tag:blogger.com,1999:blog-137597932024-03-23T11:20:27.717-07:00A Photon in the DarknessA collection of random thoughts from someone who has spent much of their life trying to bring illumination where there is darkness and ignorance. Like Prometheus, the author has found that no good deed ever goes unpunished!Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.comBlogger98125tag:blogger.com,1999:blog-13759793.post-25159335779937820862007-09-02T18:48:00.000-07:002007-09-02T15:53:23.486-07:00Moving DayI've decided, based on expert advice from a number of people, to move my 'blog. It will from now be found at:<br /><br /><br /><br /><a href="http://www.photoninthedarkness.com/">http://www.photoninthedarkness.com/</a><br /><br /><br /><br />I'll keep the current 'blog in place for a while to allow time for everybody to notice that I've moved and update their bookmarks and links.<br /><br /><br /><br />Come on over and see the new Photon in the Darkness 'blog!<br /><br /><br /><br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.comtag:blogger.com,1999:blog-13759793.post-28339996681943742742007-08-24T13:00:00.000-07:002007-09-02T15:48:47.938-07:00Myths and Legends of Autism: Part 1<b><u>The Myth of the Poor Excretor</u>:</b><br /><br />Myths have traditionally been invented to provide explanations for phenomena that were beyond the understanding of the people who made them. Thus you have <a href="http://www.pantheon.org/articles/h/helios.html">fiery chariots carrying the sun across the sky</a>, <a href="http://www.thekeep.org/~kunoichi/kunoichi/themestream/apep.html">serpents swallowing the sun during an eclipse</a>, <a href="http://www.meta-religion.com/World_Religions/Ancient_religions/Europe/norse_creation_myth.htm">the world being created between fire and ice</a> or the many myths of the <a href="http://en.wikipedia.org/wiki/Cargo_cult">Cargo Cult</a> in New Guinea and Melanesia.<br /><br />Another reason for people to invent myths is to deal with unpleasant truths that they wish to ignore. This impulse has given rise, in more modern times, to “<a href="http://www.talkdesign.org/faqs/icdmyst/ICDmyst.html">irreducible complexity</a>” and the <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12933322&ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">Myth of the Poor Excretor</a>.<br /><br />The original impetus for the Myth of the Poor Excretor was the finding, by a number of practitioners involved in “alternative” autism therapies, that autistic children often had <i>low</i> hair mercury levels, which conflicted with their firmly held belief that autism was due – at least in part – to mercury poisoning.<br /><br />When <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12933322&ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">Holmes <i>et al</i> </a>completed a study of 94 autistic children and 45 age- and sex-matched controls and found that autistic children had significantly lower hair mercury levels, there were only three conclusions they could reach:<br /><br />[1] Mercury protected children from autism.<br /><br />[2] The hair mercury tests were screwed up.<br /><br />[3] Autistic children don’t excrete mercury into their hair.<br /><br />Choice [1] is strongly counterintuitive, but should not be discounted out of hand solely for that reason, since much that is true in science goes against our best intuition. Choice [3] is contrary to decades of research data on mercury metabolism in mammals and so is clearly wrong. Choice [2] appears to be the most likely explanation.<br /><br />Unfortunately for the authors, the only choice that doesn’t either nullify their hard effort (as [2] would) or contradict their immutable belief that mercury causes autism (as [1] would), is the only choice that is clearly <i>wrong</i>. Instead of abandoning their immutable belief that mercury causes autism - as their data would suggest - they invented the Myth of the Poor Excretor.<br /><br />According to this myth, autistic children are unable to excrete the mercury they receive from the environment and – more importantly – their childhood vaccines. As a result – so goes the myth – they accumulate the toxic metal and become autistic. It’s a compelling tale, except that it’s complete rubbish.<br /><br />If you read the study, you will find that this “hypothesis” of "poor excretion" arrives on the scene like a <i><a href="http://en.wikipedia.org/wiki/Deus_ex_machina">deus ex machina</a></i>, without any data supporting “poor excretion” in autistic children – except for their low hair mercury levels, which can be better explained in other ways - and no data supporting the implied idea that mercury accumulation in hair can be impaired by any means - apart from cutting off the blood flow to the scalp.<br /><br />There are also no citations of the scientific literature to show that this “hypothesis” is supported by the researches of other scientists. There is not even any mention of how this “hypothesis” flies squarely in the face of decades of research into mercury metabolism and how that might be reconciled.<br /><br />In other words, it appears to have been made up out of thin air to keep the authors from having to abandon their cherished belief that mercury causes autism.<br /><br />Now, it may be true that mercury causes autism in a small number of children – the currently available data is not able to eliminate that possibility. But that is a <i>long</i> way from saying that mercury <i>does</i> cause autism. And the Holmes <i>et al</i> study does nothing to support either the claim that mercury causes autism <i>or</i> that autistic children are “poor excretors” of mercury.<br /><br />As it turns out, there has been a fair bit of research into the distribution of mercury – both organic and inorganic – into hair. Stuides by <a href="http://www.jstage.jst.go.jp/article/tjem/210/4/301/_pdf">Yasutake and Hachiya (2006)</a> and <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8920740&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">Wilhelm, Muller and Idel (1996)</a> have clearly shown that hair mercury levels are proportional to blood mercury levels at the time the hair is growing. <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=2335158&ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">Shi, Lane and Clarkson (1990)</a> showed that the uptake of mercury by hair was dependent on hair growth.<br /><br />And 'way back in 1986, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3569185&ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">Mottet, Body, Wilkens and <i>Burbacher</i></a> showed that the amount of mercury in the hair depended primarily on the amount of mercury in the blood. They also found that the ratio between blood and hair mercury was constant over a wide range of doses and between animals.<br /><br />But, even with <i>all</i> of this evidence available to them, the Holmes <i>et al</i> authors chose instead to create the Myth of the Poor Excretor. Like most denialist myths (myths invented to ignore unpleasant truths), the survival of the myth depends largely on the existence of a large number of people who <i>also</i> don’t want to face reality. For whatever reason, that pool of people exists and the Myth of the Poor Excretor has persisted to the present day, some four years after its invention.<br /><br /><br />Next: The Legend of the Maverick Doctor(s)<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com0tag:blogger.com,1999:blog-13759793.post-65824045704744548272007-08-20T13:33:00.001-07:002007-09-02T15:48:13.166-07:00Another Nail in the Coffin...Although I have begun to despair that the "mercury-causes-autism" hypothesis can ever be killed, a recent study by <a href="http://www.pnas.org/cgi/content/full/104/31/12831">Zhao <i>et al</i></a> has driven another nail into its coffin.<br /><br />In their study - "A unified genetic theory for sporadic and inherited autism." - the authors describe exactly how spontaneous mutations could cause both sporadic autism (autism in families without a family history of autism) and familial or inherited autism.<br /><br />You see, this has been the <i>real</i> mystery in autism (not the <i>faux</i> myteries of "poor excretion" and "mercury poisoning") - how families with inherited autism can show the same mutation in all affected members yet <i>not</i> have the same mutation as <i>other</i> families with inherited autism (for example, see <a href="http://www.blogger.com/http//www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12721956">here,</a> <a href="http://www3.interscience.wiley.com/cgi-bin/abstract/76502505/ABSTRACT?CRETRY=1&SRETRY=0">here</a>, <a href="http://www.springerlink.com/content/k5k7r831w0536535/">here</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17436248&ordinalpos=42&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">here</a> and <a href="http://www3.interscience.wiley.com/cgi-bin/abstract/112398430/ABSTRACT">here</a>).<br /><br />The answer, it appears, is that females with mutations associated with autism may be resistant to developing autism. Why this is so is not yet clear, but it has been shown pretty conclusively. These women may have one of the <i>many</i> mutations that cause autism but they do not develop the disorder themselves.<br /><br />However, even those who don't develop autism are still <i>carriers</i> of that genetic mutation and (on average) 50% of their sons will receive that the mutation. Of the sons receiving the mutation, a high percentage of will develop autism. Additionally, about 50% of their daughters will also get the mutation, although only a few will develop autism (all who receive the mutation will be carriers).<br /><br />This, of course, is not the entire story, but it is a reasonable lay summary of the article.<br /><br />For those people who will immediately say, "Aha! It's those nasty chemicals/viruses/cell phones that are causing mutations in our children!", let me point out one thing:<br /><br />The mutations are in the <i>germ cells</i> (<i>i.e.</i> sperm and eggs) of the <i>parents</i> of the autistic children. For these mutations to happen in a child and cause autism, it would have to happen at the single-cell stage (immediately after fertilization).<br /><br />I encourage people to <i>read</i> the article for themselves - it's available free online. Don't just take <i>my</i> word for it. It's not an easy read, but even if you can't understand it all, you should come away with the idea that [a] this looks less and less like a simple case of "environmental toxicity" and [b] it is a <i>much</i> more complex issue than many of the autism "advocates" would have you believe.<br /><br />Happy reading!<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com8tag:blogger.com,1999:blog-13759793.post-7563987709934324572007-07-30T17:15:00.000-07:002007-09-02T15:47:52.996-07:00How Science WorksFrom reading what many of the vaccines/mercury/”toxins”/whatever-causes-autism promoters have written about the science of autism, it is clear that most of them have only the vaguest idea of what science is and how it works. Here is what I hope will be a clear and concise “debunking” of some of the more pervasive “myths” about how science works.<br /><br /><br /><b><i>Vox populi:</b></i><br /><br />One of the most commonly repeated misconceptions is that scientific “facts” (what scientists refer to as “generally accepted theories of reality”) are determined by popular vote. Thus you see many of the so-call autism advocates crowing about how many people “believe” their particular line of nonsense.<br /><br />Unfortunately for them, reality has shown itself supremely indifferent to majority rule. For thousands of years, the majority of people were convinced that the world was flat, but that had no effect on the spherical nature of the world. For hundreds of years, the majority of people thought that the Sun revolved around the Earth – which had no effect on celestial mechanics.<br /><br />So, even if seven thousand people think that Andy Wakefield’s thoroughly disproven hypothesis about measles vaccine causing autism is true, that will have <i>no</i> impact on the ability of the vaccine strain of measles to cause autism.<br /><br />The sad fact is that the purpose of science is to <i>discover</i> the underlying realities of nature, <b>not</b> to confirm our most cherished hypotheses. When people (even people calling themselves “scientists”) set out to prove themselves right, they often <i>overlook</i> the data that show they are wrong. <i>That’s</i> why it’s so important to have <i>independent</i> confirmation of results.<br /><br />In the end, it not the “voice of the people” that determine whether a hypothesis lives or dies, it is the “voice of the data”.<br /><br /><br /><b>Authority figures:</b><br /><br />As the Autism Omnibus Proceedings have shown, there are experts and there are “experts”. The plaintiffs, so far, have had the latter. It is passing strange that the people who are generally so dismissive of the findings of doctors and scientists are so willing to blindly accept whatever <i>their</i> doctors and <i>their</i> scientists say without question.<br /><br />The Omnibus Proceedings <i>should</i> have been a golden opportunity for the parents following the advice of these “experts” (the ones who have “…found the truth…” about autism) to see how their knowledge compared to that of “mainstream” scientists (you know, the ones who are too hidebound to see the plain truth of how measles vaccine/mercury/”toxins”/immune disorders/gut problems/etc. <i>clearly</i> causes autism). It should have been, but for the vocal minority, it wasn’t.<br /><br />Part of the problem with authority figures in autism is that the majority of parents – the <i>grand</i> majority, in all liklihood – have no idea <i>what</i> these experts are talking about. Here’s a little quiz to find out which camp you are in:<br /><br />[1] If a child has a “damaged” immune system that is unable to “fight off” a viral infection (<i>e.g.</i> the attenuated vaccine strain of measles), what would be the effect of giving that child corticosteroids?<br /><br />(a) The child will improve.<br />(b) The viral infection will worsen, making the child more ill or even dead.<br />(c) No effect<br /><br />[2] When using polymerase chain reaction (PCR) to amplify the genetic material of a measles virus strain, what is the purpose of the reverse transcriptase (RT) step?<br /><br />(a) It is an optional step, used in “mainstream” science only.<br />(b) It creates more false negative results.<br />(c) It copies RNA into DNA<br /><br />[3] To which of the following does ethylenediamine tetraacetate (EDTA) bind with the <i>least</i> strength?<br /><br />(a) mercury<br />(b) calcium<br />(c) magnesium<br /><br />(Answers: b, c, a)<br /><br />I bring this up because a number of parents I have spoken with about the Omnibus Proceedings have <i>no idea</i> why it was so important that the O’Leary lab had failed to do the RT (reverse transcriptase) step when they were testing for measles virus. To them, it was just another piddling technical detail that was essentially meaningless. To <i>me</i>, on the other hand, it was proof positive that the O’Leary results were baloney – nothing more than contamination and poor technique.<br /><br />You see, the measles virus doesn’t use DNA for its genetic material, it uses RNA (single strand, negative sense) and does not go through a DNA intermediate (unlike the retroviruses). And the PCR process doesn’t amplify RNA, only DNA. So, the only way to amplify measles genetic material is to first copy it into DNA (<i>via</i> reverse transcriptase) and <i>then</i> amplify the DNA copy (cDNA).<br /><br />In fact, one of the checks routinely done to rule out the possibility of contamination (or poor primer selection) is to do the test without the RT step. If you get a positive result, you know that you have a problem.<br /><br />The O’Leary lab <i>clearly</i> had a problem.<br /><br />So, what are parents to do if they lack the specialized knowledge to judge for themselves if the “experts” know what they’re talking about? Unfortunately, relying on your “gut feeling” is probably <i>not</i> the way to go. My experience has been that <i>true</i> experts in a scientific field are often not the most personable, easy to like people in the world. Some, in fact, are not good with people.<br /><br />Salesmen, charlatans and confidence men, on the other hand, are <i>marvelous</i> with people. They have to be – it’s their livelihood. Now, this isn’t to say that a reliable expert can’t be personable and easy to trust – that’s not true. But you can’t rely on an person's charm and charisma to inform you about their accuracy.<br /><br />What it often comes down to is going with the crowd. The more people who are well-informed about the field that agree with the “expert” in question, the more likely that “expert” is to be accurate. Sad to say, but the maverick who turns his back on the majority of his scientific peers is <i>usually</i> wrong. The <i>very few</i> who have turned out to be right tend to overshadow – in the public’s eye – the thousands who were wrong and simply faded into well-deserved obscurity.<br /><br />One sporting gentleman on the mercury-causes-autism side has said that betting on the maverick is a long-shot with a tremendous payoff. How I wish it were so. In fact, most of the “mavericks” bucking the “mainstream” in the “alternative” autism world have already been shown to be wrong. Andy Wakefield is just one of many in that category. A more accurate analogy would be betting on a horse that has already been taken to the knacker’s and rendered into dog food, glue and baseball covers.<br /><br /><br /><b>Science by <i>fiat</i>:</b><br /><br />Another popular concept is that scientific reality can be legislated. This has been tried a number of times previously and has a dismal history. One of the most famous was the 1633 trial of Galileo Galilei, where he was forced, by threat of death, to recant his heliocentric hypothesis of the Solar system. A more recent one is the attempt by the Dover, Pa. school board to render Intelligent Design a viable hypothesis. It failed, as well.<br /><br />“Science by decree” appeals to those who are <i>absolutely</i> convinced that there is no possibility that they might be wrong. It was supremely ironic that Andy Wakefield, facing possible censure in the UK, quoted Vaclav Havel’s famous statement: “Seek the company of those who seek the truth and run from those who have found it.” Wakefield is so clearly one of those who have “…found it…” but is unable to see that.<br /><br />Science is not well suited to legislation because it needs the flexibility to change when confronted with new information. Laws must be repealed – a long and tedious process. Scientific theories and hypotheses are altered or discarded in a moment. If science needed to move at the pace of law, we would still be “texting” on parchment.<br /><br />A more practical problem is when <i>incorrect</i> science is enshrined in law (and what other kind would <i>need</i> to be legislated?). We all know that the true point of the effort to make a law out of bad science is so that somebody (maybe <i>many</i> somebodies) will get some money. This is not inherently bad – sometimes people <i>need and deserve</i> governmental assistance.<br /><br />But what happens when it becomes apparent that the legislated “science” is in error? What will the legislators say to those who entreated them to make the law in the first place? How receptive will they be to another group of parents who come to them, saying “Well, it turns out that vaccines <i>weren’t</i> the cause of autism and we need a bunch of money to research the <i>real</i> cause.” Do you think that any law maker is going to want to bring <i>that</i> before their peers?<br /><br />I think that everybody knows that if the various autism “advocacy” groups had the data, they wouldn’t need to do an “end run” around science (and, curiously, the courts) to the legislature. What they are saying, in essence, is: “We can’t convince scientists, we can’t convince the courts and we can’t even convince a majority of parents with our data, so we’re asking you to <i>force</i> everybody to say that we’re right.”<br /><br />And that’s what it <i>really</i> comes down to, folks - <i>force</i>. They’ve given up trying to prove their point; they’ve even given up trying to persuade the parents who haven’t already jumped on their bandwagon. Now they’re going to enlist the coercive power of the government to <i>force</i> you to pay them to do what they (the autism "advocates") think is <i>right</i>.<br /><br />Does that seem right to you?<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com15tag:blogger.com,1999:blog-13759793.post-829929290669963182007-07-18T23:05:00.000-07:002007-09-02T15:47:34.989-07:00Let's do a study!A reader wrote in with concerns that I was overlooking a key point of the abysmal telephonic autism "survey" - namely, showing how many unvaccinated children were available to study the interaction of vaccines and autism... or "neurological disorders" (AKA autism spectrum and ADD/ADHD).<br /><br />Actually, I think that the folks at the CDC and university medical centers all over the country (and in other countries) are <i>acutely</i> (even painfully) aware of the number of people who aren't vaccinated.<br /><br />What GR and other advocacy groups have been agitating for is a study comparing groups that don't vaccinate their children (<i>e.g.</i> the Amish, although they actually <i>do</i> vaccinate their children) with vaccinated children. The folks at GR are pushing for this <i>despite</i> the fact that their baloney "survey" showed no connection between autism and vaccination.<br /><br />Here are a few reasons why <i>that</i> study wouldn't work, followed by my own "modest proposal" for a study that <i>would</i> work.<br /><br /><b>[1] The unvaccinated population is not necessarily the same as the vaccinated population:</b> People who don't vaccinate their children may not be the same as those who do. In fact, studies have shown that those who <i>don't</i> vaccinate their children tend to be at either end of the socioeconomic and educational spectrum. It would not be valid to draw any conclusions about the impact of vaccines on autism (or ADD/ADHD) with such marked differences between the groups (apples and oranges).<br /><br /><b>[2] Selection biases:</b> Recruiting people for a study is one of the biggest sources of error, especially when looking for something that is a public controversy. You will tend to attract more people who believe in a connection than those who do not.<br /><br /><b>[3] Inadequate power:</b> If the GR survey is correct, about 3% of the overall population in the 4 - 17 year age range is completely unvaccinated. On the other hand, the prevalence of autism is only 0.65% in the same age range. It will be easier to detect a statistically significant difference in unvaccinated children between autistic and non-autistic groups than it will be to detect a difference in autism prevalence between vaccinated and unvaccinated children.