Paul Offit and Charlotte Moser. The article is highly critical of "The Vaccine Book: Making the Right Decision for Your Child", by Dr. Robert Sears, also known in media-friendly mode as Dr. Bob in his role as one part of "America's family of pediatricians". This is something that I haven't seen before: the journal of a learned society publishing a rebuttal of a popular health book. The article goes through Dr. Sears's book, and picks out misleading statements, flawed logic and questionable assumptions, particularly concentrating on the alternative vaccine schedules suggested in the book.

It seems unlikely that worried parents will pick up this article; they are much more likely to read the book. But perhaps by putting these arguments in one place in Pediatrics, it makes it easier for pediatricians themselves to counter the arguments against vaccines that they hear from parents. It might even be possible to give parents the article to look through. And many of the arguments in Dr. Bob's book ARE arguments against vaccines, in spite of the protestations of Dr. Bob himself. The paper is not written in overly technical language, although it does contain a lot of references that are unlikely to be easily available to the average concerned parent. It gives pediatricians a chance to say that actually mainstream scientific opinion does not agree with Dr. Bob. This is unlikely to do much to sway those who've drunk the anti-vaccine kool-aid and think that Dr. Offit is an unscrupulous shill of big pharma, willing to cause lasting harm to untold numbers of children in order to make money (just do a google search to see what I mean). But it might sway sensible people who have inevitably picked up doubts from the unbelievably incompetent reporting of the science surrounding vaccines in the media.

Perhaps it could be worth putting a similar article debunking the myths on MMR into something like the BMJ or the Lancet? Or perhaps something similar already exists and I've missed it?

Friday, 12 December 2008

News on latest Homeopathy submission

A while ago a submitted a comment to the journal Homeopathy, discussing a paper published in the journal by Rutten and Stolper, claiming to find a number of serious flaws in the Shang et al. meta-analysis that appeared in the Lancet in 2005. I had a slightly cryptic e-mail back from the journal last week:

Dear Dr Wilson,

Thank you for sending us this article. We have sent the article to the authors for comment.

We will be in touch again shortly.

I assume that means that the comment will be published, with a reply by the authors. I'll be interested in what they have to say, because at this point some of the errors in their paper seem to be indefensible.

Post #100, and what Wilson is up to

The previous post on Manchester's congestion charge was the hundredth post on Hawk/Handsaw. I'd celebrate with a beer, if I hadn't come back from fieldwork in Egypt with some friendly bacteria that are currently restricting me to soup and toast.

For those how are interested in what I'm doing, I've just completed my first post-doctoral project at the University of Manchester. The first paper from that work now has a DOI number and is available as an "accepted manuscript" at the Journal of Structural Geology website (behind a paywall, I'm afraid: if anyone is desperately interested and can't access it, e-mail me and I can bung you a PDF).

I will be starting a new project in January, still based at Manchester, working on sub-surface data from the North Sea. I'll be sponsored by StatoilHydro, so I'll be doing a fair bit of work at various StatoilHydro offices in Norway, starting in Harstad in late January. It's a three year contract, so I have a bit of stability. The plan is to get more papers out, and try for lectureships towards the end of the project.

Manchester says No!

The results of Manchester's referendum on congestion charging and improvements to public transport are in, and they could hardly be clearer. According to the Guardian, 79% of respondents said no, on the back of a 53% turnout. That's close to a general election level of turnout around here. Although the Yes campaign claimed that 9 out of 10 people would not pay the charge, around 4 out of 10 people decided that they didn't want it.

I have distinctly mixed feelings about this. Mostly, I'm disappointed; after all, I did vote yes myself. That's easy for me: I don't own a car, walk to work, and rely on public transport to get around Greater Manchester. The congestion charge would cost me precisely nothing. According to the No campaign, it would work out at £1200 a year for those who would have to pay the maximum amount. It's clearly a regressive tax, and that is not a small amount of money for people who are already struggling to make ends meet. Of course, that's the point: the charge wouldn't work if everyone could easily afford it.

For me, the most important thing about the proposals was the improvements to public transport. There is no doubt that these are needed. Some of them, such as extensions of the Metrolink tram system to Oldham and Rochdale, will happen anyway. But I suspect we will be stuck with an unreliable and expensive (deregulated) bus service for a long time to come.

The problem is that, in the words of the Yes campaign, "there is no plan B". That being the case, it seems crazy to put the question to a referendum. Saying that you either agree with these proposals or you get nothing is hardly a democratic way of posing a referendum question; it's a pretense of democracy. It would have been more sensible, and democratic, to either have our local representatives on the Manchester Council decide to implement the proposals come what may, or have a referendum in which there was a genuine choice of competing proposals.

Improvements in public transport are a good thing, but on their own they will not reduce car use. Driving will always be more convenient than taking the bus, unless there are clear disincentives for car use. It seems that congestion charging is a political impossibility in Manchester, at least right now. An alternative might be to make driving in the city less convenient, by restricting parking, restricting access to certain streets, etc. This would have the advantage of not stinging the poor with another regressive tax. What is clear is that doing nothing is not an option in the long term: it's back to the drawing board for Manchester's transport policy.