Sunday, March 08, 2009

A Review of Insidevaccines’ “Scary Stats IV: Polio”.

I would like to take this opportunity to review “Scary Stats IV: Polio”. This is my third review of an article from the Insidevaccines blog. Some might wonder why I am reviewing a science issue not related to autism. Well, as said before, Insidevaccines is sometimes described as a model of good science. They are quoted on occasion by those advocating a vaccine etiology theory of autism.

I was very interested to see how well this claim held up. Vaccines are by no means perfect, they do cause injury, and it is possible that they cause at least some cases of autism. Any clarity on vaccine science, even if it points toward an uncomfortable truth, is a good thing. However, one will not find that at Insidevaccines. The first two articles I reviewed had rather remarkable errors of logic and science, this one was no different.

The worst problem in the article is the graph of polio over the years that appears early in the article. It correlates polio with DDT and other chemicals. This is cherry picking on an absolutely epic level. The authors at Insidevaccines state that the discussion will not address the relationship between DDT and polio. The authors give their rationale for using this graph as being that it begins earlier and gives a more accurate picture of the pattern and extent of disease notifications prior to the Salk vaccine. Further, Insidevaccines links to the same or similar graph stretching back further into the 1800s and based on general historical commentary to produce the data points.

The source of the graph is a New Age site promoting a range of metaphysical ideas and alternative medicine, complete with advertising tours for sacred places of power. However, what is interesting is that the site author does not even get simple ideas like incidence correct. Further still, the site author doesn’t mention how s/he obtained the data for the first half of the 20th century.

So, this is what Insidevaccines leaves us; a graph the veracity of which we cannot check, which attempts to correlate DDT and other chemicals to Polio. I argue that their choice was an inappropriate and ill served their readership. That they did not address the argument for DDT as a cause of polio is no excuse. In the realm of science, even in the realm of popular science you present what you mean. If the authors at Insidevaccines do not agree with the DDT argument then they should have created their own graph. Or if they did agree they should have offered their support for this idea. By leaving it as is, their actions do lend themselves to charitable description.

The authors write (references removed):

“Depending on whether you consult the CDC data compiled for parents or the CDC data compiled for medical professionals,
the fatality rate for paralytic polio is between either 2-5% or 5-10%."

If one journeys to the source one will see that the CDC is providing a general rate and then a rate for a specific age group.

“The actual historical data from the peak years: 19,794 avg. acute cases in 1941-1950, which is 0.6% of the total average births for the US from 1941-1950”

Actually, based on the sources the authors’ provide, they miscalculated here. It should be 1.0% of the total average births.

“In 1951-1954, an avg. 16,316 paralytic cases (notice that this data conveniently stops at the time of the definition change and the introduction of the Salk vaccine, thus implying that subsequent reduction in incidence is due to the vaccine. Unfortunately for this hypothesis, the Salk vaccine was shown to have very little positive effect, prompting the switch to the Sabin vaccine)”

A lesser effect is not the same as “little positive effect”. In fact in the field trials, the Salk vaccine was found to be over at least 60% effective for all subtypes of polio and often more than 90% effective (Smith, 1990).

“Based on Table 1
, using the hypothetical birth cohort of 3,803,295 infants as stated in the article, we get 1,179 paralytic cases per year, with an estimated 23 (2%) to 118 (10%) deaths. For 60,974 cases of polio, using CDC metrics of 200:1 inapparent:paralytic (leaving aside how they can project an estimate for an inapparent infection), we would get 3,048 cases of paralytic polio, resulting in 61 (2%) to 305 (10%) deaths, rather than 723.”

The Insidevaccines authors are taking a rate from a single age group and trying to apply it across ages. This comparison has no validity.

“So, what can we conclude from these discrepancies and contradictions? The data doesn’t support the headlines. The numbers presented by vaccine defenders do not stand up to scrutiny.”

Actually it is the poor mathematical practice used by Insidevaccines that is the problem here.

“Our analysis above shows that data are not consistent within an individual publication, or from one publication to the next.”

Offering different rates based on age cohorts or via total should not be a problem for a careful reader. The authors at Insidevaccines have failed to exercise this concept.

“Sometimes, they do not even correlate with numbers from the CDC, an organization whose primary objective appears to be the defense of vaccines!”

This is a ridiculous claim. One does not have to like the CDC or even think they are good people, to recognize this claim as absurd.

“Is their work just sloppy, erroneous, or intentionally misleading? Are they so focused on marketing the vaccines that they are unwilling to critically parse the data? Perhaps they think parents aren’t paying attention.”

Insidevaccines has made basic errors in mathematics, reasonable comparison, data checking, and graphical presentation. Are they prepared to argue that they are paying attention?

In the first article I reviewed from Insidevaccines the authors note that many who advocate for vaccines want nothing to do selective or delayed vaccinators. The authors challenge this stance, as delayed or selective vaccinators may be allies who advocate for certain vaccines. In response, I wrote a number of concerns I think should be addressed before any collaboration was considered. I would like to add a few more.