<br /><br /><b>[4] Loss of useful information:</b> It would be a shame to spend the time and money to do a study and only be able to answer a single question. After all, if there is no connection between autism and vaccination - as the GR "survey" suggests - wouldn't it be nice to be able to "mine" the data for other possible connections? By looking for subjects based on their vaccination status, the only question that <i>can</i> be answered is whether there is a correlation between the two.<br /><br /><br /><b>My Modest Proposal:</b><br /><br />This is a study that could be done rather quickly and with a minimum of expense. It would eliminate many of the sources of bias and would fairly easily generate balanced study populations that would be a good match to most of the general population.<br /><br /><b>[a]</b> Contact a large HMO with actual facilities (<i>e.g.</i> Humana or Kaiser) and arrange to get access to their patient medical records. This is routinely done, although the HMO will want assurances that patient confidentiality will be maintained.<br /><br /><b>[b]</b> Obtain a list of patients with autism diagnosis in the proper age range (I would suggest 6 - 12 years).<br /><br /><b>[c]</b> Select one thousand of these patients at random. This would allow you to detect a difference if the prevalence of unvaccinated children is less than 1/3 that in the general population (alpha error level 5%, beta error level 5%). If the difference is less than that, you'll need to select more subjects.<br /><br /><b>[d]</b> Confirm the diagnosis by having a child psychiatrist or psychologist review the records.<br /><br /><b>[e]</b> For each of the remaining children, select a non-autistic control child from the HMO database that is of the same age, sex, geographical region, etc.<br /><br /><b>[f]</b> Determine how many of the children in each group have received all, none or some of their vaccinations (keep track of which vaccines, when, etc.). If the GR "survey" was right (a <i>very</i> big "if") about the number of children unvaccinated, each group should have around 30 unvaccinated children, unless there is a correlation between vaccination and autism.<br /><br /><b>[g]</b> If the autism and non-autism groups have statistically significant differences in their vaccination rates, <i>then</i> a correlation can be claimed. If the study shows no correlation, then the relative risk is less than 3. You'd have to have twice as many subjects to bring the minimal relative risk to below 2.<br /><br />Using HMO patients eliminates any issues of affordability (which is minimal) or access to health care. Although the population of people who have HMO coverage is not necessarily the same as the overal US population, using the <i>case control</i> design ensures that the two groups are as similar as possible.<br /><br />This study could have been done in the time - and for the reported cost - of the GR "survey". If they had done a <i>real</i> study - like the one I've outlined above - the answer would already be here.<br /><br />If anybody would like to fund such a study, please contact me. If I can't find anyone else to do it, I'd be willing to coordinate it myself.<br /><br />I doubt that any of the federal funding agencies will be interested in funding this study - not because of any conspiracy, but because the only people who <i>want</i> the study will probably not <i>believe</i> the likely outcome (<i>i.e.</i> no association - just as in the GR "survey").<br /><br />So, this is my challenge to those who want this study: if you want it, <i>do</i> it. The advocacy groups have the money - all they need to do is find the will to take a chance. And make no mistake - this is a risk. There is a better than even chance that the study - if it isn't "fudged" - will show no correlation.<br /><br />If they <i>really</i> want to know, they can find out for less than the cost of a full-page ad.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com26tag:blogger.com,1999:blog-13759793.post-12098049140068210502007-06-27T19:22:00.000-07:002007-09-02T15:47:06.287-07:00Survey says..... Nothing!!!Generation Rescue just published their long-awaited telephone survey results that showed - surprise! - that vaccinations cause autism.<br /><br />Well, actually, it doesn't <i>really</i> show that vaccines cause autism, what it shows is that vaccines cause "neurological disorders", loosely defined as autism (or autistic spectrum disorder) and/or ADD/ADHD.<br /><br />Except that it really doesn't show <i>that</i>, either.<br /><br />So what <i>does</i> the survey show? Well, let's just take a look.<br /><br />Not surprisingly, they <i>did not</i> publish the questions they asked, which would have given us the opportunity to analyze their survey for systematic bias. What they <i>did</i> do was publish the raw data, which allows us to analyze their results.<br /><br /><b>Assessing the survey:</b><br /><br />When looking at a survey, the <i>first</i> step is to examine the survey structure - particularly the questions, but also the area covered and population contacted - for any flaws or biases. This survey was conducted in nine counties of California and Oregon - generally the more populous counties - which gives it a West Coast bias. Since autism, ADD/ADHD, asthma and diabetes do not show a coastal preference, this bias should not create a serious problem for the survey.<br /><br />Next, looking at the data, we need to see if there are age or sex biases. Since the data do not include a detailed breakout of the ages year-by-year, it is impossible to analyze for age biases, but the sex ratio (52% male, 48% female) - although it is <i>close</i> to the US Census Bureau data for that age range - shows a statistically significant difference from the US population.<br /><br />Looking at the sex ratios of the unvaccinated and vaccinated (both fully and partially) groups, the differences are not statistically significant, so the imbalance in the sex ratio is equal in both groups.<br /><br />It would be helpful to know how many people they had to call to get the number of responses they did - this gives a good measure of how skewed the responses might be. The higher the percentage of people refusing to take the survey, the more likely that the people who <i>do</i> answer are not a representative sample of the population.<br /><br />Unfortunately, we are not provided this information, so we have no way of knowing how many of the people who were called hung up or otherwise refused to participate, which makes it impossible to know the degree of participation bias. We'll just have to soldier on.<br /><br /><b>Assessing the data:</b><br /><br />Looking at the data, one thing that pops up as an immediate <i>red flag</i> is that the prevalence of autism is greater than the prevalence of PDD-NOS. This is an inversion of the usual finding, which is that autism (with stricter diagnostic criteria) is less common than PDD-NOS (which is essentially <i>some</i> of the criteria for autism but not enough to diagnose autism). This suggests that the people involved in the survey may not be asking the right questions.<br /><br />Looking a bit closer, the prevalence of the autistic spectrum disorders is way out of line with the most recent data. In February of this year, the <a href="http://www.cdc.gov/mmwr/pdf/ss/ss5601.pdf">CDC published a report</a> on the prevalence of autism in six states. This prevalence was widely reported and was frequently cited as more evidence of the "autism epidemic" by the <i>chelationistas</i>, so it should be familiar.<br /><br />This CDC report found that the prevalence of autistic spectrum disorders ranged from 4.5 to 6.5 per 1000 children, which would be 0.45 - 0.65%.<br /><br />The GR survey found that the prevalence of autistic spectrum disorders was 4.7% in their overall sample and ranged from 1.3% (female, fully vaccinated) to 8.4% (male, partially vaccinated). This is nearly <b>ten times</b> the CDC prevalence.<br /><br />To put the number into perspective, the CDC data say that somewhere between 1 in 222 to 1 in 154 children have an autistic spectrum disorder. The GR survey would suggest that 1 in 21 children have an autistic spectrum disorder. Ridiculous!<br /><br />Clearly, there is a serious problem with this survey.<br /><br />This is reminiscent of the infamous Holmes <i>et al</i> study, which found that their control subjects had over ten times the amount of mercury in their hair than the <a href="http://www.ehponline.org/members/2004/7046/7046.html">NHANES study</a> found in children of similar ages less than a year later.<br /><br />Now, the people who ordered this survey may argue that it's the difference between the two groups - not the absolute number - that is important. This <i>sounds</i> reasonable, but it isn't. There is no way to know if the <i>degree</i> of error is the same in all the groups.<br /><br />If the "over-reporting factor" is only 5% less in the "unvaccinated" group than in the other groups, the difference between the groups disappears. This completely invalidates the "results".<br /><br />So, with this glaring evidence of error, is there any point in looking any further?<br /><br />No, not really. But we <i>should</i> examine the major claim being made about the survey results, just to be thorough.<br /><br /><b>"Vaccinated boys have a 155% greater chance of having a neurological disorder like ADHD or autism..."</b><br /><br />Let me start off by saying that - even if the survey was accurate, which it clearly is not - an increase in autism and ADD/ADHD would not constitute an increase in "neurological disorders", which their conclusion implies. There may, in fact, be neurological disorders (<i>e.g.</i> measles inclusion-body encephalitis) that are <b>reduced</b> by vaccination. So, even without looking at the data, this assertion is pure nonsense.<br /><br />But, back to the survey data.<br /><br />To get a statistically significant difference between the unvaccinated and vaccinated boys, they had to lump the partially vaccinated and the fully vaccinated boys together and they also had to lump autism, PDD-NOS, Asperger's syndrome, ADD and ADHD together.roups, with the partially and fully vaccinated boys having - as a group - 55% more reported "neurological disorders".<br /><br />However, if you look at the "autistic spectrum disorders" by themselves, there is no statistically significant difference between unvaccinated and vaccinated (partially plus fully) boys.<br /><br />Curiously, there <i>is</i> a statistically significant difference between the partially vaccinated boys and <i>both</i> the unvaccinated <i>and</i> <u>fully</u> vaccinated boys. Partially vaccinated boys have a higher prevalence of autistic spectrum disorders than either the unvaccinated or fully vaccinated boys.<br /><br />Now, if you want to show that an exposure causes a disorder, it is generally a good idea to show a <i>dose-response</i> relationship. In the case of this survey, a little vaccination is worse than none or a lot. This doesn't sound like a dose-response relationship to me.<br /><br />Well, so the autism-vaccine connection doesn't work - how about ADD/ADHD?<br /><br />Out of 17,674 children in the survey, 1,875 had either ADD or ADHD. That works out to a prevalence of 106 per thousand or 10.6%.<br /><br />That seems a bit high.<br /><br />If you look at the USDE data from 2005, the percentage of children ages 4 - 17 years with "other health impairment" (the catch basin for ADD/ADHD and many other disorders) was 9.5 per thousand or 0.95%. This is over <b>ten times</b> lower than reported in the GR survey. And remember - the USDE "other health impairment" category includes a variety of diagnoses other than ADD/ADHD.<br /><br />So, it seems that there are some serious problems with the GR survey data. I don't know what the cause of the problem is (although I have my suspicions), but one thing is painfully clear:<br /><br />The survey data is garbage.<br /><br />So, what does the GR survey show?<br /><br />Absolutely nothing.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com22tag:blogger.com,1999:blog-13759793.post-67596335118633874082007-05-29T11:07:00.000-07:002007-09-02T15:45:01.105-07:00The Next Revolution?As the <i>chelationistas</i> rediscover/redefine/remarket themselves, surely there are parents who are feeling a little misled, deceived or perhaps even exploited. Maybe it's time for another "revolution" in autism? And this time, it's the <i>chelationistas</i> who need to be overthrown.<br /><br />For years, the various organizations representing the <i>chelationistas</i> have been telling parents that they are their <i>advocates</i>, that they respect parents, listen to parents and learn from parents. It's the "other side" - the doctors, "the government" and, worst of all, <i>Big Pharma</i> (cue spooky music) that lies to parents, disrespects parents, ignores parents.<br /><br />Now, it turns out, the <i>chelationistas</i> are admitting that they <i>don't</i> respect parents - they don't even trust the parents' intelligence enough to tell them the whole truth. And telling less than the whole truth is....that's right; <i>lying</i>.<br /><br />The <i>chelationistas</i> are now claiming that they knew all along that autism wasn't just mercury poisoning - <a href="http://www.youtube.com/watch?v=e7Hhgaf3Co0">despite earlier claims to the contrary </a>(see <a href="http://www.youtube.com/watch?v=0uGrGL9OY6U">here</a>, also). The fact that they didn't tell parents is explained as "not wanting to confuse the issue". Or, it could be argued, not wanting to risk losing parents' support on a complicated and complex issue.<br /><br />So, the <i>chelationistas</i> respect parents, but not enough to tell them the truth.<br /><br />And the <i>chelationistas</i> listen to parents, but don't hear them when they say, "we want the facts".<br /><br />And the <i>chelationistas</i> learn from parents, but only in order to better market their product.<br /><br />Many people may now find themselves unsure <i>when</i> the <i>chelationistas</i> are telling the truth (hint: only when their lips aren't moving).<br /><br />After all, if it is true - as the <a href="http://scienceblogs.com/insolence/2007/05/even_the_zealots_cant_defend_this_hypoth.php"><i>chelationista</i> revisionistic propaganda </a>says - that the <i>chelationistas</i> hid the full scope of possible causes of autism from the parents, then those parent have the right - no, the <i>duty</i> - to ask a simple question:<br /><br /><br /><br /><br /><br /><br /><div align="center"><span style="font-size:180%;">Why?</span></div><br /><br /><br /><br /><br /><br /><br /><div align="left">Ironically, it appears - again, from the <a href="http://www.kevinleitch.co.uk/wp/?p=542"><i>chelationistas'</i> own "clarifications"</a> - that the <i>chelationistas</i> didn't trust the parents' ability to understand a more complex issue. The <i>chelationistas</i> didn't want to muddy the water with facts.</div><br />In other words, they are claiming that <i>they</i> lied to parents in order to further the <i>chelationista</i> movement.<br /><br />Funny - that's pretty much what the <i>chelationistas</i> accuse the government and "mainstream medicine" of doing.<br /><br />Of course, another possibility is that the <i>chelationistas</i> really <i>did</i> believe that mercury caused autism (and may still believe so) but are afraid that parents will start to doubt them as the <a href="http://www.uscfc.uscourts.gov/OSM/Autism/Autism%20Update%20Untitled.pdf">mountain of data refuting the mercury-causes-autism hypothesis bears down</a>. So, in order to keep from looking like uninformed dolts, they lie about having known "all along" that autism was "more complex than just mercury poisoning".<br /><br />Either way, the <i>chelationistas</i> have been caught in a lie.<br /><br />Now, the majority of parents caught up in the <i>chelationista's</i> web will buy the "<a href="http://onedadsopinion.blogspot.com/2007/04/new-generation-rescue-site.html">clarification</a>" and will not be offended by the blatant condescension that it contains. A few will have their eyes opened and will leave. Most will leave quietly, burning in silent resentment, but we can only hope that a couple of parents are angry enough at this travesty to lead a revolt.<br /><br />After all, the only way to bring down a cult is from the inside.<br /><br />I have a theme song in mind for this revolt:<br /><br /><blockquote><br /><br /><p>Devo, <i><a href="http://www.youtube.com/watch?v=wiLGI7rIEcY">Jerkin' back 'n' forth</a></i><br />(from the album "New Traditionalists")<br /><br /><i>I know I let you tell me what to do<br />You were confident, you knew best<br />Now things aren't working like you want them to<br />Your confidence is what I detest<br /><br />You got me lookin' up high<br />You got me searchin' down low<br />You got me - I know you know<br />You got me jerkin' back 'n' forth</i> </p></blockquote><br /><br />That pretty much sums it up, doesn't it?<br /><br />It's time for parents of autistic children to stand up and say they <i>won't</i> be manipulated, deceived or dismissed - not even by organizations that claim to represent them. It's time for parents of autistic children to <i>demand</i> the truth - <i>especially</i> from organizations that claim to represent them.<br /><br />It's time for a new revolution.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com11tag:blogger.com,1999:blog-13759793.post-78745313590100038572007-05-19T08:17:00.000-07:002007-09-02T15:46:26.899-07:00A Crisis of Faith or "Bait and Switch"?Over the past year, I've noticed an odd trend among the supporters of the mercury-causes-autism hypothesis. It began gradually, as trends often do, with a few seemingly random phrases like "...and other toxins...", "...and environmental exposures...", "...other vaccine components...", "...formaldehyde, aluminium and benxyl alcohol..." and "...viruses and bacteria...".<br /><br />But now, the shift in emphasis is unmistakeable. <a href="http://www.kevinleitch.co.uk/wp/?p=542">Kev</a>, <a href="http://scienceblogs.com/insolence/2007/05/even_the_zealots_cant_defend_this_hypoth.php">Orac</a> and <a href="http://onedadsopinion.blogspot.com/2007/04/new-generation-rescue-site.html">others</a> have blogged about specific attempts at historical revisionism among the <i>chelationistas</i>, but I'd like to assess the "bigger picture" and what it means to the hypothesis-formerly-known-as-mercury-causes-autism.<br /><br />For those who are not intimately familiar with the daily ins and outs of the <i>chelationistas'</i> arguments (you lucky people!), the Central Dogma of the <i>chelationista</i> faith has been - since the infamous <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=11339848&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;query_hl=1&itool=pubmed_docsum">Bernard <i>et al</i></a> paper, in which a group of people who had never seen mercury poisoning compared it to autism - that mercury causes autism. Period. Full stop. The end.<br /><br />Apparently, that is no longer true.<br /><br />In a move reminiscent of George Orwell's <i>1984</i>, the <i>chelationistas</i> have changed their minds about mercury being <i>the</i> cause of autism, but they are claiming that they <i>haven't</i> actually changed their minds - they're simply "clarifying their position".<br /><br />That's <i><a href="http://en.wikipedia.org/wiki/Newspeak">newspeak</a></i> for "the data don't support our position, so we're doing our darndest to keep from having to admit we were wrong."<br /><br />So, what <i>does</i> cause autism, according to the <i>chelationistas</i>?<br /><br /><ul><li>"Heavy metals" (does this include <a href="http://www.defleppard.com/">Def Leppard</a>?)</li><li>Aluminium (not a "heavy metal")</li><li>Live viruses</li><li>Bacteria</li><li>"Maternal toxic load" (perhaps from watching <i>Oprah</i>?)</li><li>Antibiotics</li></ul><div align="left">Note that they haven't given up on their favorite cause: mercury. They have just provided it with some camouflage.<br /><br />The advantage of this "clarification" (translation: "<a href="http://en.wiktionary.org/wiki/obfuscation">obfuscation</a>") is to make it impossible (or at least highly impractical) to ever prove them wrong. Let me demonstrate.<br /><br />In order to show that the mercury-causes-autism hypothesis was wrong, we just needed to show that there was no correlation between mercury exposure (<i>i.e.</i> thimerosal exposure, environmental mercury, etc.) and autism. While correlation does not equal causation, a <i>lack</i> of correlation <i>is</i> essentially equal to a lack of causation.<br /><br />That was relatively easy to do, although many of the <i>chelationistas</i> are still struggling with that unpleasant lump of reality.<br /><br />However, in order to definitively squash the new "heavy metals"-aluminium-live viruses-bacteria-etc.-cause-autism hypothesis, you would need to explore all possible combinations of these "exposures". If you don't, it is a sure bet that the next "hypothesis" will be that the <i>one</i> combination you <i>didn't</i> check is the <i>real</i> cause of autism.<br /><br />Just like mercury was... until it wasn't.<br /><br />So, how many combinations would that be? It seems simple enough - there are only six items on the list. Except that some of the items are a bit broad.<br /><br />You could lump all "heavy metals" together (if you can get a ruling from the <i>chelationistas</i> on exactly which metals are included in this group), which would leave you with a manageable number, right?<br /><br />The "live viruses" <i>could</i> just be the ones in vaccines, <i>or</i> they could be any live virus that the <i>chelationistas</i> care to claim (without having to provide data) are in vaccines. Or they could be any live virus in "the environment". It is a number with a great potential for <i>flexibility</i>.<br /><br />"Bacteria" is another ambiguous category. Are they referring to the killed bacteria in vaccines, or will they want to expand that into all environmental bacteria (a number in the millions, if not billions)? Or will they want to reserve the right to claim that vaccines - or any other product with a manufacturer they can sue - are contaminated with bacteria that only the DAN! doctors and their faithful laboratories can detect?<br /><br />Of course, the "maternal toxic load" is another extremely broad (one might even say deliberately vague) category. We'd need to get a ruling from the <i>chelationista</i> high court on which "toxins" they have in mind. And we'd better get that in writing, in case they try to "clarify their position" later. I suspect that this is another "trapdoor" they've left in their new "hypothesis" in order to allow them to escape again.<br /><br />Simply <i>defining</i> the problem is impossible, given the vague and fuzzy nature of the new "causes of autism". And even if we were to get the problem defined - and get it to <i>stay</i> defined - there is another factor to consider.<br /><br />If we were to assume (naively) that there were only six variables to examine, how many combinations would that make? If we have n items ("n" is a variable) and we group k ("k" is another variable) of them at a time, the number of possible combinations (where order doesn't matter) is: [<a href="http://www.mathsisfun.com/combinatorics/combinations-permutations.html">see here for a tutorial</a>]<br /><br /></div><blockquote><div align="center"><span style="font-size:180%;">n! / (n - k)! k!