February 23, 2010

Trisha Greenhalgh's Competing Interests in Wakefield Case

By John StoneTrishaGreenhalgh 

Prof Trisha Greenhalgh, whose analysis of the controversial Wakefield Lancet paper, was published by Sunday Times journalist Brian Deer on his website (HERE) has received more than £1.4m in grants from the UK government’s Department of Health since 2003.
When Deer’s original allegations were published in the Sunday Times in February 2004 they were supported by the then Prime Minister, Tony Blair, and the Chief Medical Officer, Sir Liam Donaldson. Prof Greenhalgh failed to disclose either her government funding or her assistance of Deer when earlier this month she published an article in British Medical Journal criticising the Lancet’s delay in retracting article (HERE). Nor have BMJ so far published the letter (see below) pointing out her unfortunate omissions.

Greenhalgh’s reading of the paper was not only contested by Andrew Wakefield (HERE) and Carol Stott (HERE) on one side of the MMR controversy, but also implicitly by prominent Guardian science journalist Ben Goldacre on the other. Goldacre wrote in a 2005 award winning article (HERE): 

  "...people periodically come up to me and say, isn't it funny how that Wakefield MMR paper turned out to be Bad Science after all? And I say: no. The paper always was and still remains a perfectly good small case series report, but it was systematically misrepresented as being more than that, by media that are incapable of interpreting and reporting scientific data." 

Goldacre’s opinion apparently led to bad feeling between himself and Deer (HERE ).

Greenhalgh’s analysis projected a hypothesis onto the paper which was not partof its design and may have indirectly influenced the decision of the General Medical Council who decided that paper was not an early report, as stated, but a bungled version of a more formal scientific paper, commissioned by the Legal Aid Board, which the defence always insisted was never undertaken.

This is the text of my letter to BMJ, so far unpublished by them:-
"Trisha Greenhalgh: competing interests" 
Prof Greenhalgh [1] does not disclose any competing interests. She 
has, however, contributed a controversial article [2,3] attacking the 1998 
paper [4] to journalist Brian Deer's website. Although not disclosed here 
by Greenhalgh or in the accompanying article by Deer [5], Deer was named 
as a complainant against Andrew Wakefield in the High Court by Mr Justice 
Eady, who stated [6]:
"Well before the programme was broadcast [Mr Deer] had made a 
complaint to the GMC about the Claimant. His communications were made on 
25 February, 12 March and 1 July 2004. In due course, on 27 August of the 
same year, the GMC sent the Claimant a letter notifying him of the 
information against him."

Since 2003 Greenhalgh has benefitted from more than £1.4m in research 
grants from the Department of Health [7]. When Deer's original allegations 
were published in the Sunday Times in February 2004 he was supported by 
the then Prime Minister, Tony Blair, who told ITV [8]: 
"There is absolutely no evidence to support this link between MMR and
autism. If there was, I can assure you that any government would be 
looking at it and trying to act on it. I hope, now that people see that 
the situation is somewhat different to what they were led to believe, they 
will have the triple jab because it is important to do it." 
and by Chief Medical Officer, Sir Liam Donaldson, who told the BBC 
"I don't think that spin and science mix. If they are mixed, it is a 
very unfavourable position for children's health. Now a darker side of 
this work has shown through, with the ethical conduct of the research and 
this is something that has to be looked at." 
and Jeremy Laurance reported in the Independent [9]: 
"At the Department of Health, which has striven for the past six 
years to bolster public confidence in the vaccine, joy is unconfined at 
the discrediting of Andrew Wakefield, as the researcher responsible for
the scare." 
Meanwhile, Health Secretary John Reid asked the GMC to investigate 
I express concern that conflicts that go up to the highest ranks of 
government are still conflicts, that the government itself is not a 
disinterested player, and has not behaved like one. At the same time Prof 
Greenhalgh's research has benefitted hansomely from its largesse. I 
believe there should be an inquiry. 
[1] Trisha Greenhalgh, Why did the Lancet take so long? 
BMJ 2010; 340: c644 
[2] Professor Trisha Greenhalgh. Analysis of Wakefield MMR study asks
why flaws weren't spotted by Lancet editors. April 2004. 
[3] Mark Struthers, 'Unfonded and Unjust' BMJ Rapid Responses 8 
February 2010http://www.bmj.com/cgi/eletters/340/feb02_4/c644#230993 
[4] Wakefield et al, 'Ileal-lymphoid-nodular hyperplasia, non- 
specific colitis, and pervasive development disorder in children, THE 
LANCET, Vol 351, p.637-41, February 28, 1998 637 
[5] Brian Deer,'Reflections on Investigating Wakefield'  Published 2 
February 2010, doi:10.1136/bmj.c672 
[6] Melanie Phillips, 'A deer in the headlights', The Spectator 16 
February 2009,http://www.spectator.co.uk/melaniephillips/3362116/a-deer- 
[7] Profile: Prof Trisha Greenhalgh: Funding Received: 
[8] James Meikle, 'Claim that MMR work mixed science and spin', 
Guardian 24 February 2004, 
[9] Jeremy Laurance, 'Ministers temper their triumphalism but delight 
spreads at Whitehall', 24 February 2004, 
[10] BBC NEWS, Top doctor wades into MMR debate', 
Competing interests: 
Autistic Son 
John Stone is UK Contributing Editor to Age of Autism