I think potential allies:

Should accurately quote science

Should not pull graphical shenanigans

Should not mis-compare data

There is room for disagreement and debate in the world of vaccines and autism. Any site that offers science or criticism that illuminates the issue is a blessing. Unfortunately, it is clear that this role will not be fulfilled by Insidevaccines.

Reference

Smith, Jane S. (1990). Patenting the Sun: Polio and the Salk Vaccine.

6 Comments:

Anonymous HCN said...

Deetee at the JREF forum noted that the InsideVaccine guys were big on cherry picking. He posted an example here:
http://forums.randi.org/showthread.php?p=3457177#post3457177

Afterwards the InsideVaccines poster "MinorityView" did admit "Okay, I admit it that my remarks above were slightly deceptive and I'm sorry. However, I didn't use the word "just" as in just checked it out. So I wasn't actually being dishonest, just omitting a few things. Well, a lot of things."

Even later in the thread on the second page, another comment is "Minority View and some of the other JABS regulars won't post on badscience because of spyware.(!) Or so they say."

2:54 PM  
Blogger Elaine said...

As you are very well aware, the prevalence of children being diagnosed with an Autism Spectrum Disorder is increasing at an alarming rate. We would appreciate your assistance in helping us try to identify if the use of epidural analgesia/anesthesia and Pitocin during childbirth have any association with the development of autism.

If you are willing to participate in a survey questionnaire, please email Elaine DeLack, RN at elaine@edmsllc.com and the questionnaire will be emailed to you for your completion.

Thank you in advance for your participation in this research.

5:45 PM  
Anonymous Chris said...

Epic fail, Elaine!

Elaine DeLack spamming her silly study has already been told that the increase in diagnosis is not necessarily an increase in autism:
http://www.theness.com/neurologicablog/?p=454

And that the collection of anecdotes this way is a bad way to get data. It is a self-selected survey relying on old memories.

Let me repeat:
Elaine, I suggest you go back to school and learn about basic research randomization. Basically it means that self-selected surveys are stupid. Sorry, but that is reality.

What you need to do is to go back and search the medical records (with basic permissions that a real researcher would need) to check to see if there were a certain number of autistic children born with epidurals versus those who did not have epidurals (like mine)… compared to the number of neurotypical children born with epidurals versus those without epidurals (whoa… like my younger two kids… OMG —- I have three kids, and never had an epidural!).

Anyway, those databases are available in many HMOs. These are available to real researchers and have been used for several epidemiological studies, that if you were a real researcher you would be familiar with. (the only folks who get denied access are those who muck with HIPAA requirements, like the Geiers, sorry—- but your survey should also not violate certain privacy concerns)

And to repeat Joseph’s comment from the LeftBrainRightBrain “Autism and Murder” posting: “Elaine’s comment is spam that has been appearing in most Hub blogs. The study is biased a priori anyway since the comment says “We would appreciate your assistance in helping us try to identify if the use of epidural analgesia/anesthesia and Pitocin during childbirth.” Obviously, parents of autistic children who had epidurals will be more likely to contact Elaine than anyone else.”
and from his blog: “@Elaine: Are you aware you just posted that same comment at LB/RB? I could delete it as spam. Instead I will point out that recruiting from blogs will result in selection bias. If you were researching something about vaccines, that’s certainly the case. But you’re still researching something having to do with Big Pharma. Inevitably, you’ll find autism parents who are more likely than controls to remember the childbirth drugs you’re studying.”

4:44 PM  
Blogger Pensive said...

Interverbal, since you portray yourself as an expert in all things from autism to nose-picking, why don't you put up factual counterpoints instead of barking inuendo?

For instance, if you don't like their "worst" sin, that graph, why don't you put up a "real" one with actual data?

I doubt that you know the polio topic at all. To use a 1990 article on the Francis Trials to extrapolate that to mean that would have had any relevance to the years that followed is ludicrous.

There are many different data sets from the Francis trials in many different medical articles. So many different efficacy data were published at the time in the lay media as well, that any logical thinking person would wonder which one was even correct.

It was very revealing then, that in 2004, someone on the Francis trials pointed out that half of the polio cases in the Francis trials were not polio at all, and they knew it (PMID 16281468 page 133)but considered that to be okay science.

Yet apart from the 1990 breadcrumb you toss us as if it's a valid reference, there is also very good evidence to show that the whole of the science on the Francis Trials was crapshoot.

Because only 38% of the American population was vaccinated with salk vaccine by 1959, the Polio Unit Surveillance Stats are the best source of data. They broke down all the data into percentages of vaccinated and unvaccinated with polio, which was enough to convice a blind mand that the SALK vaccine was causing extensive provocation polio in the recipients. given the scientific climate of the time, it was pretty obvious why that was never discussed publicly. Perhaps you should go and the PSU stats yourself, interverbal?