</span></div><div align="center"></div><p><div align="center">(the "!" stands for "factorial") </div></blockquote><div align="left">So, if we have six possible causes and we examine possible combinations of any two, we have fifteen (15) possible combinations. A large number, but not an impossible task.<br /><br />But, we have to count <i>all</i> possible combinations, including groups from one to six of the possible causes. This gives us a grand total of sixty-three (63) possible combinations.<br /><br />And that's what we get by considering "heavy metals" and "maternal toxins" as <i>one</i> category. What happens if we expand "heavy metals" to the "big five" of toxic metals (mercury, lead, arsenic, cadmium, antimony)?<br /><blockquote>Total combinations = 1023</blockquote>And if we expand "maternal toxins" to include the five toxic metals? <blockquote>Total combinations = 16,383</blockquote>Mind you, we haven't even <i>begun</i> to exhaust all of the potential "maternal toxins", "live viruses" or "bacteria" - the potential number of <i>those</i> could be in the thousands, if not the millions.<br /><br />So now you see the shrewd cunning of the <i>chelationistas</i>. By making their "position" more vague, they have ensured that they will never again find themselves in the bind they are now. Never again will science be able to say - with any certainty - that the <i>chelationistas'</i> "hypothesis" about the cause(s) of autism is unfounded.<br /><br />That's because it is practically untestable. It is not absolutely untestable - if we were to commit the entire scientific resources of the world to searching various combinations, it would probably take slightly less than an infinite amount of time to check them all. But it will never happen.<br /><br />And that's <i>exactly</i> what the <i>chelationistas</i> want.<br /><br /><br />Prometheus </div>Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com15tag:blogger.com,1999:blog-13759793.post-71669333957980481802007-04-23T15:06:00.000-07:002007-09-02T15:46:08.352-07:00But we have to do something!I always find a little shiver of fear going down my spine whenever I hear someone - especially someone in elected office - say the words, "We have to <i><u>do</i></u> something about [X]!"<br /><br />In my experience, those words have been the prelude to innumerable disasters, debacles and misadventures. The problem is that the urge to action is rarely accompanied by any planning or investigation. What we end up with when we rush to "<i><u>do</i></u> something!" is the equivalent of "Ready. Fire! Aim."<br /><br />In other words, we miss the mark. In fact, we're lucky if we don't hurt somebody in the process.<br /><br />Over the past several years, I have heard a number of parents with autistic children say, "We can't wait for scientific studies, we have to <i><u>do</i></u> something for our children!" While I can completely sympathize with them, I continue to urge caution. Doing <i>something</i> is only better than doing nothing if "something" isn't harmful.<br /><br />Why do I bring this up, you might ask?<br /><br />In February, <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17384765">a study was published</a> that showed - for the first time - that treatment with DMSA (a chelating agent) can improve the intellectual functioning of lead-poisoned rats. This was a big deal because human studies (on children poisoned by lead-containing paint) had <a href="http://pediatrics.aappublications.org/cgi/content/full/114/1/19">failed to show any improvement</a> in behavioral or neuropsychological development.<br /><br />Unfortunately, the study <i>also</i> showed that treating rats who were <i>not</i> lead-poisoned decreased their cognitive abilities. Permanently.<br /><br />Now, people who are treating their children with DMSA for mercury poisoning would be right to be concerned about these findings, especially if they are relying on doubtful laboratory tests to determine that their children are "mercury poisoned". And those folks who are treating their autistic children with DMPS have no reason to smirk. There is currently no known mechanism to explain these cognitive impairments, so DMPS could be just as bad...or worse.<br /><br />I hadn't planned to 'blog about this study - too many unanswered questions - but then I got an disturbing piece of news. It seems that a proposed autism-chelation study is being held up while the researchers test the DMSA for lead and mercury. I'm still trying to get confirmation of this, but it seems important enough for parents to know <i>right now</i>.<br /><br />DMSA and DMPS are absolutely wizard at binding to lead, mercury, cadmium, arsenic and other "heavy metals". It's what they do. As a result, they will grab onto and carry along any lead, mercury, cadmium... that they come in contact with during their synthesis and subsequent handling. Given the ubiquitous nature of lead, mercury and arsenic, it is not improbably that these chelating agents could come in contact with - and grab onto - some in their progress from synthesis to final user.<br /><br />Might <i>this</i> be the reason that so many parents using chelation report that the mercury is "...pouring out..." of their children? If you're pouring it <i>in</i>, you would hope that it would pour out.<br /><br />I must emphasize that I have not yet confirmed that the proposed chelation study is being held while they test the DMSA for lead and mercury, but I feel that it is important for people who are doing chelation with DMSA (or DMPS) to get the news.<br /><br />I'll keep you posted as I know more.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com8tag:blogger.com,1999:blog-13759793.post-45158571080759122532007-04-21T08:10:00.000-07:002007-09-02T15:45:48.339-07:00Theories of EverythingPhysics, that most pure of pure sciences, has been pursuing the "Theory of Everything" - a theory that will explain the <a href="http://en.wikipedia.org/wiki/Fundamental_interaction">four fundamental forces and their interactions</a> - for some time now. Nobel Prize aspirants hope to connect the electromagnetic, strong nuclear and weak nuclear forces with gravity in a Grand Unified Theory. They've managed to connect the electromagnetic and weak forces into the "<a href="http://en.wikipedia.org/wiki/Electroweak_force">electroweak</a>" force, but the other two forces obstinately refuse to join the game. For now.<br /><br />Chemistry, which is sometimes referred to as "applied physics" (usually by physicists), has <a href="http://courses.chem.psu.edu/chem38/quantum/quantum.html">quantum chemistry</a>, which is a close approach to a "theory of everything" in that field.<br /><br />Biology (which snide chemists refer to as "applied rudimentary chemistry") has yet to develop anything even remotely resembling a "theory of everything". This is due to the immense complexity of the systems involved (so say the biologists) <i>or</i> the immense simplicity of the biologists involved (so say the chemists and physicists), take your pick.<br /><br />However, I have noticed that at least one small segment of the biological sciences seems to be developing a "theory of everything". In fact, it seems to have developed several.<br /><br /><br />I refer, of course, to the field of autism "alternative" research.<br /><br /><b>The Grandmother of Grand Unified Theories of Autism</b><br /><br />The first truly successful (in the sense of "popular" rather than "accurate") candidate for the "Grand Unified Theory of Autism" has to be the <a href="http://www.autismwebsite.com/ari/vaccine/p_mercury.htm" rel="nofollow">"mercury-causes-autism" hypothesis</a>, first published (in <i><a href="http://www.elsevier.com/wps/find/journaldescription.cws_home/623059/description#description" rel="nofollow">Medical Hypotheses</a></i>) by Bernard <i>et al</i> in April 2001. This hypothesis asserted that autism and mercury poisoning were one and the same, based on the use of similar words (in English) to describe certain features of both disorders.<br /><br />Despite the fact that none of the authors had actually <i>seen</i>, let alone <i>diagnosed</i> a person with actual mercury poisoning, this hypothesis resonated with the <i>zeitgeist</i> of the community of parents with autistic children and resulted in massive popular support. Its scientific support has been less massive, unfortunately, and it stands in peril of fading to a mere cult phenomenon.<br /><br />As a "theory of everything" in autism, the mercury hypothesis has met most of the requisite criteria. It is flexible enough to "explain" the features of autism, even as the definition of autism continues to change. In part, this is due to the protean nature of mercury poisoning, which has a wide variety of symptoms and signs.<br /><br />However, a large part of the credit goes to the flexibility of the people <i>applying</i> the mercury-causes-autism hypothesis, who are willing to overlook significant ways in which autism differs from mercury poisoning. It is this willingness to suspend critical thinking, more than any inherent validity of the hypothesis, that accounts for its continued survival despite its lack of supporting data and the vast amounts of direct and indirect data refuting it.<br /><br />With only a vague and easily disputed connection between signs and symptoms of autism and mercury poisoning and a few unrelated (and some might say also trivial and obvious) studies to support it, the mercury-causes-autism hypothesis is in trouble. The few studies that have been held up in support of the hypothesis, on closer examination, do not support it.<br /><br />Some of these studies merely confirm what is already known (trivial), <i>e.g.</i> that mercury is neurotoxic. Others have shown that mercury can cause other types of disorders, <i>e.g.</i> autoimmunity, without connecting that to autism. In the end, most of the studies used to support the hypothesis are of three basic types:<br /><br /><b>[1] The study fails to show a connection to autism</b> - <i>i.e.</i> mercury causes X, X is a bad thing, but no indication that either X causes autism or that X is part of autism, with X being a sign or symptom.<br /><br />Example: <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15184908&query_hl=4&itool=pubmed_docsum">Hornig, <i>et al</i>, "Neurotoxic effects of postnatal thimerosal are mouse strain dependent".</a> This study demonstrated that mouse strains that were known to be prone to develop autoimmune disorders were more likely than other strains (which were <i>not</i> prone to develop autoimmune disorders) to develop autoimmune disorders after exposure to thimerosal. This is the <i>trivial</i> part of the study.<br /><br />They then go on to posit that a variety of behavioral responses of the mice - decreased movement and decreased reaction to novelty - were signs of mouse autism. This is more than a bit of a stretch, as there are several alternative explanations, including the simple explanation that the mice were not feeling well, having developed autoimmune disorders.<br /><br /><b>[2] The study shows association without data supporting causation</b> - <i>i.e.</i> the sudy shows that X is found in children with autism, but fails to show that X might cause autism. X might be caused <i>by</i> autism or simply be a co-traveler.<br /><br />Example: <a href="http://www.ajcn.org/cgi/content/full/80/6/1611">James, <i>et al</i>, "Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism</a>", which demonstrates signs of increased oxidative stress in autistic children without showing that the oxidative stress led to autism or what the cause might be. Significantly, when they corrected the signs of oxidative stress with betaine and folinic acid, the children remained autistic.<br /><br /><b>[3] The study proposes mechanisms that are either unsupported by the data <i>and/or</i> are contrary to known physiology</b><br /><br />Examples: <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17365626&itool=iconabstr&query_hl=15&itool=pubmed_docsum">Kern, <i>et al</i></a>, "Sulfhydryl-reactive metals in autism", and <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12933322&itool=iconabstr&query_hl=16&itool=pubmed_docsum">Holmes, <i>et al</i></a>, "Reduced levels of mercury in first baby haircuts of autistic children". Both of these studies found reduced levels of mercury in the hair of autistic children and both propose - without providing a single citation or shred of data to support the proposal - that autistic children <i>excrete less mercury into their hair</i>.<br /><br />This is contrary to decades of research into hair physiology, and so <i>should</i> have been accompanied by at least a paragraph of explanation. However, neither group of authors have found it necessary to provide support for their astounding claim that hair excretes mercury. Until they can, both studies are merely sources for scientific amusement.<br /><br /><br />The mercury-causes-autism hypothesis also has no explanation for the continued rise in autism numbers (from data sources that its proponents used to establish the "autism epidemic" in the first place) despite falling mercury exposure (both in vaccines and from the environment) and so its supporters have resorted to circular reasoning.<br /><br />Despite having failed to establish that mercury causes autism, the proponents have boldly claimed that trace amounts of mercury remaining in vaccines, along with environmental mercury (which has been dropping since the 1960's), are sustaining the rise in autism.<br /><br />This, of course, completely negates their earlier assertions that it was the rise in vaccination - and exposure to thimerosal - that <i>caused</i> the rise in autism, since the mercury exposure to children born after 2000 has been less than that of children born before 1980 (before the onset of the "autism epidemic").<br /><br />What they have done - or <i>tried</i> to do - is say that the continued rise of autism (in USDE and California CDDS numbers) supports the mercury-causes-autism hypothesis because of the continued exposure to mercury - this continued exposure being proven by the continued rise in autism. And so, even though it took mercury exposures far in excess of what children are <i>presently</i> receiving to <i>start</i> the "autism epidemic", it takes only trace amounts to <i>sustain</i> it. Anyone want to go around again?<br /><br /><br />Another tactic used in support of the mercury-causes-autism hypothesis is to claim that <i>chelation</i> "cures" (or <i>treats</i>, if you like) autism. This supposedly establishes that mercury is the <i>cause</i> of autism, although it conveniently overlooks the fact that the chelating agents - if they <i>do</i> work - have effects beyond removing mercury.<br /><br />Even more fundamentally, the proponents of the modified mercury-causes-autism-because-chelation-cures-autism have failed to support their claim that chelation has an effect on autism that is greater than placebo. Until this is established, they have no argument. They are trying to "prove" one unproven statement with another unproven statement.<br /><br /><br /><b>Other "Theories of Everything" in Autism</b><br /><br />Other "theories of everything" have arisen in the field of "alternative" autism research since the rise of the mercury-causes-autism hypothesis, although none have generated as much press or excitement. What these lesser hypotheses share with the mercury-causes-autism hypothesis is an emphasis on anecdote, unrelated (to autism) studies and hype.<br /><br />Some of the current contenders for the "theory of everything" are:<br /><br />[1] Nitric Oxide - since this is a widespread inter- and intra-cellular signalling molecule, it is not surpising that it is found in association with a variety of disease states. It is also not surprising that it is <i>affected</i> in a variety of conditions, both normal and pathological. This is roughly equivalent to saying that calcium is associated with autism, since calcium fluxes are critical in release of many neurotransmitters, including those thought to be important in autism.<br /><br />Unless nitric oxide can be shown to either <i>cause</i> or <i>treat</i> autism, it remains just an interesting footnote. Considering the amount of hype that nitric oxide has in the "alternative" medicine and "nutraceutical" fields, it is no surprise that it has found its way into "alternative" autism therapy.<br /><br />[2] Allergens (especially latex) - what could be more ubiquitous than latex? It's in car tyres, surgical gloves and a myriad of medical, industrial and household products. Latex allergies are on the rise - probably due to increased exposure, although this can be debated - and so is autism. Coincidence? Almost certainly, but this hasn't stopped some people from seeing a connection. It's not their fault - finding connections is what our brains are "hardwired" to do - even when there <i>isn't</i> a connection.<br /><br />[3] RF energy (from cellphones, of course) - this seems to be a revival of the old "cellphones cause brain tumors" urban legend and should be as readily dismissed. Yes, the use of cellphones has paralleled the rise in autism. So has use of the Internet, popularity of Britney Spears and numbers of hybrid automobiles.<br /><br />Doubtless, there are many others that I have overlooked. Feel free to e-mail me your favorite "theory of everything" for autism.<br /><br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com12tag:blogger.com,1999:blog-13759793.post-4522311752370722592007-04-08T16:22:00.000-07:002007-05-03T09:00:13.577-07:00The Age of UnreasonBefore I get too far into this narrative, I should divulge that I am a “<a href="http://en.wikipedia.org/wiki/Post-World_War_II_baby_boom">Baby Boomer</a>”. This is not something I am proud of, as “<a href="http://www.last.fm/music/The+Who/_/My+Generation">My Generation</a>” was one of the most spoiled and self-centered generations of all time. The fact that there are innumerable members of the Baby Boom generation who are rational, selfless and modest does not change how history will see the generation as a whole.<br /><br />Our legacy will be one of self-absorption, greed, obsession with youth and – at the end of our lives – pitiful attempts to shift the blame for our actions and inactions. This latter failing is clearly shown in Billy Joel’s immortal song, “<a href="http://en.wikipedia.org/wiki/We_Didn">We Didn’t Start the Fire</a>”. It is the story of how T-shirts and bumper stickers failed to have any significant impact on world events.<br /><br />But I digress.<br /><br />The 1960’s were often referred to – by the generation we now call the “Baby Boomers” – as the “<a href="http://www.youtube.com/watch?v=Vx2IRqBmW2Q">Age of Aquarius</a>”. This simply shows their appalling sense of reality, since the earliest that astrologers place the dawning of the “Age of Aquarius” is 2150. By then, the “Aquarian generation” will all be dead. Even those who don’t believe in such negative things as “death”.<br /><br />Astronomers, incidentally, place the beginning of the “Age of Aquarius” at <a href="http://en.wikipedia.org/wiki/Age_of_Aquarius">2600</a>.<br /><br />In the 1960’s, the Baby Boomers felt that an era of peace and worldwide love was in the offing and that they were the generation that was going to make that a reality. Their beliefs could be summed up by something I found on an <a href="http://www.astrology.com/aboutastrology/transits/ageofaquarius/" rel="nofollow">astrology site</a>:<br /><br /><br /><br /><blockquote>“The key phrase for Aquarius is ‘I Know,’ but that knowledge is not a righteous, superior or exclusionary knowledge. It's a sort of wisdom that draws people together, for Aquarians are, above all else, social animals.“ </blockquote><br /><br />I couldn’t have said it better. So, the Baby Boomers spent their twenties trying various magical means to bring about world peace and brotherly love (or just getting stoned out of their minds) and then got distracted by making a fortune in the stock market, buying loft condos and finding a way to keep from getting old.<br /><br />However, the magical thinking never left them – and they’ve passed it on to succeeding generations.<br /><br />So, after centuries of slow but steady progress against the <a href="http://en.wikipedia.org/wiki/The_Demon-Haunted_World">forces of unreason</a>, a single generation is trying to send us back to the Dark Ages. After centuries of scientific progress in medicine, a single generation brings back homeopathy, naturopathy and introduces any number of new variations on shamanism. Crystals, “<a href="http://www.thesecret.tv/home.html" rel="nofollow">The Secret</a>” and <a href="http://www.quantumhealing.com.au/" rel="nofollow">Quantum Healing</a> are all the result of this steady erosion of critical thinking.<br /><br />It is this sort of unreason that has led people to make the most absurd statements without any apparent fear of contradiction, since – as the <a href="http://www.as.ua.edu/ant/Faculty/murphy/436/pomo.htm">postmodernists</a> tell us – there is no privileged reality. It has reached the point where many people believe that <i>wanting</i> something to be true will <i>make it true</i>. Some examples:<br /><br />[1] Iran’s nuclear program is much in the news of late and all reports include a comment to the effect that “Iran claims that the nuclear program is solely for power generation”. What I never hear said is that Iran is a net exporter of oil and has an infrastructure that is so dysfunctional that it has to import gasoline.<br /><br />It seems extremely unlikely that Iran would put the money and effort into something so complicated as nuclear power when it could buy oil-fired power plants for a fraction of the cost. And without stirring up the threat of UN sanctions.<br /><br />Still, the talking heads and pundits seem to all be of the mind that by not actually <i>saying</i> that Iran’s rationale is full of baloney, they won’t have to face the ugly truth that Mahmoud Ahmadinejad is trying to make a nuclear bomb in order to destroy Israel – as he has <a href="http://www.rferl.org/featuresarticle/2005/12/6f3acbdf-d5f9-4ba1-8c9d-278c700ae2ea.html">repeatedly said he was</a>.<br /><br />[2] Ardent believers in “<a href="http://www.actionbioscience.org/evolution/nhmag.html">Intelligent Design</a>” (the belief system formerly known as “Creation Science”) repeatedly claim that their brand of bunkum is a “science”, despite the fact that it has no data to support it (it is, in fact, <i>unfalsifiable</i> and so <i>untestable</i>) and makes no predictions about the universe. Some of the top people in the “ID” world are scientists who <i>should</i> know better. Yet, somehow, they have the conviction that by saying that “ID” is a science that it will become one.<br /><br />In the end, “Intelligent Design” is not science, not even bad science. It is religion dressed up to look like a science – if the light is bad and you squint a lot. And yet it has a serious following, even among people who call themselves “scientists”.<br /><br />[3] “<a href="http://www.fmbr.org/papers/sc2.php">Quantum connectedness</a>” continues to be all the rage in the Western world, as demonstrated by the number of people who mindlessly repeat bits of the movie, “What the #$*! Do We Know!?”