This rapid response from Clifford
Miller awaits publication in the BMJ.
Dr Dhillon's Statement - BMJ Allegations Not As Cut & Dried As Editor
Suggests
The journal paper Dr Dhillon cites in his personal statement [1] appears to cast light on these matters. It is entitled “Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative” [2].
It also appears to illustrate why journalists and non-specialist journal editors might find it wise not to stray too far from their appointed roles. The questions are now begging, why would a journal Editor step so far out of that editorial and publishing role to undertake such high profile campaigning advocacy of the kind seen in this case.
The message from these guidelines repeatedly appears to be that what may seem mild or normal may not be and can be significant. These British Society of Gastroenterology Guidelines appear to present a contrary view to the views of journalist and commissioned BMJ author Mr Deer. Mr Deer has a degree in philosophy from Warwick University and no medical or scientific qualifications.
Further, the transcripts of the GMC hearings also reveal interesting information, which calls most seriously into question what now appear to be in comparison somewhat casual allegations of research misconduct.
The sworn testimony of Professor Simon Murch [3] shows there was meeting at the Royal Free, it seems on a Friday lunchtime and at the request of Dr Davies, arranged in the manner of a normal histology meeting in the histology seminar room at the Royal Free Hospital. It seems the various pathologists who had seen the tissues attended at the same time.
It further seems from this testimony that there were 10 expert medical specialists present at this meeting. The names recorded in the transcripts as being present are: Dr Davies, Professor Walker-Smith, Dr Thomson, Dr Murch [now Professor]. Dr Andrew Anthony, Dr Dhillon, Dr Casson, Dr Malik, Dr Wakefield. Drs Heuschkel and Phillips possibly also present [from recollection].
But there is more. The GMC testimony records that the original histology slides that had gone to Dr Davies’ laboratory were considered at that meeting. All the pathologists present when the slides were reviewed case by case agreed that the wording in the 1998 Lancet paper all agreed that the wording was reasonable.
What is remarkable is the direct attack by a leading medical journal, the BMJ, on academic freedom, the ability to carry out research and to publish in a scientific manner for calm consideration, scrutiny and criticism post publication by scientific peers in a formal academic manner. UCL and every one of its academics and researchers are put under scrutiny. It seems an unusual position for a purportedly scientific journal to take. However, the full financial competing interests of the BMJ remain undeclared, and that is demonstrable from publicly available information.
What appears now to be occurring is a delayed post publication scientific peer review of the 1998 Lancet paper, but in the febrile atmosphere created firstly by Mr Deer and now by the BMJ itself. Perhaps the non medical academics and researchers at UCL are entitled to insist on a full, fair, transparent, independent, objective unbiased examination of these matters. But will that ever happen and in that manner?
It is now well accepted in mainstream published medical scientific papers and there is now a medical scientific consensus that:
”Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs” [4]
“Gastrointestinal disturbances are commonly reported in children with autism, complicate clinical management, and may contribute to behavioral impairment. ” [5]
“People with autism are also known to suffer from gastrointestinal disorders and they have a different makeup of bacteria in their guts from non-autistic people.” [6]
[1] Amar P Dhillon, Pathologist, Department of Cellular Pathology, UCL Medical School,”Re: Pathology reports solve “new bowel disease” riddle BMJ Rapid Responses Thu, 2011-11-17 09:10
[2] (Jenkins D et al. “Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative“. J Clin Pathol 50,93-105;1997). British Society of Gastroenterology Guidelines in Gastroenterology July 1997
[3] Day 113 Friday 16 January 2008 Pages 43/44
[4] Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: PEDIATRICS Volume 125, Supplement 1, January 2010 [Added 22 May 2010].
[5] Williams BL, Hornig M, Buie T, Bauman ML, Cho Paik M, et al. (2011) Impaired Carbohydrate Digestion and Transport and Mucosal Dysbiosis in the Intestines of Children with Autism and Gastrointestinal Disturbances. PLoS ONE 6(9): e24585. doi:10.1371/journal.pone.0024585
[6]
Children with autism have a different chemical fingerprint in their
urine than non-autistic children, Imperial College News Release
Thursday 3 June 2010,
“Urinary Metabolic Phenotyping Differentiates Children with Autism from
Their Unaffected Siblings and Age-Matched Controls,” Journal of
Proteome Research, published in print 4 June 2010.
Competing interests: I have paid professional interests in related
matters.
The problem as I see it is that these internists pediatricians and endocrinologists do not have any 'skin in the game'. Doctors with Dr Wakefield competence, integrity, and compassion are one in a million.
Seems obvious to me, all effort should be made to ferret out doctors having damaged children or grand children. Hopefully, they would be more diligent and understanding! For the rest of these guys/gals; I can only wish that a touch of Autism strike someone close to them.
ANGRY? Not me!
Posted by: Paul Shapiro | November 21, 2011 at 09:45 PM
Posted by: Paul Shapiro | November 21, 2011 at 09:17 PM
Your story echoes around the world. It becomes increasingly frustrating when we rely on "so-called" experts to do what they have been trained to do, only to fail you.
I took my son to a paediatric gastroenterologist to determine the exact cause of his abdominal distension. On this particular day his abdomen was swollen and this would give the paediatrician an opportunity to examine him.
I left disillusioned and with a "stool test kit" in my hands.
I did the test and the results were;- well,close to,not too bad,practically normal;- said the paediatrician.
Elizabeth
Posted by: AussieMum | November 21, 2011 at 07:26 PM
Posted by: Glax Britannicus | November 21, 2011 at 07:09 PM
Posted by: Gatogorra | November 21, 2011 at 06:32 PM
Posted by: Debra | November 21, 2011 at 06:31 PM
To me, the worst stories of war atrocities involve acts of lethal violence against a child while parents are forced to watch but restrained from stopping it. You and your son endured this in slow motion over the course of forty years. The three minute nightmares I've had like this have left me sick for days. Crime is not the word. We need a new word. I'm so sorry.
Posted by: Gatogorra | November 21, 2011 at 06:12 PM
Posted by: Taximom | November 21, 2011 at 05:58 PM
The dis-United UK ..so sad..
Angus
Posted by: Angus Files | November 21, 2011 at 04:00 PM
My son who never talked during the 40 years of his life weighed on about 40 lbs when he died. He had various diagnoses of things that are not to the point right now. It should have been obvious that there was intestinal damage. Doctors did a "thorough" investigation of malabsorption (celiac). Pictures were taken of the suspected parts of Erik's intestines etc. Nothing was found while he was alive. When we got his pathology report after he died last year, Erik's main problem appears to have been severe inflammation of a large section of his intestines. Reading the article above makes me cringe to think that anything intestinal can be downplayed the way it is being down-played by the BMJ people.