Instead of accusing others of graphic shenanigans, not accurately quoting science, and miscomparing data, what proof, what data, what science and which graphics do you produce here, to present a valid counterpoint to Inside Vaccine?

None. Astonishing.

Perhaps you need to remove the forest from your eyes first?

6:54 PM  
Blogger Interverbal said...

Hi there Pensive,

“Interverbal, since you portray yourself as an expert in all things from autism to nose-picking”

Well, autism in particular is my interest and since my profession is education I do deal with nose picking so…. You have me dead to rights. However, I am always happy to learn new things. If you have something to teach, then I am pleased to learn. However, you had better believe that I will judge what you say through the lenses of science and logic. With that in mind let’s look at your post.

“why don't you put up factual counterpoints instead of barking inuendo?”

I would recommend re-reading my critique to see if you are now able to spot my rather detailed and specific counter-points. However, if reading comprehension is not your strong-point I am happy to provide a list of the specific concerns I noted. Just ask.

“For instance, if you don't like their "worst" sin, that graph, why don't you put up a "real" one with actual data?”

No, if there are problems with the graph or with the way the authors at Insidevaccines use the graph, then this is their burden, not mine.

“I doubt that you know the polio topic at all.”

Let’s pretend that is true. Let’s say that I am absolutely pig ignorant of the polio topic. If I was a visitor to this site I would attempt to prove this by using impeccable logic and a firm grasp of epidemiology. I have been looking for these 2 aspects in your comments; they are entirely absent thus far. Maybe they are further down? Let’s see…

“To use a 1990 article on the Francis Trials to extrapolate that to mean that would have had any relevance to the years that followed is ludicrous.”

Actually it is a book, not an article. Even if one hasn’t read the book itself the title kind of gives it away. Generally, technical articles have dry technical titles. The use of simile or metaphor is more common in book titles (although not exclusive per se).

As to my extrapolation, I do not accept your criticism. The Insidevaccine authors claimed the Salk vaccine had little effect. The vaccine trials showed that at least initially there is reason to believe otherwise. If you have evidence that challenges this based on the years that followed, you may present it. However, I am not interested in supposition.

“There are many different data sets from the Francis trials in many different medical articles. So many different efficacy data were published at the time in the lay media as well, that any logical thinking person would wonder which one was even correct.”

Okay, so present the citations in the peer reviewed articles and let’s see if you claim holds up.

“It was very revealing then, that in 2004, someone on the Francis trials pointed out that half of the polio cases in the Francis trials were not polio at all, and they knew it (PMID 16281468 page 133) but considered that to be okay science.”

You are correct, that is poor science. However, that was not a point raised in the Insidevaccines post. That is a new point and while it may rebut my point, it cannot be seen as a cogent defense of the Insidevaccine article.

“Yet apart from the 1990 breadcrumb you toss us as if it's a valid reference, there is also very good evidence to show that the whole of the science on the Francis Trials was crapshoot.”

I only worked off of citations that Insidevaccines provided with the exception of Smith (1990). And even that book was referenced by the New Age site on the same web page where the graph was found (although I had read it before). However, if you have evidence that the vaccine trial was inadequate then present it. Of course, this is still not evidence for what the authors stated in their article.

“Because only 38% of the American population was vaccinated with salk vaccine by 1959, the Polio Unit Surveillance Stats are the best source of data. They broke down all the data into percentages of vaccinated and unvaccinated with polio, which was enough to convice a blind mand that the SALK vaccine was causing extensive provocation polio in the recipients. given the scientific climate of the time, it was pretty obvious why that was never discussed publicly. Perhaps you should go and the PSU stats yourself, interverbal?”

No, if you have an argument, then you present the data and reference. Burden in on you here, not me.

“Instead of accusing others of graphic shenanigans, not accurately quoting science, and miscomparing data, what proof, what data, what science and which graphics do you produce here, to present a valid counterpoint to Inside Vaccine?”

You just listed them. Those are valid counterpoints all by themselves.

“Perhaps you need to remove the forest from your eyes first?”

Oh, I am all for attempting to remove personal bias from my analyses, just like I am all for keeping an open mind. Just not so open that the rain nips in.

Thanks for your time,

12:03 PM  
Anonymous Jupiter said...

Hi, Interverbal.
Regarding the effectiveness of the Salk vaccine, read the lefthand column of this page:

http://s45.photobucket.com/albums/f71/Angladrion/Present%20Status%20Polio/?action=view&current=img626.jpg

Also, this page where they start the interview with doctor Cox:

http://s45.photobucket.com/albums/f71/Angladrion/Present%20Status%20Polio/?action=view&current=img627.jpg



Here's the fulltext, which takes a long time to read, but is extremely interesting:

(you have to start with the bottom righ page, and move left, and up, from there)

http://s45.photobucket.com/albums/f71/Angladrion/Present%20Status%20Polio/?start=20

10:59 PM  

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