. People who wouldn’t recognize a <a href="http://www.physics.nmt.edu/~raymond/classes/ph13xbook/node94.html">wave function</a> if it bit them on the bum splutter on about its collapse by an observer which, so they claim, means that we can create our own reality by thinking it. Or they will wax eloquently about how <a href="http://plato.stanford.edu/entries/qt-entangle/">quantum entanglement</a> shows that we are all connected.<br /><br />One of the most famous of the quantum-confused is Deepok Chopra, whose many books cash in on the general public’s ability to understand only that quantum physics is strange and seemingly paradoxical. He has repeatedly claimed that he has studied quantum physics, but his writings convince me (and others) that he may have <i>studied</i> it, but he surely hasn’t <i>understood</i> it.<br /><br />[4] Much of “alternative” medicine encourages people to abandon scientific principles that have brought us in the West to a level of health and longevity that are unrivalled in human history. If we want to see what happens when that happens, we only have to look to those parts of the world where – for economic or philosophical reasons – scientific medicine is unavailable.<br /><br />Yet, in the midst of the best medical care in the world – now or ever in history – a growing number of people are turning to magic. Whether it’s “quantum healing”, homeopathy, chiropractic, “energy medicine”, “thought field therapy” or any of a thousand others, it’s magic if it invokes unmeasurable “energies” or other undetectable properties.<br /><br />This is not to say that there aren’t energies or other properties of the universe that we can’t currently detect or measure – not at all. It’s just that if we can’t currently detect or measure them, how can anyone propose that they exist? To echo that infamous movie, “How the #$*! Do They Know!?”. What special power do <i>they</i> have that allows them to <i>know</i> that these energies or other properties exist?<br /><br />One of the common responses from these folks is that Newton didn’t know about radio waves, even though they existed (from the Sun other natural sources) in his time. True enough, but Newton also didn’t make any hypotheses that required radio waves. <i>That’s</i> the difference.<br /><br /><br />I could go on, but I won’t. I hope you get the point.<br /><br />Our society is growing more and more dependent on rationality, science and technology to keep it from collapsing. It’s too late to turn back, now – giving up on reason and returning to magical thinking will cause a human (and probably environmental) catastrophe that would beggar the imagination. And, at the same time, the forces of Unreason encourage us to turn our back on reality in favor of “The Secret” or other such nonsense.<br /><br />The technology that most people take for granted is far beyond the knowledge of the “average” citizen – not because they <i>can’t</i> understand it, but because they <i>don’t</i>. We run a very real risk of having an increasingly smaller proportion of our population that understands how critical technologies work or – even worse – the principles behind them.<br /><br />Now is the time to take a stand – to come out on the side of Reason over Unreason, of Science over Magic, of Reality over Fantasy.<br /><br />Or, we can all sit and meditate on a happier future.<br /><br /><br />Prometheus.Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com15tag:blogger.com,1999:blog-13759793.post-13277095605011685752007-04-06T13:00:00.000-07:002007-05-03T08:59:57.270-07:00If Everything works, is Anything Working?A few weeks ago, I wrote about ARI’s parental survey and how that could be used to show the natural progression of untreated autism. Today, I’d like to delve a bit deeper into some of the implications of all of those “effective” (or not) treatments.<br /><br />Even with the <a href="http://photoninthedarkness.blogspot.com/2007/03/finding-truffles-amongst-clods.html"><i>caveats</i> previously noted </a>about the shortcomings of the survey results, one thing that can certainly be said is that a rather large number of therapies are felt to be effective in the treatment of autism. Picking a threshold level of 10:1 on ARI’s “better:worse” scale (see previous posting for a discussion on this), the following treatments are felt to be “effective”:<br /><br /><br /><blockquote><span style="font-size:85%;">Antifungals: Diflucan<br />Antifungals:Nystatin<br />Calcium<br />Candida Diet<br />Cod Liver Oil<br />Detox.<br />(Chelation)<br />Digestive Enzymes<br />Fatty Acids<br />Feingold Diet<br />Folic<br />Acid<br />Food Allergy Treatment<br />Gluten- /Casein-Free Diet<br />Removed<br />Chocolate<br />Removed Eggs<br />Removed Milk Products/Dairy<br />Removed<br />Sugar<br />Removed Wheat<br />Rotation Diet<br />Vitamin A<br />Vitamin B3<br />Vitamin B6<br />with Magnesium<br />Vitamin B12<br />Vitamin C<br />Zinc</span></blockquote><br /><br />Again, even if these treatments <i>aren’t</i> actually effective (and most, if not all, probably aren’t), this still speaks to the dizzying number of treatments that parents are <i>claiming</i> work to treat autism.<br /><br />Now, I’ve read the chelationista apologists’ hypotheses of how all (or most) of these treatment “successes” can be explained by mercury poisoning, but I’m still waiting for the data. “<i>Could</i> be explained…” is a long, long way from “<i>Is</i> explained by…” – despite what many of the chelationistas might wish.<br /><br /><br />So, we have a large number of treatments with no discernible connection that are all reported to be effective in the treatment of autism. And that’s if we apply a pretty high cut to the pack.<br /><br />And what does it usually mean when a disparate group of treatments are all felt to be effective for a single disorder?<br /><br />[1] The disorder isn’t a single entity; it’s a group of several disorders with similar presentations (but different causes and underlying abnormalities).<br /><br />[2] None of the treatments is effective, which is why so many of them seem equally effective. Placebos all trend toward the same degree of effectiveness with prolonged use.<br /><br />[3] Both [1] and [2] are true.<br /><br />Case [1] is what we saw up to the late 1800’s in the treatment of “fever”. A variety of different (and usually unrelated) treatments showed true effectiveness, but only in certain patients. Quinine worked for some, willow bark for others but it wasn’t until modern microbiology developed that we understood why (it wasn't until the late 1900's that we understood how willow bark actually worked).<br /><br />Case [2] was widely seen up to the early 1900’s, when not only a variety of treatments but also entire treatment <i>philosophies</i> had relatively equivalent efficacy. Homeopathy, naturopathy and chiropractic were equally as effective (or equivalently <i>ineffective</i>) as “mainstream” medicine of the time. It was only when “mainstream” medicine developed safe and effective treatments and medicines that it began to show a distinct “edge” over the others in effectiveness.<br /><br /><br />It is only fair to say that some of the myriad of “alternative” autism therapies may eventually be shown to be effective in a subset of autism – or whatever autism fragments into in the future. All that can be said today is that the few “alternative” treatments that have been studied in a scientific manner have been found wanting (<i>e.g.</i> secretin).<br /><br />You would think that, having seen secretin burst onto the scene, become wildly popular (with countless anecdotes of success) only to crash and burn when it was tested, that the others would be somewhat more cautious in their claims.<br /><br />But it hasn’t worked out that way. The pattern to date has been one of over-ambitious claims (one might even say hyper-inflated claims) followed by dozens of testimonials and speaking engagements, then disappointment, retrenchment of the “true believers” and eventual consolidation into a core of die-hard followers.<br /><br />In a way, it reminds me of the evolution of a white dwarf star.<br /><br /><a href="http://imagine.gsfc.nasa.gov/docs/science/know_l2/dwarfs.html">http://imagine.gsfc.nasa.gov/docs/science/know_l2/dwarfs.html</a><br /><br />The sad thing is that the people in the middle of it all – the poor parents – don’t have the historical perspective to see it coming (or they are assured, “This isn’t like secretin – our treatment <i>really</i> works!”). So, they are either consumed in the inflationary helium burning stage, blown out with the planetary nebula or remain as the white-hot core of “true believers”.<br /><br />Oh, if they could only know and believe the history of such things!<br /><br />Here is another point to ponder.<br /><br />“Mainstream” medicine is not a very fastidious entity; it will absorb anything that works, regardless of its history. When <i>H. pylori</i> was found to be a causative agent in stomach ulcers, “mainstream” medicine gulped it up without so much as a “by your leave”. The same thing has happened time and again – whenever “alternative” medicine comes up with something that really works, “mainstream” medicine takes it, like a schoolyard bully taking a ball.<br /><br />Poor “alternative” medicine is left with the dregs – the therapies that don’t work or haven’t (yet?) been shown to work. To take the bully analogy a bit further, they are left with the broken toys and the ones they can’t figure out.<br /><br />My point is this: if these therapies actually <i>worked</i> - if they could truly be shown to work – then they wouldn’t be “alternative” anymore. “Mainstream” medicine would have scooped them up and claimed them for itself.<br /><br />Maybe <i>that’s</i> why the “alternative” practitioners won’t release their data – they’re afraid of the playground bully: “mainstream” medicine.<br /><br />So, to get back to the title of this post, if there are so many disparate "therapies" that "work", what does that tell us in the absence of any hard data? Again, if <i>everything</i> works, then it is all too likely that <i>nothing</i> is working and we are simply seeing the unaltered natural course of the disorder.<br /><br />We have some hint of this in that many of the "alternative" autism practitioners are still using secretin (again, a therapy very thoroughly discredited in the treatment of autism) and claiming that "it works!". If secretin - which is no more effective for autism than placebo - works as well as the rest of their "therapies", well, that's all we need to know.<br /><br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com16tag:blogger.com,1999:blog-13759793.post-82536331364360250402007-03-24T18:56:00.000-07:002007-05-03T08:59:38.995-07:00A Tale of Two Studies<i><b>“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness…”</i></b><br /><br />In March of 2007, two studies on different aspects of autism have been published. These two studies, although they are both published in peer-reviewed journals, could not be more different in quality.<br /><br />The first study is “<a href="http://www.informaworld.com/openurl?genre=article&title=Journal%20of%20Toxicology%20and%20Environmental%20Health%2c%20Part%20A&issn=1528%2d7394&volume=70&issue=8&spage=715&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;epage=721&doi=10%2e1080%2f15287390601188060&date=2007&atitle=Sulfhydryl%2dReactive%20Metals%20in%20Autism&aulast=Kern&aufirst=Janet&auinit=K%2e&sid=informa%3ainformaworld">Sulfhydryl-reactive metals in autism</a>”, by JK Kern, <i>et al</i>. This study attempts to correct the shortcomings of the dreadful Holmes <i>et al</i> study, which I have <a href="http://photoninthedarkness.blogspot.com/2005/07/pefect-example-of-how-not-to-do-study.html">discussed </a>in <a href="http://photoninthedarkness.blogspot.com/2005/07/perfect-example-of-how-not-to-do-study.html">depth</a> some time ago.<br /><br />My mother used to tell me, “If you can’t say something nice, don’t say anything at all” – so, to follow the <i>letter</i> of that maxim (if not the <i>spirit</i>), I will begin with the <i>positive</i> aspects of this study:<br /><br />[1] They <i>did</i> do their statistics correctly, using non-parametric statistics when it was clear that their data did not follow a normal distribution. Bully for them!<br /><br />[2] They explained their reasons for picking the statistical analytical method they did (the <a href="http://udel.edu/~mcdonald/statkruskalwallis.html">Kruskal-Wallis test</a>)<br /><br />[3] The values they obtained for hair mercury for both subjects and controls were within the range found in the larger <a href="http://www.ehponline.org/members/2004/7046/7046.html">NHANES study</a>, unlike the Holmes <i>et al</i> study, which had control values that were completely off the scale.<br /><br />[4] Their use of the case-control method reduced concerns that the controls might be different from the subjects in some way unrelated to autism.<br /><br /><br />Now, unfortunately, we come to the major shortcomings of this study - shortcomings that are as fatal to its conclusions as those of the Holmes <i>et al</i> study. In fact, the major shortcoming is <i>the same</i> in both studies:<br /><br /><b>Hair Doesn’t <u>Excrete</u> Mercury</b><br /><br />I’d like you to keep that sentence in mind for the next few paragraphs.<br /><br />You see, despite their perseveration on the idea that mercury is <i>excreted</i> into the hair – which would, in turn, make a low hair mercury level indicative of “poor excretors” – mercury uptake by hair is completely passive. There is no excretion mechanism that can be “impaired”. Mercury in the blood flowing through the hair follicles is passively bound to the sulfhydryl groups of the amino acid cysteine, which is especially abundant in hair.<br /><br />It’s as simple as that. No excretion, just passive absorption and binding to the growing hair.<br /><br />But don’t take <i>my</i> word for it.<br /><br />[1] <a href="http://www.jstage.jst.go.jp/article/tjem/210/4/210_301/_article">Akira Yasutake and Noriyuki Hachiya “Accumulation of Inorganic Mercury in Hair of Rats Exposed to Methylmercury or Mercuric Chloride”. Tohoku J. Exp. Med., Vol. 210, 301-306 (2006)</a> .<br /><br />“These findings suggest that the inorganic mercury is also taken up by rat hair from the blood circulation, as is the MeHg, irrespective of the consequences of the biotransformation of MeHg or exposure to inorganic mercury itself.”<br /><br />[2] <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=2335158&itool=iconabstr&query_hl=6&itool=pubmed_DocSum">Shi CY, Lane AT, Clarkson TW. Uptake of mercury by the hair of methylmercury-treated newborn mice. Environ Res. 1990 Apr;51(2):170-81.</a><br /><br />“Distribution of mercury in pelt and other tissues was measured. The level of mercury in pelt was found to correlate with hair growth. The amount of mercury in pelt peaked when hair growth was most rapid and the total amount of mercury in pelt was significantly higher than that in other tissues, constituting 40% of the whole body burden. [Note: the hair of mice contains a larger percentage of body mercury than it does in humans. This is because the hair (pelt) of mice is a larger fraction of the mouse body mass than the hair of humans, especially human children]<br /><br />However, when the hair ceased growing, the amount of mercury in pelt dramatically dropped to 4% of whole body burden and mercury concentrations in other tissues except brain were elevated.<br /><br />Autoradiographic studies with tritium-labeled methylmercury demonstrated that methylmercury concentrated in hair follicles in the skin. Within hair follicles and hairs, methylmercury accumulated in regions that are rich in high-sulfur proteins.”<br /><br />[3] <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=3569185&itool=iconabstr&query_hl=6&itool=pubmed_DocSum">Mottet NK, Body RL, Wilkens V, <u>Burbacher TM</u>. Biologic variables in the hair uptake of methylmercury from blood in the macaquemonkey. Environ Res. 1987 Apr;42(2):509-23.</a><br /><br />“The total mercury (Hg) in hair and blood of 45 young healthy adult female Macaque fascicularis given 0, 50, 70, or 90 micrograms MeHg/kg body wt orally in apple juice daily revealed a close and constant ratio between blood Hg and hair.<br /><br />The amount of hair Hg does not increase with time (maximum period of observation 490 days) at a given dose level. Also the ratio was unchanged between background and subtoxic dose levels. Individuals at a given dose level with a higher-than-average blood level had a proportionately higher hair level.”<br /><br /><i><b>”This was the most unkindest cut of all…”</b></i><br /><br />The last article, you will notice, was authored by none other than Thomas Burbacher, who is currently on the <i>chelationistas</i> “Most Favored Scientists” list.<br /><br />Bottom line: hair mercury (and presumably other sulfhydryl-reactive metals) reflects the blood mercury (etc.) at the time that portion of the hair was forming. If the hair mercury (etc.) is low, then the <i><b>blood</i></b> mercury (etc.) was low.<br /><br />And the only way mercury (etc.) can get into the brain is <i>via</i> the blood, unless you inject it directly into the brain.<br /><br />So, low hair mercury (etc.) equals low blood mercury (etc) equals low brain mercury (etc.).<br /><br />Any questions?<br /><br /><br />Now that we have rather thoroughly demolished the idea of mercury being <i>excreted</i> into the hair, what else does the Kern <i>et al</i> study have to say?<br /><br />The only graph in the entire article (Figure 1) is rather puzzling – it lists the mean ranks of the arsenic, cadmium, lead and mercury levels of the autistic and control groups. For those not familiar with non-parametric statistics (and for many that are), this may seem odd. Frankly, it <i>is</i> odd to show the mean ranks instead of the data themselves. It suggests that the data, seen naked and unadorned, might not be as convincing as the authors would like.<br /><br />Table 3 gives the mean (average) and standard deviation of the various hair metal levels of the two groups. This, too, is odd, since they went to great lengths to explain that their data did not follow a normal distribution and yet give mean and standard deviation – two measures that imply a normal distribution. Better would have been to give a <i>median</i> (the middle value of the ranking) and range. But they didn’t.<br /><br />And when you look at the numbers they <i>did</i> give, you begin to understand <i>why</i> they didn’t show a graph of their data.<br /><br />Zooming in on the mercury levels, the mean (SD) of the autistic subjects was 0.14 mcg/g (0.11) and that of the controls was 0.16 mcg/g (0.10). You’d be right if you thought that these levels were <i>awfully</i> close, although the Kruskal-Wallis test showed them to be statistically different.<br /><br />Even if there are statistically significant differences between the two groups, the question remains if they were <i>clinically</i> significant.<br /><br />I might also point out that not only are these values far lower than those measured by Holmes <i>et al</i>, they are also a bit lower than the NHANES levels (mean 0.22 mcg/g). And, curiously enough, they used the same lab as the Holmes <i>et al</i> study.<br /><br />Curious.<br /><br />It was especially curious to see them cite Holmes <i>et al</i> as supporting their hypothesis without once mentioning how very <i>different</i> their numbers were.<br /><br />So, what can we make of their data, then? Clearly, their hypothesis that autistic children are “poor excretors” based on hair metals is unsupportable in the face of data showing (over and over) that mercury and other metals are <i>passively</i> taken up by hair.<br /><br />Perhaps, the “take home message” from this study is that autistic children <i>absorb</i> less mercury. That wouldn’t sit well with Kern <i>et al</i>, but there is data to support <i>that</i> hypothesis.<br /><br />[4] <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9546365&query_hl=23&itool=pubmed_docsum">Ballatori N, Wang W, Lieberman MW. 1998. Accelerated methylmercury elimination in gamma-glutamyl transpeptidase-deficient mice. Am J Pathol 152:1049-1055.</a><br /><br />“There were no differences in methylmercury excretion between the wild-type and heterozygous mice; however, the GGT-deficient mice excreted methylmercury more rapidly at both dose levels. Wild-type and heterozygous mice excreted from 11 to 24% of the dose in the first 48 hours, whereas the GGT-deficient mice excreted 55 to 66% of the dose, with most of the methylmercury being excreted in urine.”<br /><br />Since gamma-glutamyl transpeptidase also has a profound effect on the <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17141888&query_hl=38&itool=pubmed_docsum">redox state of the cell </a>and <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&amp;amp;amp;amp;amp;amp;amp;amp;amp;db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=17227450">gluthathione</a>, (both of which have been linked to autism by another of the <i>chelationistas</i> Most Favored Scientists, <a href="http://www.ajcn.org/cgi/content/full/80/6/1611">Jill James</a>) what Kern <i>et al</i> are seeing may be nothing more than the effects of altered gamma-glutamyl transferase activity, which may be related or unrelated to autism.<br /><br /><br />So, by doggedly perseverating on a hypothesis (autistic children are "poor excretors"), <i>two</i> sets of researchers have missed a possible implication of their findings: that autistic children may actually be "over-excretors" of mercury.<br /><br />After all, that's what the data seems to be saying.<br /><br />And it's a lot more likely than hair being a significant excretory organ for mercury.<br /><br />End of Part One.<br /><br /><br />Next:<br /><br /><a href="http://www.sciencemag.org/cgi/content/abstract/1138659v1"><b>Strong Association of De Novo Copy Number Mutations with Autism.</b> </a><br /><br />Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.<br /><br />Science. 2007 Mar 15; [Epub ahead of print]<br /><br /><br />Prometheus<br /><br />Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com4tag:blogger.com,1999:blog-13759793.post-73693895535489583502007-03-23T23:50:00.000-07:002007-05-03T08:59:01.051-07:00A Tale of Two Studies – Part the Second<i><b>”…it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way…”</i></b><br /><br /><br />We now return to our previous story…<br /><br /><br /><a href="http://www.sciencemag.org/cgi/content/abstract/1138659v1"><b>Strong Association of De Novo Copy Number Mutations with Autism.</b> </a><br /><br />Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.<br /><br />Science. 2007 Mar 15; [Epub ahead of print]<br /><br /><br />In this study, the authors used ROMA, a type of comparative genome hybridization, to look for <i>de novo</i> mutations in autistic children. They looked at 195 autistic children and their parents (need to look at the parents’ genome to know if the mutation was inherited or arose spontaneously) and 196 unaffected children and <i>their</i> parents.<br /><br />What they found was – to put it mildly – very interesting.<br /><br />The size of the human genome limited the resolution of the technique (in this study) such that they could detect only about 15% of the mutations that cytogenetic techniques indicate to be present. Even <i>with</i> these limitations, they found:<br /><br />[1] Spontaneous mutations were more frequent in patients with autistic spectrum disorder (14/195) than in unaffected individuals (2/196).<br /><br />[2] The frequency of spontaneous mutations was higher (12/118) in sporadic cases of autism – children with no affected relatives – than in cases from multiplex families (2/77).<br /><br />[3] The frequency of spontaneous mutations in unaffected individuals was 1% (2/196).<br /><br />[4] Most of the mutations in autistic individuals were deletions (12/15 – one child had two mutations), while the two mutations in the controls were duplications.<br /><br />[5] None of the mutations were seen more than twice and most were seen only once.<br /><br />[6] The mutations seen in autistic children were on chromosomes 2, 3, 6, 7, 10, 12, 13, 15, 16, 20 and 22.<br /><br />If, as they suspect, their technique was only able to pick up 15% of mutations, then the actual mutation rate in autistic children may be much higher.<br /><br />What it means is that there is a statistically significant (p less than 0.0005) association between spontaneous mutations and autism. Now, I've often argued that association is not causation, and so do the authors of this study.<br /><br />However, the locations of many of the mutations were highly suggestive of a connection. For instance, one mutation - a 1.1 Mb deletion from chromosome 20 - deleted 27 genes, including the oxytocin gene <i>OXT</i>. This is particularly notable, as oxytocin has been shown to regulate social behavior and awareness.<br /><br />Five of the mutations involved only a single gene, which indicates that these genes are prime candidates for further study.<br /><br />Now, what does this mean for the people who claim that autism can’t be genetic, that it’s all the result of exposure to (fill in the blank with environmental toxin <i>de jour</i>)?<br /><br />Well, it means that they need to start thinking up a way to “spin” these results.<br /><br />Doubtless, they will find that some of the authors have – at one time in their careers – been supported by the pharmaceutical industry (“Big Pharma”) or “the government” or maybe they’ve ridden in black helicopters.<br /><br />Or they’ll find some other equally ridiculous claim of bias, corruption or conspiracy.<br /><br />But they won’t be able to stem the tide.<br /><br />"What tide?", you ask.<br /><br />There’s a tidal wave of data bearing down on the “reality deniers” in the autism world, and they’d better start heading for higher ground.<br /><br />Or learning how to swim.<br /><br /><br />Prometheus<br /><br /><br />Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com11tag:blogger.com,1999:blog-13759793.post-61886131226384627622007-03-20T11:09:00.000-07:002007-04-16T11:19:15.946-07:00Finding Truffles amongst the ClodsARI’s <i><a href="http://www.autismwebsite.com/ari/treatment/form34q.htm" rel="nofollow">Parent Ratings of Behavioral Effects of Biomedical Interventions</a></i><br /><br />For years I have advised people to avoid this site because it presents poor data in a poor fashion. The “data” is gathered (if that is the proper word) from an <a href="http://www.autismwebsite.com/ari/treatment/treatrating.htm" rel="nofollow">on-line survey </a>(it started as a paper survey) of parents. The parents, by and large, are people who already have a favorable opinion of “biomedical interventions” (meaning: “non-drug”, or at least, not the FDA-approved use of “drugs”) and – by corollary – an unfavorable opinion of “mainstream” medical therapies for autism.<br /><br />As a result, the “data” gathered is skewed in favor of “biomedical interventions” – as the results so clearly show.<br /><br />There is also no attempt made to confirm the reported results or to control for the initiation of other therapies at the same time.<br /><br />In addition, the arrangement of the categories of interventions – into “drugs”, “biomedical/non-drug/supplement” (with Pepcid and “chelation” listed as non-drugs) and “special diets” – biases the survey, as a PhD psychologist like Dr. Rimland (and his heir-apparent, Dr. Edelson) should know.<br /><br />Finally, the way the “data” is “analyzed” is … well, unusual. They take a six-point scale (another oddity, with three favorable ratings, two unfavorable and one neutral) and bin the results into “got better” (top two favorable ratings), “no effect” (the “possibly helped” and “no definite effect” responses) and “got worse” (the two unfavorable responses).<br /><br />They then effectively discard the “no effect” responses to come up with a “better:worse” ratio. This may have <i>some</i> utility, but a <i>better</i> rating would be to lump all the favorable responses together and compare that to the sum of the neutral and unfavorable responses. If you do that, then some of the current favorites start to look a bit less attractive:<br /><br />Examples:<br /><br /><span style="font-size:85%;"><b>Antifungals: Diflucan -</b> </span><br /><span style="font-size:85%;">ARI better:worse = 11:1 -- better:not better = 1.2:1<br /></span><br /><span style="font-size:85%;"><b>Secretin: Intravenous - </b></span><br /><span style="font-size:85%;">ARI better:worse = 6.7:1 - better:not better = 0.9:1<br /></span><br /><span style="font-size:85%;"><b>Vitamin A - </b></span><br /><span style="font-size:85%;">ARI better:worse = 23:1 -- better:not better = 0.7:1 </span><br /><span style="font-size:85%;"><br /><b>Pepcid (non-drug?) - </b><br />ARI better:worse = 3.2:1 - better:not better = 0.4:1<br /><br /><b>Vit B6 and Magnesium - </b><br />ARI better:worse = 10:1 -- better:not better = 0.9:1<br /></span><br /><br />You might agree, after seeing those numbers, that the ARI “better:worse” rating is a bit misleading.<br /><br />And what about that all-time autism treatment favorite: chelation? Well, ARI lumps it with “Detox. (Chelation)”:<br /><br /><span style="font-size:85%;"><b>Detox. (Chelation) -</b> </span><br /></span><span style="font-size:85%;">ARI better:worse = 35:1 -- better:not better = 3.2:1<br /></span><br />Still, if you were to believe in the numbers generated by this poorly designed survey, you might think that some of these treatments had something to offer. You might be right – you might also be wrong – there’s no way to tell from this “data” because it was gathered in such a poor way.<br /><br />But there <i>is</i> something you can glean from the ARI <i>Parent Ratings of Behavioral Effects of Biomedical Interventions</i> (PRBEBI). You can find what the natural progression of autism might be.<br /><br />You see, buried in the ARI-PRBEBI is a treatment that <i>has</i> been rigorously studied – a treatment that was extensively tested in a multi-center, placebo-controlled, double-blinded study. That treatment is secretin.<br /><br />Secretin has been exhaustively tested for effectiveness in autism and found to be no better than placebo (<i>i.e.</i> no effect). This is not in question. Even the company that held the patent to make recombinant secretin, which could have earned them a lot of money <i>if</i> it had been an effective treatment for even 10% of children with autism, has admitted that secretin has no effect in autism.<br /><br />Let me repeat that: <i><b>Secretin has no effect in the treatment of autism.</i></b><br /><br />But, if we look on the ARI-PRBEBI, we find that the parents who had secretin administered (intravenously) to their children rated it effective (“got better”) 48% of the time, ineffective 44% of the time (“no effect”) and saw their children worsen 7% of the time.<br /><br />This is pretty much <i>all</i> you need to know about the validity of the ARI-PRBEBI. It rates secretin as an effective treatment for autism despite the fact that large, well-designed and well-funded studies have found secretin no better than placebo.<br /><br />But wait, there’s more!<br /><br />Since we now know that secretin is without positive effect (and the studies <i>also</i> found very few negative effects), this is a fair placebo trial for the natural progression of autism without treatment: 48% get better, 44% are unchanged (at least over the short time the parents waited for an effect from secretin) and 7% worsen.<br /><br />Of course, this result <i>also</i> carries with it the limitations of the ARI survey, namely:<br /><br />[1] The reported results are not confirmed by anything other than parental impressions.<br /><br />[2] There is likely to be a confirmation bias, <i>i.e.</i> the parent population taking this survey is more likely to report improvement than worsening.<br /><br />[3] This is certainly not random or evenly distributed parent or patient population.<br /><br />[4] It is likely that other “treatments” were instituted at the same time as the secretin, which would confuse the issue.<br /><br /><br />Still, as a first approximation of what parents might experience as the untreated progression of autism, it isn’t bad. And it rather confirms the clinical impressions of physicians and psychologists who treat autistic children – that most of them show improvement over time.<br /><br />Given that the time period over which improvement was looked for after secretin injection was probably a matter of weeks to months, the fact that 44% of the children showed “no effect” (<i>i.e.</i> no change) is also confirmation of the periods of stasis (no discernible developmental progression) that autistic children experience.<br /><br />So, having tried my darnedest to derive <i>something</i> positive and useful from the ARI-PRBEBI, I leave you with the following summary points:<br /><br />[1] The ARI <i>Parent Ratings of Behavioral Effects of Biomedical Interventions</i> (ARI-PRBEBI) is <i>not</i> a reliable gauge of how effective a treatment <i>really </i>is.<br /><br />[2] The ARI <i>Parent Ratings of Behavioral Effects of Biomedical Interventions</i> (ARI-PRBEBI) can be used to demonstrate that a significant percentage of untreated autistic children can be expected to show noticeable improvement over a short time course (weeks to months).<br /><br />This pretty much puts an end to the claim (oft-repeated but never substantiated) that, but for the brave use of “biomedical interventions”, autistic children would be stuck at the same developmental stage they were at the time of diagnosis. It should also help people realize that autistic children <i>do</i> continue to develop – to <i>improve</i> - even without treatment.<br /><br />I can only hope that some people will take notice.<br /><br /><br />Prometheus<br /><br />Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com1tag:blogger.com,1999:blog-13759793.post-38527372008111276342007-03-12T13:17:00.000-07:002007-04-16T11:18:53.039-07:00Listening to AutismPeriodically (every other day, if not more frequently), some outraged parent will send me a blistering e-mail about how I am "not listening to the parents" or "not listening to the autistic children" or (even more curiously) "not listening to autism".<br /><br />I assume that these people are not being strictly literal in their complaints, as I listen to anyone who cares to speak to me (and read what people send me).<br /><br />I suspect that their <i>core</i> complaint is that I listen but don't agree.<br /><br />Here is the gist of the matter:<br /><br />Parents have a great deal of observational data about their children - what they do, how they respond etc. - and many of them feel that this translates into <i>understanding</i> their children's emotions and thought processes.<br /><br />How many of these parents will have cause to question this "understanding" when their children reach puberty?<br /><br />But, to the matter at hand.<br /><br />Many parents of autistic children also feel that their wealth of observational data gives them a special insight into their child’s physiology, as well. They feel – and many feel this way because they have been <i>told</i> by well-meaning “experts” – that they know more about <i>autism</i> than the people who study it, simply by the virtue of having “lived with it”.<br /><br />These parents often lose patience with doctors and scientists who are hesitant to accept at face value the parent’s claims of dramatic improvement with “alternative” treatments or their explanation of what caused their child’s autism. The parents see the doctors’ cautious skepticism as a direct challenge to the parents’ innate knowledge.<br /><br /><br />Why is it that I don’t “trust” the parents’ stories of how (fill in the blank) improved their child’s autism? Well, at least a part of the reason is the track record of autism “cures”.<br /><br />As an example, let's review the history of a "<a href="http://www.drgreene.com/21_761.html" rel="nofollow">breakthrough</a>" treatment for autism: secretin.<br /><br />Secretin first hit the <a href="http://news.bbc.co.uk/1/hi/health/171203.stm">public scene</a> in 1998, when it was reported that a single secretin injection (done as a routine part of endoscopy) dramatically improved the language and social functions of an autistic child. These initial reports led to a massive run on secretin and a number of studies - good, bad, short-term and long-term - were rapidly started.<br /><br />The excitement for secretin kept building, even after some initial studies <a href="https://www.autismwebsite.com/ari/newsletter/secretin.htm" rel="nofollow">failed to find</a> the dramatic results. In fact, the interest in secretin continues even after a large number of studies, including a focused, multi-center, multi-million dollar study sponsored by a drug company that had the patent for recombinant secretin, have <a href="http://www.autismwebsite.com/ari/newsletter/controversycontinues.htm" rel="nofollow">failed to find secretin any better than placebo</a>.<br /><br />Should I be listening to the parents that believe that secretin improved their child’s autism? Even though well-designed studies sponsored by a company that had every financial reason to want to find an effect failed to find any effect? Would that be wise?<br /><br />Enlarging the view a bit, a brief survey of parent-focused autism websites and newsletters reveals a dizzying number of “cures” for autism. Special diets, vitamins, minerals, and a growing (and worrying) number of prescription drugs (off-label uses) are being used to good effect, if parental reports are to be taken at face value.<br /><br />So, if all of these treatments are effective, as the parents claim, then what are we to make of it all? As I see it, there are two overall possibilities:<br /><br />[1] Autism can be improved by an amazingly broad range of “biomedical” therapies (as distinguished from behavioral therapies).<br /><br />or<br /><br />[2] Autism shows a pattern of alternating developmental stasis and progression, which fools parents into believing that the last “treatment” they tried before the improvement was the “cure”.<br /><br />Interestingly, <i>normal</i> child development shows a pattern of alternating developmental stasis and progression. Most parents are vaguely aware of this, but the parents of children with developmental disabilities are <i>hyper</i>-aware of the developmental progress of their children.<br /><br />Thus, if a “treatment” is proposed (or promoted) for autism and a large group of parents try it on their autistic children, the possible outcomes, even if the treatment is completely <i>ineffective</i>, are:<br /><br />[a] If given at the end of a period of progression, the “treatment” will be assessed as having made the child <i>worse</i>.<br /><br />[b] If given at the end of a period of stasis, the “treatment” will be assessed as having made the child <i>better</i>.<br /><br />[c] If given in the middle of a period of stasis <i>or</i> a period of progression, the “treatment” will be assessed as being <i>ineffective</i>.<br /><br />Remember, these are the possible outcomes even if the treatment is utterly without effect (either good <i>or</i> bad).<br /><br />Hopefully, you are getting an idea of why I don’t put a lot of stock in parental reports of “treatments” for autism.<br /><br />Let me try to explain the parental fervor for some of these “treatments” with a small fable.<br /><br /><br /><br /><blockquote><p align="center">The Tale of the Lucky Stockbroker</p><br /><p align="left">Long, long ago, a smart fellow decided that he would try to make a lot of money in the stock market. Having watched the market for some time, he realized that the best way to make money on stocks wasn’t to buy and sell them, but to sell <i>expert advice</i>.<br /><br />Knowing that most people who invested in stocks were wary of advice, he set out to <i>prove</i> to people that he had a special power for knowing when stocks were about to go up or down. He got a list of a ten thousand people who were avid stock traders and sent each of them an e-mail describing his services (and fees) and giving them a “sample” stock pick.<br /><br />Half of the prospective customers got an e-mail saying that the stock would go up in the next week, and half of them got an e-mail saying that the stock would go down. At the end of the week, the stock he picked had gone down, so he sent another e-mail to the five thousand people who had received the “correct” stock advice.<br /><br />Half of the five thousand got an e-mail saying that another stock would go up in the next week; half got an e-mail saying it would go down. At the end of the week, he sent out another e-mail to the remaining 2500 would-be customers.<br /><br />At the end of six weeks, he was down to a little over 150 potential customers, but those 150 has seen him make six correct stock predictions in a row! The last e-mail he sent them was to tell them that they could continue to get these predictions only if they bought a five-year subscription to his service.</p></blockquote><br /><br />In autism therapy, much the same system is at work, although I don’t claim that anyone is doing it deliberately, unlike the stockbroker in the story. Parents who get results will convince themselves that the “treatment” is working. They may have seen improvements in the past, but without a “treatment” to hang them on, these improvements would have seemed maddeningly random (as, in fact, they are).<br /><br />The parents who <i>don’t</i> see any improvement will quietly drift away from the “treatment”. If they choose to tell other parents that the “treatment” didn’t work for their child, that is easily explained away by “every child is different – you need to find what works for <i>your</i> child”. And so, they head off into the sunset on a search for the “treatment” that will work on their child.<br /><br />When you take in a broader view of the autism “treatment” landscape, it seems painfully clear that this is happening. <i>Every</i> therapy has its own group of parents who swear that it has “cured” or “recovered” their children. And each therapy also has a rather pitiful group of people who haven’t seen the “cure” yet, but are hoping that it will happen soon.<br /><br />And there are <i>dozens</i> (if not hundreds or thousands) of “treatments” out there that are just like secretin – a few anecdotal stories (or even just one), a hint of biological plausibility (which, given that nobody knows <i>what</i> autism is, can be pretty vague) and a cluster of “me too!” stories.<br /><br />In fact, even though secretin has been very thoroughly shown to be ineffective, there are still large numbers of “alternative” practitioners using it to “treat” autism. Apparently, no amount of good science is going to penetrate the core believers.<br /><br />Unfortunately, most of the other “treatments” for autism are not going to get as thorough scientific evaluation as secretin did. Many of them have so little “biological plausibility” that no real scientist is going to want to bother submitting a proposal to study them. The rest have so little biological plausibility that they don’t even seem worth debunking for the fun of it.<br /><br />And, given what happened with secretin, why would anyone bother? If people are going to “listen to autism” and ignore the science, what’s the point?<br /><br /><br /><br /><br />Prometheus<br /><p></p>Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com14tag:blogger.com,1999:blog-13759793.post-16876101189713292342007-03-07T22:48:00.000-08:002007-04-16T11:18:32.557-07:00Fear PressureFor some time now, I’ve wondered why promoters of the mercury-causes-autism get <i>so</i> hostile when they talk to us skeptics. Time after time, I’ve been accused of:<br /><br />[1] Preventing parents from treating their children with (insert therapy).<br /><br />[2] Preventing parents from hearing about (insert therapy).<br /><br />[3] Keeping kids from getting (insert therapy).<br /><br />This, of course, is utter nonsense.<br /><br />I’m not standing in the way of parents who want to “treat” their autistic children with whatever voodoo they want to use. I’m just a single person writing a single ‘blog – I’m not blockading their homes, picketing “supplement” stores or standing in the doorway of even one DAN! doctor.<br /><br />Parents have a wide variety of woo-based websites, parental support groups, newsletters etc. to inform them of the latest in woo-based autism therapies. I can’t hope to compete with the amount of baloney available to parents. I’m just a single voice shouting (actually, writing) in the wilderness.<br /><br />I’m not hacking websites (although folks on the “other side” have done that), I’m not buying up web domains with similar names (although folks on the “other side” have done that) and I’m not trying to harass, intimidate or litigate against people who want to tell their side of the story (although folks on the “other side” have done that).<br /><br />Finally, I’m not doing anything to keep the children from getting whatever therapies – woo or otherwise – their parents see fit to inflict on them. Nothing but quietly telling <i>my</i> side of the story.<br /><br />Yet, they are offended by my skepticism. More than offended – <i><b>enraged</i></b>. People have said things to me and about me that are offensive, accused me of base and dishonorable behaviors and have told me – in no uncertain terms – to SHUT THE F**K UP!<br /><br />Why does my lack of belief in their viewpoint make them so angry?<br /><br />To be honest, it’s not just me. They seem to hate <a href="http://www.webcomicsnation.com/taillefer/chelation_kid/series.php?view=single&ID=37443" rel="nofollow">anybody</a> who’s not on board with their “program”. And "hate" is the correct word - make no mistake about that.<br /><br />A few days ago I found myself with a bit of unstructured free time, so I decided to spend the time trying to understand the anger I seem to provoke in the mercury-causes-autism believers.<br /><br />I started by imagining that I had a child with a poorly-understood disability of unknown origin and uncertain prognosis. That was the easy part.<br /><br />Then, I pictured what it would be like to have someone – or a group of someones – tell me that they had discovered THE CAUSE and THE CURE of the dread illness that was afflicting my child. So far, so good.<br /><br />Then I tried to imagine what it would be like to have other people, perhaps people with expertise in medicine and science, disagree with THE CAUSE and THE CURE.<br /><br />How would that make me feel?<br /><br />Frankly, I was at a loss to see why I would give two shakes of a lab-rat’s tail <i>what</i> the “experts” might think if I had (or <i>thought</i> I had) a cure for my child’s ailment. As long as they weren’t getting in my way, why should I <i>care</i> they thought?<br /><br />After all, in the post-modern world, people ignore the experts <i>all the time</i>. In the US, they’ve raised it to a cultural icon. The only thing that “the people” distrust more than “experts” is “the government”.<br /><br />Indeed.<br /><br />But then I considered how I would feel if I was doubtful about whether or not THE CURE worked.<br /><br />That would change things. A lot.<br /><br />If I was harboring secret doubts, doubts that I scarce could admit to myself, then someone <i>else</i> doubting THE CAUSE and THE CURE would be a big problem.<br /><br />As long as everyone around me was chanting the party line (“Mercury causes autism and chelation is its cure.”), I could bury my own doubts. After all, if I was the <i>only</i> person with doubts, then it <i>must</i> be true.<br /><br />Right?<br /><br />But once I started to hear other people doubting THE CURE or THE CAUSE then my own doubts would start gnawing at me. They’d start keeping me up nights.<br /><br />And why, you might ask, would I <i>have</i> doubts?<br /><br />Well, maybe the improvement wasn’t as dramatic as I was making it out to be. Of course, my child was getting better, but he wasn’t CURED, not like all the other kids were being CURED. And the other kids I saw, they weren’t as CURED as they were made out to be.<br /><br />Of course, I wouldn’t be tactless (or stupid) enough to tell the other parents that their “recovered” kids didn’t look all that “recovered” to me. And I <i>certainly</i> wouldn’t be bold enough to say that I didn’t think that my child’s improvement was as much as I expected, based on their descriptions.<br /><br />Of course not. That would be like saying…oh, I don’t know…like saying, “The Emperor has no clothes!”<br /><br />And we wouldn’t want to say <i>that</i>, would we?<br /><br />So, what are my options? I can’t admit to myself – or my spouse or fellow mercury-causes-autism parents – that I have doubts about THE CURE or THE CAUSE. That would cause unacceptable mental anguish, since I’d not only have to admit that I was <i>wrong</i> (never an easy thing to do, in the best of circumstances), I’d have to admit that I didn’t have a cure for my child’s illness.<br /><br />That’s not going to happen. Uh-uh. Nope. Never.<br /><br />And the other option? I can get angry at the doubters. I can accuse them of bias, corruption, ignorance, arrogance, insensitivity, or whatever else comes to mind. I can circle the wagons and excommunicate anyone who admits to doubt.<br /><br />And why would I do these things?<br /><br />Because I’m afraid.<br /><br />Very afraid.<br /><br />Because without THE CAUSE and THE CURE, I’d have nothing to offer my ailing child.<br />I would be defeated.<br />I would have no hope.<br /><br />Or so I might think.<br /><br />So, when the mercury-causes-autism proponents take their next poke at me, I’m going to try my very best to remember that, although their actions are hostile and belligerent, they aren’t <i>really</i> angry with me.<br /><br />They’re just afraid that I might burst their bubble. That I might force them to face their <i>own</i> doubts.<br /><br />And they’re not ready for that.<br /><br />Yet.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com13tag:blogger.com,1999:blog-13759793.post-42403079835300593232007-02-26T12:56:00.000-08:002007-04-16T11:18:14.544-07:00The Power of Critical Thinking: Bias and Self Deception<b>Bias:</b><br /><br />Some time ago, during one of those post-conference informal discussions, I heard a fellow give the best description of bias that I've ever heard. I will attempt to paraphrase:<br /><br />Bias is the natural result of every person's self-centrism. We all - except for the few who are incapacitated by self-doubt - are utterly convinced that our beliefs, actions and opinions are absolutely correct <i>at the time</i>.<br /><br />The <i>caveat</i> "at the time" is an essential part, because all of us (except for those who are pathologically incapable of acknowledging error) have had occasion to realize that we have made a mistake, that our beliefs, actions and/or opinions were wrong.<br /><br />However, at the moment we thought <i>that</i>, we were convinced we were correct - correct about us having previously been in error.<br /><br />You can see how this could rapidly get out of hand.<br /><br />But it holds together very well as a general statement of how people view their own thinking process. We (with very few exceptions) are sure that we are doing or thinking the "right" thing at the time that we are doing it or thinking it.<br /><br />So, what has this got to do with bias? Plenty.<br /><br />Bias is a sort of "blind spot" in a person's thinking - a place where their assurance of being right makes them vulnerable to imagining the world to be different from how it truly is. It is, in short, a minor delusional state.<br /><br />As Mark Twain is reported to have said: <a href="http://www.quotedb.com/quotes/1097">"It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so." </a>So it is that the blind spot of bias gets people into trouble. Ignorance is merely a need for information or education; error - especially when it is believed wholeheartedly - is a calamity waiting to happen.<br /><br />A good analogy would be a map. If your map of reality has blank spots, you are likely to be more cautious in those areas. You'll ask questions, listen to what people who have been there have to say and keep you eyes open. On the other hand, if your map has roads where there are none and smooth plains where there are cliffs and pits, then you are standing into trouble.<br /><br />Bias can lead to self-deception (more about that later) when it convinces a person to ignore good information because it conflicts with their pre-formed (and self-corroborated) view of reality. Some spectacular examples of this have occured in the media in recent years, when otherwise <a href="http://www.cnn.com/2004/US/09/10/rather/index.html">sage and seasoned journalists </a>were completely taken in by fakes and phonies. That they often did so in the face of evidence that they were being hoodwinked only serves to underscore the pernicious nature of bias.<br /><br />As an aside, it is laughable in the extreme to see people state that they are "not biased". Ridiculous! Everybody is biased in some way - everybody has an opinion on everything, even if that opinion is "That's too unimportant to think about." As a result, everybody is prone to - biased toward - a particular view of reality.<br /><br />To reiterate: no matter what you think, you think that's the right thing - <i>at that time</i>. If it were a conscious decision, it wouldn't be bias. Bias influences, shades and slants conscious decisions, in ways that we are not aware of <i>at the time</i>. Looking back, we may be aware of how our assurance of correctness led us to disaster, but we don't - we <i>can't</i> - see it <i>at the time</i>.<br /><br />To be sure, people are often aware that they are doing or thinking things that "aren't right", but that is the imposition of an external measure of correctness. It has nothing to do with whether the person feels that their thoughts or actions are right <i>for them, in their situation, at that time</i>. The person who is shoplifting a loaf of bread knows that it is a crime (possibly even a sin), but is assured that they are doing the right thing <i>for their own reasons</i>.<br /><br /><br /><b>Self Deception:</b><br /><br />Bias is usually a necessary precondition for self-deception. It would take an incredible strength of will to truly believe something you <i>know</i> to be false. I'm not sure that it can be done this side of insanity.<br /><br />However, humans have shown themselves to be masters of convincing themselves that the real is false and the false is real. And the first step in this process is to be assured of the correctness of one's own thinking - our old friend <b>bias</b>!<br /><br />In some ways, it's rather amazing that people can <i>ever</i> avoid self-deception. What keeps most people sufficiently grounded in reality to allow them to carry out the day-to-day activities of living is a regular contact with aspects of reality that cannot be easily ignored.<br /><br />Someone who has convinced themselves of their ability to fly (<i>sans</i> aeroplane) will rapidly (at 9.8 m/sec/sec) be disabused of this notion. They may even survive to "internalize" the lesson. Likewise, reality intrudes its unwanted self into most self-deceptions, sometimes, sooner, sometimes later; sometimes subtly, sometimes dramatically.<br /><br />But there are some self-deceptions that are resistant to reality therapy. Some of them lack a sufficient grounding in reality to ever run across a contradiction. Most religious thought is of this nature. There is simply not enough contact between religion and reality - with some notable exceptions - to provide a convincing "whack" to the deceived... er, the devout.<br /><br />Other times, the collision with reality is a long time coming, allowing people a "grace period" to believe (and perhaps entrench) their self-deception. For example, people who try quack remedies for real illnesses often have a period of time before the reality of their unchecked disease breaks through their belief. Even worse off are the people who try quack remedies for <i>imaginary</i> illnesses - they will now have <i>two</i> mutually-reinforced self-deceptions!<br /><br />Additionally, there are some counter-reality thoughts that can diminish the impact of reality. Some of these are (not an exhaustive list by any means):<br /><br />- It would be <i>so</i> embarrassing if I were wrong!<br />- I've invested too much time/money/effort/reputation on this to admit that I was wrong!<br />- People would be <i>so mad</i> at me if I were wrong!<br />- I <i>really</i> trust the person who told me this...they can't be wrong!<br />- I <i>really</i> need for this to be right!<br /><br /><br />You'll notice that I haven't included anything like "It's all a conspiracy!" or "They're lying to me!" That's because these sort of thoughts are the <i>result</i> of self-deception (and might even be considered <i>diagnostic</i> of it) rather than contributing factors. Once a person has convinced themselves that the cost of being wrong is (for <i>them</i>, at <i>this time</i>) greater than the cost of persisting in error, then the mind will generate a suitable set of excuses (sometimes called "rationalizations" or even "delusions") in order to maintain their denial of reality.<br /><br />Rationalizations are a way of covering up the gap between reality and a person's conception of reality. The more their mind-generated world-view comes in conflict with reality, the more rationalizations are needed. At some point, they may even cross the imaginary line between denial and delusion.<br /><br />People who are in denial are often very hostile toward people who try to bring them back to reality. After all, it's hard work to maintain all those rationalizations and they do not appreciate visitors who want to track reality all over their snug, safe sanctuary. They will often lash out at people who have the temerity to disagree with them.<br /><br />As a result, people in denial often seek out others with the same - or similar - world-view. The Internet has aided this process immensely, providing innumerable places for people to gather to share, refine and reinforce their denial of reality.<br /><br /><br /><b>Avoiding Self Deception:</b><br /><br />While it would be nice if we could all look reality in the face at all times, this simply is not the human condition. Failing a complete refit of the human psyche, what <i>can</i> we do to avoid self-deception?<br /><br />[1] Check your ideas with someone else.<br /><br />This is the basic concept behind "peer review" in scientific journals. Your ideas, methods, data and conclusions are put before a number of independent (they aren't all sitting in one room, influencing each other) reviewers who read it and give their critique (and usually criticisms). This provides a number of minds that - in all probability - do not have the same biases (the same blind spots) as the author(s).<br /><br />For the average citizen, "peer review" can be a bit harder to find. A common mistake is to ask someone who already thinks as you do to critique your idea. Thus we have UFO conspiracists asking other UFO conspiracists if the small sharp thing in their bum is a splinter or an alien mind-control device, with the predictable bizzare answer.<br /><br />This is also where a lot of the news media have fallen foul of self-deception. In a group with the same political and social mindset, it may be hard to find someone to say, "Gee, Dan, that memo doesn't sound very believable to me. Maybe you ought to check it out better." It's also unreasonable to expect people to tell the boss that they think he's gone crackers. Better to find an independent appraisal.<br /><br />[2] Be skeptical of everything you hear, <i>especially</i> if you agree with it.<br /><br />Again, the news media would have saved themselves a number of black eyes and bruised egos if they had followed this simple rule. For that matter, a number of <a href="http://www.cnn.com/2004/HEALTH/02/12/science.clone/">people in science </a>would have been better off if they, too, had heeded this advice.<br /><br />You are very much more likely to be taken in by a falsehood that conforms to your world-view (your <i>biases</i>) than to believe a truth that doesn't. Keep that always in your mind. Question the basis for <i>any</i> statement that claims to be "fact"; question it <i>twice</i> if you find yourself <i>wanting</i> to believe it.<br /><br />[3] Occasionally step back and ask yourself, "What would it take to make me believe/not believe this?"<br /><br />When we are self-deceived, the answer to this simple question - if we are honest with ourselves - is most often "There is nothing that would change my mind." This is a <i>very</i> bad answer because it means that your belief (or non-belief) in something is a matter of religious devotion, not reason. If that's OK for you, so be it. But it might just prevent a nasty misstep if you can recognize that you are not seeing the world as it really is.<br /><br /><br />This has just scratched the surface of a topic that could fill volumes (and has!). Perhaps I'll add another volume to the world's collection someday. It's on my list (right after cleaning out the attic).<br /><br />Until next time!<br /><br /><br />Prometheus</li></li> <ol></ol><ul></ul>Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com14tag:blogger.com,1999:blog-13759793.post-49061233409270730932007-02-18T16:04:00.000-08:002007-04-16T11:17:55.794-07:00The Power of Critical Thinking: Scientific Method“Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.” <i>Richard Feynman</i><br /><br /><span style="font-size:85%;">(from the lecture “What is and What Should be the Role of Scientific Culture in Modern Society”, given at the Galileo Symposium in Italy, 1964.)<br /></span><br />There’s really no better definition of science than that.<br /><br />So, how do we do science? It’s really quite easy. Just follow these four simple steps.<br /><br /><b>[1] Hypothesis.</b><br /><br />Contrary to what some people think, a hypothesis is not “just a guess” – it is a proposed model of how the universe works. Usually, it is a model of how a small part of the universe works, but it is still a model of the universe.<br /><br />The most important requirement is that the hypothesis be <i>testable</i> - it must be <i>falsifiable</i>. There must be some way to determine if the model is correct (or incorrect), otherwise, it is useless. Hypotheses that invoke unseen beings, undetectable forces or supernatural beings are all untestable.<br /><br />Needless to say, a hypothesis must explain the available data on the topic in question, although it can explain that some (or all) of the data is wrong. However, hypotheses that start out with the claim that all of the existing data are wrong usually don’t fare too well.<br /><br /><b>[2] Observation / Experimentation.</b><br /><br />The reason that hypotheses need to be testable is that the second step is to test them. No matter how “brilliant” or “progressive” a hypothesis is, it is utterly worthless if it either cannot be tested or makes no testable predictions.<br /><br />This is the core problem of “Intelligent Design” – it makes no predictions that can be tested. Since “Intelligent Design” essentially states that everything is as it is because some supernatural being – the “designer” – made it that way. No matter how things are – no matter <i>what</i> a researcher might find – it is all exactly as it was made by the “designer”. It’s a tidy bit of religious philosophy, but it isn’t a hypothesis.<br /><br />Once you have a hypothesis in hand, the very next step is to come up with a way to test it. The best way is to see if a prediction made by the hypothesis comes true. This can either be an observation, such as the bending of starlight as it passes close to the sun, or it can be an experiment, such as the Yellow Fever experiments. The distinction between observation and experiment is a subtle one, but either one can be used to test a hypothesis.<br /><br />One thing that many want-to-be scientists fail to realize is that they aren’t the only ones who get to test their hypothesis. Anyone can do it – and will, if your hypothesis is interesting enough. This leads us to the next step:<br /><br /><b>[3] Evaluation.</b><br /><br />Once a hypothesis has been tested, the time comes to see how well it did. An unsuccessful test – one where the results <i>were not</i> what the hypothesis predicted – indicates that the hypothesis is not a valid model of reality and needs to be revised. Sometimes, the needed revision is drastic – such as completely abandoning the hypothesis. Either way, a hypothesis that fails to predict what will happen is not valid – it needs to be fixed or discarded.<br /><br />This step is the one that separates the <i>real</i> scientists from the pseudoscientists. It is especially revealing when a researcher refuses to respond to criticism of their hypothesis, especially when that criticism includes data that contradicts their findings. This is a recurring problem in science and – in my experience – indicates a serious flaw in the research.<br /><br />Peer review is an integral part of the evaluation process. Peer review starts with the review prior to publication but continues long after. It is a critical part of the process because it exposes flaws or weaknesses that the original researcher failed to think of – it illuminates any potential blind spots. Peer review also has the uncomfortable effect of forcing the researcher to explain their assumptions, their methods, their results and conclusions.<br /><br /><b>[4] Repeat.</b><br /><br />That's right. Repeat. And repeat again. No hypothesis gets confirmed by just one test. Not even <i>theories</i> - which are veteran hypotheses that have been tested and confirmed so thoroughly that they are given a certain degree of respect - get to rest on their laurels.<br /><br />Sooner or later, somebody will find a new way to test, say, the theory of gravity and find a problem. Then they get to propose how to correct the theory. And then everybody else gets to critique that proposal and offer their own changes, tweaks and suggestions. And the process goes on.<br /><br /><br /><br />The process has its flaws, to be sure. It slows down the acceptance of radical new ideas and can prolong old ideas beyond their time. However, it is the best system that the human has yet devised for sorting the few grains of “truth” from the vast amount of chaff. And if it slowed the widespread acceptance of some ideas – such as stomach ulcers caused by <i>Helicobacter pylori</i>, a favorite of “scientific method bashers” – it also prevented the premature acceptance of ideas like cold fusion.<br /><br />Imagine, if it hadn’t been for stodgy old scientific method, our homes would be powered by cold fusion – and we’d all be sitting in the dark.<br /><br /><br />Up next – bias and self-deception.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com3tag:blogger.com,1999:blog-13759793.post-25778763844055597732007-02-11T13:56:00.000-08:002007-04-16T11:17:32.506-07:00Word Play: BelievingThe English language is often tricky, even for those of us who grew up speaking it. One problem is that some words have several - often somewhat contradictory - meanings. One such word is "believe":<br /><br /><a href="http://dictionary.reference.com/browse/believe"><span style="font-size:85%;">be·lieve</span></a><span style="font-size:85%;"> </span><a href="https://secure.reference.com/premium/login.html?rd=2&u=http%3A%2F%2Fdictionary.reference.com%2Fbrowse%2Fbelieve"></a><span style="font-size:85%;">/bɪˈliv</span><br /><span style="font-size:85%;"></span><br /><span style="font-size:85%;">–verb (used without object)</span><br /><span style="font-size:85%;"><br />1. to have confidence in the truth, the existence, or the reliability of something, although without absolute proof that one is right in doing so: Only if one believes in something can one act purposefully. </span><br /><span style="font-size:85%;"></span><br /><span style="font-size:85%;">–verb (used with object) </span><br /><br /><span style="font-size:85%;">2. to have confidence or faith in the truth of (a positive assertion, story, etc.); give credence to. </span><br /><br /><span style="font-size:85%;">3. to have confidence in the assertions of (a person). </span><br /><br /><span style="font-size:85%;">4. to have a conviction that (a person or thing) is, has been, or will be engaged in a given action or involved in a given situation: The fugitive is believed to be headed for the Mexican border. </span><br /><br /><span style="font-size:85%;">5. to suppose or assume; understand (usually fol. by a noun clause): I believe that he has left town. </span><br /><br />"Believe" crops up in the context of this 'blog because of the disparate ways in which people have validated the assertions that they make.<br /><br />In my business, "believe" is used in the sense of definition 2, with the additional <i>caveat</i> that our confidence in the truth of some statement is based on examination <u>and understanding of</u> the data used to support that statement.<br /><br />Thus, when I say, "I believe in the Theory of Evolution.", I am <i>not</i> expressing a religious faith (as the Creationists/Intelligent Designers would have you think), but am stating:<br /><br />"I have examined the theory of evolution and have found it consistent with the available data from current life and the fossil record"<br /><br />It's just shorter to say that I "believe" it.<br /><br />Another way in which some people use "believe" in the realm of science (as opposed to religion, where definition 1 would be entirely appropriate) is to indicate that they trust the <i>source</i> of their information such that they are willing to accept it without actually understanding it. In essence, they are simply "parroting" what they have been told.<br /><br />Now, most of the people who are acting as "parrots" don't see it that way. They are usually convinced that they understand the topic quite well enough to see that their assertions are correct. They assume that a superficial - and usually over-simplified - understanding of an issue can make them equal to people who have studied the topic in depth.<br /><br />To some extent, this belief (definition 1) that "everyday people" can understand a topic as well (or, in some instances, better) than the "experts" is a lingering <a href="http://dictionary.reference.com/browse/zeitgeist">zeitgeist</a> of the 20th century, epitomized by many in the "Baby Boomer" generation (my generation, regrettably). It is, unfortunately, no more a reflection of reality than most of the philosophical nonsense to come out of that generation.<br /><br />Moral philosophy, no matter how good it makes you feel, never trumps reality. The Soviet Union had to learn this lesson the hard way (see: <a href="http://en.wikipedia.org/wiki/Trofim_Lysenko">Trofim Lysenko</a>) and it appears that many in the Western World are determined to repeat their mistakes.<br /><br />No, as much as we might like it to be different, there is no substitute for actually <i>learning</i> the subject. Reading "Molecular Biology for Dummies" will not put you on par with someone who has put in the hours and effort required to really learn the subject. This is not to say that people with lots of education and advanced degrees cannot be wrong - that is most <i>definitely</i> not true (see: <a href="http://www.princeton.edu/~chm333/2002/spring/Fusion/tour2/coldfusion2.html">cold fusion</a>)! However, when discussing their field, the smart money is betting on the "expert" over the "self-educated".<br /><br />So, why <i>is</i> it that so many people think that they know more about, say, autism and mercury than the people who have studied it for decades? For the answer to this question, we have to go to the source - literally.<br /><br />These days, it is considered <i>indelicate</i> for a doctor or scientist to say (or imply) that a topic is too complex for the "public" (<i>i.e.</i> the "average" person) to understand. This despite the all too obvious fact that many - if not most - topics in science have grown too complex even for scientists outside the field to fully grasp. The "average" person, with at most a semester or two of college science, hasn't a chance.<br /><br />As a result, people read about some aspect of biology, chemistry or physics in <i>Scientific American</i> and think that they can intelligently discuss the matter with someone who does research in the field (true story). And in situations where the source either doesn't have a full grasp of the topic <i>or</i> has a personal reason to over-simplify the matter (actually, those two aren't mutually exclusive), the potential for deception - intentional or not - is extreme.<br /><br />For example, there is currently a belief that the GnRH agonist, leuprolide (Lupron) will help autistic children. On the part of the people originating this idea, the belief (definition 2) in Lupron's effectiveness is based on two other beliefs (definition 2?):<br /><br />[1] Autism is caused by mercury toxicity<br /><br />[2] Testosterone and mercury form a complex, with sheets of testosterone surrounding mercury atoms<br /><br />The validity of belief [1] is very doubtful at present, but belief [2] is valid - with one <i>caveat</i>:<br /><br /><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=5756987&amp;amp;amp;amp;amp;query_hl=1&itool=pubmed_DocSum">The complex of testosterone and mercury </a>has only been seen when equimolar amounts (equal number of molecules of each) were mixed with the minimal amount of hot (50 degrees C, about 120 degrees F) <a href="http://www.bt.cdc.gov/agent/benzene/basics/facts.asp">benzene</a>.<br /><br />Now, it is entirely possible that the people who started this idea are unaware of the little <i>caveat</i> above. But I'd be willing to bet a largish sum that the people who are parroting the "lupron helps cure autism" claim are <i>completely</i> unaware of it. Yet it is information that is freely available...if you can understand it.<br /><br />So why do I worry about people repeating nonsense they don't understand?<br /><br />A large part of the problem with the parroting of bad (or unsubstantiated) information is that people - so the psycholgists tell me - tend to give credence to things they hear from numerous other people. "Everybody's saying it, so it <i>must</i> be true!" Such tempting logic, but false.<br /><br />This same sort of "logic" crops up in the various autism <a href="http://www.autismspeaks.org/inthenews/naar_archive/msnbc_autism_poll_rise.php" rel="nofollow">polls</a>, <a href="http://www.autismwebsite.com/ari/treatment/form34q.htm" rel="nofollow">surveys</a> and questionaires that litter the Internet. The folks running them must believe (definition 1, I suspect) that a collection of "average people" will generate an above average understanding of the topic. The myth of the "wisdom of the common man" is repackaged as the myth of the "wisdom of common parents".<br /><br />Don't get me wrong; I think that parents know a lot about their kids - I know a lot about mine. I also know a lot about my car, but I don't think for a moment that I understand its inner workings better than my mechanic. I still get peeved when she can't find the rattle or shimmy that I describe, but I don't think that I know more about how my car works than she does.<br /><br />In the end, scientific "fact" has traditionally shown no respect for opinion polls. No matter how many school children want Pi to equal 3, the mathematical relationship between a circle's radius and circumference remains obstinately the same (3.14159...). And even <a href="http://www.msnbc.msn.com/id/6470259">majority support on the school board</a> won't make "Intelligent Design" a valid hypothesis - let alone a theory. The same will happen with polls and surveys about the cause of autism - no matter how many people "vote" for mercury, the facts will remain unchanged.<br /><br />You can choose to believe that or not.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com7tag:blogger.com,1999:blog-13759793.post-1170826745478583852007-02-07T01:01:00.000-08:002007-04-16T11:17:13.115-07:00What You Want is What You GetA few weeks ago, a reporter interviewed me about my research. During the interview, she asked me, “What do you want the result to be?” I was flabbergasted – it truly had never occurred to me to “want” an outcome to my research. I want to find out what really happens, what reality is – at least in the small world of my research project.<br /><br />“Wanting” an outcome is what starts a lot of pseudoscience. The <a href="http://photoninthedarkness.blogspot.com/2006/03/undead-bad-science.html">Holmes, <em>et al</em> </a>paper is a great example of what happens when you “want” a certain result. Certain that mercury was the cause of autism, the authors took their very screwy results and spun a “Just So” story that, as it turned out, “Just Isn’t So”.<br /><br />This is not always a conscious distortion of reality. Too often, it is the absolute certainty that their hypothesis is right that leads otherwise rational scientists over the edge and into the abyss. Just ask Stanley Pons and Martin Fleischman, “discoverers” of <a href="http://www.lycos.com/info/cold-fusion--stanley-pons.html">cold fusion </a>. Neither of them was a “crackpot”, but they let their belief in their own hypothesis blind them to the flaws (major flaws) in the data.<br /><br />Which leads us to the question of mercury and autism.<br /><br />Let’s go ‘way back to the beginning of the hypothesis. Some folks thought that the apparent rise in autism prevalence (the “autism epidemic”) starting around 1985 could be due to the increase in thimerosal-containing vaccines that happened at about the same time. The timing wasn’t particularly close, but it wasn’t the worst hypothesis ever written. The known neurotoxicity of mercury made it biologically plausible (but didn’t prove that thimerosal could cause autism).<br /><br />In real science, a hypothesis needs to explain the data – all the data – or it needs to be revised (or replaced). Things started to go wrong with the mercury-autism hypothesis when the <a href="http://pediatrics.aappublications.org/cgi/content/full/112/3/604">Madsen, <i>et al</i></a> study failed to show a drop in Danish autism prevalence after Denmark removed thimerosal from its vaccines. There were some methodological problems with the study (which were spelled out by the authors), but it certainly raised a lot of doubt.<br /><br />Before too long, more studies came out showing the lack of association between thimerosal dose and autism prevalence (<a href="http://pediatrics.aappublications.org/cgi/content/full/112/3/604)">Verstraeten, <em>et al</em> </a>and <a href="http://pediatrics.aappublications.org/cgi/content/full/113/1/184">Andrews, <em>et al; </em></a><a href="http://pediatrics.aappublications.org/cgi/content/full/118/1/e139">Fombonne, <em>et al</em></a>). Rather than modifying (or abandoning) the mercury-causes-autism hypothesis, its proponents concentrated on attacking the motivations and ethics of the researchers.<br /><br />A few studies using the thoroughly discredited VAERS database (see <a href="http://pediatrics.aappublications.org/cgi/content/full/117/2/387">Goodman and Nordin</a>) attempted to refute the better-designed studies, but were generally disregarded, except by those who were desperately trying to keep the mercury-causes-autism hypothesis alive. A report of declining autism prevalence (<a href="http://www.medscimonit.com/pub/vol_12/no_6/8025.pdf">Geier and Geier</a>) was not only poorly done but, as later data revealed, wrong.<br /><br />Here is the crux of the matter: the autism prevalence data from the California Department of Developmental Services (CDDS) and the United States Department of Education (USDE) have not shown a decline in autism prevalence. That is not an issue in question – it is simple fact. Whether or not this data is valid (and there is some doubt about that, see <a href="http://pediatrics.aappublications.org/cgi/content/abstract/117/4/1028">Shattuck</a>, <a href="http://pediatrics.aappublications.org/cgi/content/full/115/3/e277">Newschaffer</a> and <a href="http://pediatrics.aappublications.org/cgi/content/full/116/1/e120">Laidler</a>), it was what the original mercury-causes-autism hypothesis was based on.<br /><br />The reason that the prevalence of autism is so critical to the mercury-causes-autism hypothesis is, of course, because thimerosal was removed from children’s vaccines in the US sometime between 2000 and 2001 (depending on which source you use). No matter when it was finally completely removed, the thimerosal dose received by children in their vaccines has [a] not risen since 1999 and [b] has significantly fallen since 2000.<br /><br />Thus, even if thimerosal had remained in all children’s vaccines at its 1999 concentration – which it hasn’t – the autism prevalence should have reached a plateau by now. And it hasn’t.<br /><br />Let me repeat that, for emphasis.<br /><br />Even if the total amount of thimerosal that a child received in vaccines had remained at the 1999 level, the prevalence of autism would have reached a plateau by now if thimerosal was a major cause of autism.<br /><br />Given that the thimerosal dose received by children born after 2001 (to allow an overly generous time for all the “on the shelf” doses to be used) has been significantly reduced, we should have seen a decline in autism prevalence by now, if thimerosal caused a significant fraction of autism cases. And we haven’t – decidedly not.<br /><br />Now, the mercury-causes-autism proponents have been forced to resort to a variety of “bait and switch” tactics to keep their supporters’ eyes off of the poverty of their hypothesis. Mercury from power plants, China and crematoria has been invoked – despite the fact that mercury deposition rates have been declining since 1961 (<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16749680&amp;amp;amp;amp;amp;amp;amp;amp;query_hl=21&itool=pubmed_docsum">Roos-Barraclough, <i>et al</i> </a>).<br /><br />They have also proposed mercury in dental amalgams, Rho-Gam shots and flu shots as potential sources of mercury.<br /><br />The basic problem with all this “bait and switch” is that they are acting as though the core assertion of their hypothesis – that mercury can cause autism – has been proven, which it decidedly has not!<br /><br />The failure of US, UK, Danish, Swedish and Canadian autism prevalence to fall following the removal of thimerosal from children’s vaccines has not supported their claim – in fact, it has weakened it. In addition, showing that mercury can cause autoimmune disorders, “oxidative stress” and neuronal injury is not the same as showing that it can cause autism.<br /><br />Pretty much everybody knows that mercury is not a good thing for you. This is not the question. The question at hand is whether it can cause autism. And the answer to that question – at least so far – has been “No.”<br /><br />So, asking if I’m in favor of exposing kids to mercury or if I think that mercury is a good thing for kids is simply a ploy to shift attention away from the glaring absence of data supporting the mercury-causes-autism hypothesis.<br /><br />And pointing out that flu shots have mercury, or that there is mercury in our food, water and air is just more of the same. The onus is on those who propose that mercury causes autism to bring sufficient data (data, not testimonials, stories about “recovered” children or wild fantasies about governmental conspiracies) to the table to show why <i>their</i> hypothesis is a better explanation of how the universe (and neurobiology) works than the “null hypothesis” (that mercury <i>doesn't</i> cause autism).<br /><br /><br /><b>A few ground rules:</b><br /><br />As a personal pre-condition (a promise made to myself) of returning to ‘blogging, I have elected to moderate all comments. I do this to prevent the sort of free-for-all insult-fests that are all too common from certain individuals (who need not be named).<br /><br />I expect people to behave themselves in a civilized fashion. Do not bring fights from other ‘blogs into this one simply because you have been banned somewhere else. Fore Sam has already gotten himself banned for a day for doing just that. And because he has already used up his lifetime allotment of second chances. Fore Sam, consider yourself on permanent probation – you’ve earned it.<br /><br />If it upsets you that your commentary is not appreciated here, then you are free to set up your own ‘blog and rant about my arbitrary justice to your heart’s content. You are free to say what you want here, as long as you remain within the bounds of civilized discourse.<br /><br />Finally, do not be surprised or upset if your assertions ("It's right because I <i>say</i> it's right! Are you callin' me a liar!?!"}, anecdotes ("It worked for me!"), unsupported hypotheses ("I don't have any data! I don't have <i>time</i> to get data - I'm busy saving lives!") and conspiracies ("It's a guv'mint plot!") fail to convince. That's just the way science works.<br /><br /><br />Enjoy!<br /><br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com21tag:blogger.com,1999:blog-13759793.post-1170645315710872692007-02-04T17:08:00.000-08:002007-04-09T14:18:03.870-07:00Prometheus RisesSorry to have bugged out so suddenly and for so long. I hope that I still have a few readers left after all this time.<br /><br />I unexpectedly received a grant (these days, almost nobody <i>expects</i> to get an <a href="http://www.nsf.gov/funding/aboutfunding.jsp">NSF grant</a>) and have been busy getting things underway. With only a year to show results, I decided it was better to scurry now than scramble later.<br /><br />Anyway, life has returned to the usual degree of insanity, so I'm going to take a foray back into blogging. In the six months that the blog has been cooling, I have continued to monitor the blogosphere. And what I've seen has not been encouraging.<br /><br /><br /><b>Mercury/Autism Madness:</b><br /><br />Despite several goalpost moves, time is running out on the thimerosal-causes-autism hypothesis. Autism numbers from the USDE and Cal DDS continue to rise in blatant disregard of several predictions from prominent mercury/autism spokespeople that autism numbers will be falling "<a href="http://www.kevinleitch.co.uk/wp/?p=429">in 2005", "in 2007" and "sometime real soon</a>".<br /><br />Anticipating the inevitable demise of the thimerosal-in-vaccines-causes-autism hypothesis, the promoters of mercury/autism are branching out. Their strategies to date (and I may have missed a few) are:<br /><br />[1] Trace amounts of thimerosal remain in the vaccines -<br /><br />This tactic has an almost homeopathic ring to it. According to its advocates, the trace amounts (nanograms) of thimerosal in vaccines are as effective at causing autism as the larger amount (micrograms) previously in vaccines. This ignores the fact that the amount of thimerosal in current vaccines is orders of magnitude lower than the amount children received in the 1960's and 1970's - before the "autism epidemic" started.<br /><br />[2] It's the <a href="http://www.autismhelpforyou.com/aluminum_connection.htm" rel="nofollow">aluminium, formaldehyde</a>, or other additives in the vaccines.<br /><br />This is the old "bait and switch" tactic. They have no data to support their proposed link between thimerosal and autism, but they <i>have</i> created a public uproar about it. This strategy is an attempt to transfer the "buzz" they created about mercury to some other vaccine component.<br /><br />It took years to put a stake through the heart of mercury/autism and it would take just as long to accumulate the data to refute the aluminium/autism hypothesis. This would be a tremendous waste of time and money, since there is even less reason to suspect that aluminium in vaccines can cause autism.<br /><br />[3] <a href="http://www.upi.com/archive/view.php?archive=1&StoryID=20050314-052518-7615r" rel="nofollow">Mercury from other sources is causing autism</a>.<br /><br />Considering the numerous studies that have shown that <a href="http://pubs.acs.org/cgi-bin/abstract.cgi/esthag/2006/40/i10/abs/es051945p.html">terrestrial mercury deposition</a> is lower now than any time since the early 1960's, this is an obvious desperation shot. It is clearly aimed at the general public, rather than anyone in the scientific community, where it was dead on arrival. Mercury from power plants, crematoria or China are not going to push exposure above where it was in the 1960's (or 1880's), so this has no real hope of success.<br /><br />[4] Data from USDE and Cal DDS are not valid.<br /><br />This one is almost embarrassing, since it's what their opponents have been saying all along. However, there are a few arguments in the blogosphere from mercury/autism proponents that are using this line of "reasoning". Having used the USDE and Cal DDS data to support their "autism epidemic", they now argue that the same data source cannot show the expected decline. In other words, the data can only show a rise in autism prevalence, not a decline.<br /><br />Of course, more than a few people have argued for years that the USDE and Cal DDS don't show <i>anything</i> useful about real autism prevalence - up <i>or</i> down. Now, having (ab)used the data to come up with an "autism epidemic", they argue that the data is no good. Amazing!<br /><br /><br /><b>Autism "Therapies"</b><br /><br />The insanity continues unabated. Risperidone is an <i>evil</i> pharmaceutical and <a href="http://www.neurodiversity.com/weblog/article/83/">Lupron</a> is a wonder drug. Amazing. There are numerous studies showing that the former is a useful treatment for some children with autism and nothing except some wild (and nonsensical) supposition to support the latter. Yet parents are told to fear and shun "drugs" and treat their children with Lupron (not a drug?) instead.<br /><br />I eagerly await the news that the "alternative" autism treatment community has found a single therapy without merit and abandoned it. But it hasn't happened yet. And I suspect that it will never happen.<br /><br />Real medicine periodically finds therapies lacking and discards them. "Alternative" medicine appears to make no mistakes and adopts nothing but effective therapies. This would be in keeping with the larger-than-life superhuman nature of its practitioners, no doubt.<br /><br /><br /><b>Creationism ("Intelligent Design")</b><br /><br />Having undergone several painful and public drubbings, the Creationists have returned to their holes to lick their wounds. But, they <u>will</u> be back - count on it. In fact, they are already sending out some tentative feelers to see how they can get their religion back into the science classes. The first of these may be an attempt to cast <a href="http://www.discovery.org/scripts/viewDB/index.php?command=view&id=3850&program=CSC%20-%20Views%20and%20News" rel="nofollow">"Darwinism" as a religious faith</a>. Another is the portrayal of the recent court cases as attempts to "<a href="http://www.discovery.org/scripts/viewDB/index.php?command=view&id=3850&program=CSC%20-%20Views%20and%20News" rel="nofollow">suppress scientific dissent</a>".<br /><br />In either case, we will have to remain vigilent against the intrusions of the creationists into the science classrooms. I have my own ideas, which I will in due course trot out for evaluation right here.<br /><br /><br />For the meanwhile, it's good to be back in the blogosphere.<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com20tag:blogger.com,1999:blog-13759793.post-1153588356894604502006-07-22T11:30:00.000-07:002007-02-04T17:08:14.196-08:00Another Autistic Child Murdered (Take Two)I have deleted the previous post under this title after reading the comments - including my own - and reflecting on them. In what may be a once-in-a-lifetime occurence, I find myself in agreement with JB Handley on one thing - that I was wrong to suggest that Generation Rescue or any of the other autism advocacy groups bear part of the blame for this latest string of killings. People are responsible for their actions, regardless of their mental state at the time, and so the <i>only</i> people who can be fairly blamed in these killings are the killers themselves. <br /><br />As I reflected on this, I found myself wondering <i>why</i> these four murders - Alison Davies, Christopher DeGroot, Katie McCarron and William H. Lash, IV - had affected me so deeply. The obvious answer is that any death <i>should</i> affect me, but the hard, cold truth of the matter is that, with people being killed in wholesale lots both in this country and elsewhere, it is hard to maintain that sort of intensity for long.<br /><br />Another plausible answer is that these are murders of children, which seems somehow worse than the murder of an adult. This is certainly true enough, but still seems a bit too pat. In 1993, the <i>Chicago Tribune</i> put all murdered children (defined as age 19 and less) on their front pages - ending with a massive front-page photo spread on December 31st. As I recall, the number was well over 100. It was saddening and shocking, but somehow it didn't hit me the same way - it didn't get under my skin and into my head the way these four murders have.<br /><br />Quite possibly, the reason is that I also have a disabled child, and so these murders resonated with me more strongly than others. But then it hit me - what was different about these murders when compared to the hundreds that happen every years was that they were so terribly <i>premeditated</i>.<br /><br />For some reason, I find it easier to understand the "heat of the moment" murder - probably from years of television shows, starting with <i>Perry Mason</i>, in which otherwise reasonable, normal people kill in a moment of anger. Even in the <i>Chicago Tribune's</i> year-long series on murdered children, almost all were clearly done in the heat of anger (over half were teenagers killed in gang-related violence, the next largest group was infants and toddlers murdered by their mothers' "boyfriends"). <br /><br />I have tried to understand how someone could kill their own child, tried to put myself in their shoes, as it were, with little success. I have been angry at my children, have even wanted to hit them, but I have never wanted to <i>kill</i> them. For me, that emotion is like the blank areas on ancient maps - "Here there be monsters" - <i>terra incognita</i>. <br /><br />As part of my reflection, I tried to visualize what it would be like to deliberately kill my child. It just doesn't work for me - I get to the point of raising the weapon and see their sad or fearful face and I just melt. I actually wept, just from the thought of it.<br /><br />In all four cases, the parents who killed their autistic children had time to reconsider what they were doing - they had to push their child off the bridge, smother them, set fire to their apartment and lock their child inside, or take down the shotgun, load it and fire (I doubt that the Lash family kept a loaded shotgun above the fireplace, not in Washington , DC). I can't even <i>begin</i> to comprehend the frame of mind that this would require.<br /><br />And this is not to say that I haven't experienced hopelessness and despair. There have been times when I saw my entire life stretching out - past retirement and into death - as the tireless and thankless caretaker of a disabled child. But it didn't drive me to murder - it drove me to set up a trust fund. Because no matter how thankless the job may be, it's <i>my</i> job and I'm going to see that it gets done, even after I'm dead. <br /><br />Another part of the stories that has bothered me is the way that the last two - Katie McCarron and William Lash - seemed to put a lie to the usual "explanations". In neither of these families was there serious financial want or a lack of support. More government programs or more volunteer respite care would not have materially changed the situations these families were in. Neither did it apear that there had been a pattern of irrational behavior that - in retrospect, at least - could have been seen as "warning signs". <br /><br />I would like to point to the heated and polarizing rhetoric surrounding autism as a factor in these crimes, but the fact is that I just don't know. And that's because I can't even get a glimmer of what these parents must have been thinking when they set out to deliberately and with malice aforethought to murder their children.<br /><br />Years ago, I went to a wonderful lecture about the origins of the Universe - the "Big Bang". At one point, the lecturer mentioned that the condition of the newly-born Universe - the extremes of temperature and pressure - so far exceeded anything that exists in our time that he wasn't sure that our current physical laws would apply. <br /><br />That's how I feel about these murders - they are so foreign to what I know and what I've experienced that they are as incomprehensible as the first microsecond after the "Big Bang". <br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com24tag:blogger.com,1999:blog-13759793.post-1152573341099376592006-07-10T18:02:00.000-07:002007-04-09T14:21:11.906-07:00The Seven Most Common Thinking Errors of Highly Amusing Quacks and Pseudoscientists (Part 3):<b><u>Thinking Error 4 – Conspiracy Theories</u>:</b><br /><br />To paraphrase Samuel Johnson, “Conspiracy is the last refuge of a quack.”<br /><br />Assertions of conspiracy receive a great deal of play in the claims of quacks and pseudoscientists. These range from the ridiculous to the…well, even <i>more</i> ridiculous. No matter what their details may be (<i>e.g.</i> whether the enemy is “the government”, Big Oil, Big Pharma, the AMA or all four), all conspiracy claims serve the same function:<br /><br /><b>They divert attention from the failures of the person making the claim.</b><br /><br />And, no matter what the details of the particular failure may be, at the root is the same issue:<br /><br /><b>The failure to provide data to support their claim(s).</b><br /><br />So, whether it’s the automobile engine that runs on water (suppressed and sabotaged by Big Oil) or the “fact” that chelating out mercury cures autism (suppressed by “the government”, Big Pharma and the AMA), the <i>reason</i> that these conspiracy “theories” are proffered is always the same:<br /><br /><b>They can’t prove their claim(s).</b><br /><br />After all, if someone <i>had</i> a working model of an automobile engine that could run on water, or the clinical data showing that chelation could cure autism, there wouldn’t be any reason to complain about interference from “the government” or Big Oil or etc.<br /><br />So, what is it that the conspiracy claims do? They allow the quack or pseudoscientist to make their unsupported claim(s) and blame someone else for their lack of support. This is really no different than claiming that “the dog ate my homework”, except that there is no “dog” (and, of course, there was never any “homework”).<br /><br />This brings us to the <i>other</i> problem with the conspiracy excuse: plausibility.<br /><br />Ask yourself, which is more likely; that a single person (or small group of people) might lie (or be self-deceived) or that an entire bureaucracy or corporation, filled with people who might have something to gain by revealing a guilty secret, might conspire to suppress information?<br /><br />Before you answer that, consider this – the difficulty of keeping a secret rises with the number of people who know the secret. This can be mathematically represented thus:<br /><br /><b>D = n^(n-1)</b><br /><br />Where D is the difficulty of keeping something secret and n is the number of people who know the secret.<br /><br />Even without the math, anyone who can read the newspaper knows the ability of “the government” or other large organizations to keep embarrassing information secret. What makes you think that the “secrets” about water-fueled automobile engines and chelation curing autism would be any different?<br /><br />In short, claiming conspiracy is a near-certain indicator of quackery and/or pseudoscience. It is the adult (or, more properly, “pseudoadult”) version of “the dog ate my homework”. In addition, it is not even plausible, given the inability of “the government: and other large organizations to keep secrets.<br /><br /><br /><b><u>Thinking Error 5 – Personal Infallibility</u>:</b><br /><br />One thinking error that comes up extremely often is the error of personal infallibility. This one seems to be shared not only by the quacks and pseudoscientists but also by their victims.<br /><br />Personal infallibility does not necessarily mean that the person thinks that they are <i>never</i> wrong (although some do), but refers to a more subtle belief that their <i>observations</i> are an infallible source of “fact”. I find this a particularly amusing belief, especially in the context of modern technology’s ability to deceive the senses, displayed every day in movie theatres across the world. Yet, despite this near-daily demonstration that “seeing is NOT believing”, quacks, pseudoscientists and their faithful followers and apologists persist in deferring to their own experiences as if they were infallible.<br /><br />The root of this problem is the human ability to find patterns. We are genetically adapted to find patterns in the world around us; we are so good at this that we are continually finding patterns when none exist. We “connect the dots” in optical illusions and we see causation in coincidence.<br /><br />One of the most important steps on the path to what we now call “science” was the philosophy of the Empiricists. They held that the only way to learn about the universe was to <i>observe</i> it. This contrasted starkly with other “natural philosophers” of the time, who felt that they could sit in their drawing rooms and libraries, drinking brandy and philosophizing about how the universe worked. Like many of the quacks and pseudoscientists of <i>our</i> day, they felt that actually getting in the lab or in the field and seeing if their hypotheses worked was irrelevant. After all, some of the finest minds in the world (theirs and their associates) had agreed that the sun and planets circled the earth, so what was the point in getting cold and tired peering through some blasted telescope?<br /><br />Although the Empiricists eventually won the day (although their opponents continue to populate the chiropractic and naturopathic colleges), there was a small flaw in the philosophy of Empiricism that needed correcting. You see, while large-scale physics and chemistry are fairly deterministic, there is a great deal of variation and even randomness in biology (and in physics and chemistry on the smaller scales). As a result, it is often difficult to tell if a change seen in a biological system is due to an experimental intervention or simply due to random variation.<br /><br />Because of the stochastic nature of biology (which, by the way, includes medicine), it is <i>very</i> easy for a researcher to see a change in an organism and erroneously attribute it to some intervention they have made when, in fact, the change was not related at all to that intervention. In addition, since many of the changes seen in biological organisms are hard to measure quantitatively (<i>e.g.</i> pain, depression, language ability), the observer is often called upon to not only observe but to be the “measuring instrument”.<br /><br />This is the reason that the multiple subject, double blind, placebo-controlled study is considered to be the “gold standard” in research (except by those whose “claims” are disproven by such studies). This is not to say that good data cannot be gotten any other way, but this is the standard to aim for.<br /><br />So, what’s so great about the multiple-subject, double-blind, placebo-controlled study? Let me explain in parts:<br /><br />[1] Multiple-subject:<br /><br />Since biology has a great deal of inherent random variation, a single organism (a single person) is not a good indicator of what the population is like. After all, I am not a good example of what the human population is like since approximately half of the world’s population is of a different sex. Likewise, there are people shorter and taller than me, lighter and darker in skin color, etc.<br /><br />The way to arrive at what the population looks like is to take a larger sample. You can predict mathematically the likelihood that your sample is an accurate representation of the population based on the sample size (and the population size) – the bigger the sample, the greater the probability that it reflects the reality of the population.<br /><br />In addition, biological organisms change over time – if they don’t, they’re probably dead. As a result, certain changes will happen regardless of whether an intervention occurs or not. Studying a larger group will “average out” these spontaneous changes, since – by random chance – a roughly equal number will occur before and after the intervention.<br /><br />[2] Placebo-controlled:<br /><br />Taken out of order (for reasons that will become apparent), placebo-control is a critical part of biological experimentation, <i>especially</i> when the subjects are humans. A placebo, in general terms, is a treatment that is similar enough to the studied intervention that the subject receiving it (and, ideally, the person <i>giving</i> it) cannot tell it apart from the “real” treatment, but it <i>has no effect</i>. Most classically, it is a sugar pill or saline injection that is the same color and consistency as the treatment under study.<br /><br />Failure to use placebo control has tripped up any number of medical researchers, including some who are legitimate scientists. Among "real" researchers, this most commonly occurs in behavioral interventions (where interaction with the “therapist” can be as big a factor as the “therapy” is supposed to be) and surgical interventions (where questions of ethics may prevent a “placebo” surgery in human subjects). Unsuspecting quacks often fail to realize that their interaction with the patient may be causing the change they measure, rather than their “therapy”. Charlatans count on it.<br /><br />In human studies, failure to use a placebo can lead to falsely believing that a therapy has a beneficial effect when, in fact, it is the <i>expectation</i> of benefit that causes the subject to feel better. This has been borne out time and again in pain control research, where supposedly effective therapies have been overturned because subjects receiving a placebo had the same degree of relief. In pain studies, approximately 30% of subjects will report "good" or better pain relief with a placebo.<br /><br />This is sometimes erroneously referred to as the “placebo effect”, which is an oxymoron. A placebo has – by definition - <i>no effect</i>. It is the psychological effect of the subject <i>believing</i> that they will feel better that causes the effect.<br /><br /><br />[3] Double-blind:<br /><br />Double blind means that neither the subject (the organism being studied) <i>nor</i> the observer knows whether any particular subject is receiving a placebo or the studied therapy. A single-blind study would be when the observer knows but the subjects do not.<br /><br />The advantage of a double-blind study is that not only do the subjects not know who is “supposed” to feel better, but neither do the observers. This is especially important if the measurement of “success” or “failure” of the treatment is not completely objective. When measuring blood pressure or heart rate, it is not so important that the observers not know who received the placebo, since these measures leave little or no room for observer interpretation. However, if the measures are more subjective - such as behaviors, pain, depression, social interaction, etc. - then observer interpretation <i>can</i> be affected by the knowledge of who is “supposed” to get better and who is not.<br /><br /><br />None of this is hidden knowledge and none of this is particularly new. Yet, every day I read about patients, parents and practitioners who declare, “I see an improvement – are you calling me a liar?” These people are unaware – or are in denial of their awareness – that we humans often see exactly what we <i>want</i> to see and hear what we <i>want</i> to hear. To think that we can be truly objective – especially when it involves ourselves, our loved ones or a hypothesis we are in love with – is to claim an infallibility we are not capable of.<br /><br />So, when you hear someone say, “I saw it with my own eyes!”, be sure to ask (at least to yourself), “Yes, but what would someone else’s eyes have seen?”<br /><br /><br />Coming up: Cherry picking – it’s not just happening in the orchard.<br /><br /><br />Prometheus.Prometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com16tag:blogger.com,1999:blog-13759793.post-1152370451153635942006-07-08T06:40:00.000-07:002006-07-08T08:02:01.886-07:00We interrupt this blog for breaking news...<b>Extreme Humiliation - A New Sport for the Mercury-Autism Crowd?</b><br /><br />Kathleen Seidel, in her <a href="http://www.neurodiversity.com/">Neurodiversity website</a>, has broken what may be the "<a href="http://www.neurodiversity.com/court/rhogam_decision.pdf">story of the year</a>" about the "dysfunctional duo" of Geier and Geier (the <a href="http://photoninthedarkness.blogspot.com/2005/07/dumpster-diving-republished.html">subjects</a> of <a href="http://photoninthedarkness.blogspot.com/2006/03/miscellaneous-mercury-nonsense.html">many</a> <a href="http://photoninthedarkness.blogspot.com/2006/03/armchair-science-vs-real-science.html">posts</a> on this humble blog). The story is told, with great skill, by Kevin Leitch on his <a href="http://www.kevinleitch.co.uk/wp/index.php?p=393">Left Brain/Right Brain blog</a>.<br /><br />In a nutshell (which is where Geier, Sr. belongs, it would seem), in an opinion handed down on 6 July, 2006, pertaining to a lawsuit alleging that the thimerosal in RhoGam caused a young child's autism, District Court judge James Beaty addressed the qualifications (or patent lack thereof) of Mark Geier, MD in excruciating detail. Kevin covers the published legal opinion thoroughly, but there were a few aspects that I personally found too delicious to pass by.<br /><br />On page 9 of the opinion, Judge Beaty discusses how Mark Geier has testified in "about one hundred cases before the National Vaccine Injury Compensation Program" and how his testimony, since 1995, has "...either been excluded or accorded little or no weight based upon a determination that he was testifying beyond his expertise." He then proceeds to enumerate those humiliations in a footnote. Ouch! To have your personal failings summed up in a footnote - how humiliating!<br /><br />Judge Beaty then describes how Mark Geier "...relied on a number of disparate and unconnected studies, including the findings of Dr. Haley [more about him later] and Dr. Lucier, to reach a piecemeal conclusion..." That one's going to leave a bruise. And it just happens to be what I've been saying about the mercury-autism cohort for some time - but Judge Beaty said it so much more eloquently.<br /><br />Not content with just saying the obvious, Judge Beaty then methodically dismantles Mark Geier's case for thimerosal causing autism, study by study. He even takes the time to dismantle the <a href="http://photoninthedarkness.blogspot.com/2005/07/dr-hornigs-autistic-mice_29.html">Hornig "Rain Mouse"</a> study and - my favorite - the Holmes/Blaxill/Haley baby haircut study (see <a href="http://photoninthedarkness.blogspot.com/2005/07/pefect-example-of-how-not-to-do-study.html">here</a> and <a href="http://photoninthedarkness.blogspot.com/2005/07/perfect-example-of-how-not-to-do-study.html">here</a>). It's like we're the same person! He then restates what he has made so painfully obvious:<br /><br /><blockquote>"It is also significant in the review of his methodology that Dr. Geier could not point to a single study that conclusively determined that any amount of mercury could cause the specific neurological disorder of autism."<br /></blockquote><br />Bang! Another hickory stake through the heart of that undead spirit, the shade of mercury-autism.<br /><br />And in yet another painful restatement of reality, Judge Beaty concludes:<br /><br /><blockquote><p>"Moreover, Dr. Geier's conclusion that the peer-reviewed literature he has relied upon supports his theory [more properly termed a "hypothesis" or even "ridiculous obsession"] that autism can be caused by thimerosal is flatly contradicted by all of the epidemiological studies available at this time."<br /></p></blockquote><br />Bang, bang! Yet another stake through the heart!<br /><br />In a footnote, Judge Beaty points out that irrational public statements can come back to haunt a person:<br /><br /><blockquote>"Dr. Geier has also exhibited some bias against health agencies that have criticized his methodologies on other issues to the extent that he has publicly accused the Centers for Disease Control ("CDC"), the World Health Organization, the American Academy of Pediatricians, and the National academy of Sciences of deceiving the American public as to the dangers of mercury and has specifically called the CDC a 'rogue organization' "</blockquote><br />And it keeps getting better! Judge Beaty sums up his assessment of Mark Geier's ability to be an expert witness on the ability of thimerosal to cause autism thusly:<br /><br />"Thus, while Dr. Geier's presentation of the literature as part of his methodology might at first glance appear convincing, the disconnected literature he presents does not add up to the opinion and conclusion that Dr. Geier is offering."<br /><br />He then rips into the Geier and Geier <a href="http://photoninthedarkness.blogspot.com/2005/07/dumpster-diving-republished.html">dumpster-diving (VAERS database) studies</a> in a most thorough fashion. Having dismantled them, he concludes that he need go no further in discrediting Mark Geier's testimony and then, like an encore after a virtuoso performance, he proceeds to shred Mark Geier's qualifications in general. He criticizes the elder Geier's diagnostic abilities, points out that he is neither a pediatrician or a pediatric neurologist and brings up the painful (to Mark Geier - I found it delightfully ironic) fact that Mark Geier failed his pediatric genetics board examination.<br /><br />After all that, there wasn't much else that could be said about the thoroughly discredited Mark Geier, unless Judge Beaty wanted to comment on his taste in ties.<br /><br />And Mark Geier wasn't the only person getting a solid dose of ego-spanking in this opinion. Boyd Haley, who should be eternally grateful that <i>he</i> didn't come fully into the spotlight in this case, also got his measure of ego-trauma. In a footnote (which makes it even more humiliating, somehow), Judge Beaty describes the contributions of Boyd Haley, PhD, MCDU (Mad Child Disease Unapologist) thusly:<br /><br /><blockquote>"...Dr, Haley's report does not state an expert opinion that thimerosal causes autism, rather just that he has a <i>theory</i> about how such a thing could happen." [emphasis in the original]</blockquote><br />Were I Boyd Haley, I would be glad to have been accorded so little notice and thus have escaped a more detailed humiliation. However, the ego of this "great scientist" must smart a bit after being dismissed so casually.<br /><br />So, all in all it was a happy outcome for the forces of reason and honesty. It also may be a foreshadowing of things to come when the massive (and long-delayed - by the plaintiffs) class-action vaccine lawsuit reaches the put-up-or-shut-up stage later this year.<br /><br />I'll have the popcorn ready for that one!<br /><br /><br />PrometheusPrometheushttp://www.blogger.com/profile/08152102935925348052noreply@blogger.com7