WebMD talked to Fiona Godlee, MD, BMJ editor in chief, about her journal’s expose of the flawed study by Andrew Wakefield, MD.
Why publish this now, when it looked like the MMR scare was closed when the Lancet retracted the article and Wakefield lost his license?
[Journalist Brian Deer’s] realization that the paper was a fraud had grown over time, and it was certainly news to me.
So it seemed to me a very important revelation that the paper was a deliberate fraud rather than simply a rather badly done case series.
There seemed to me to be quite important aspects of this whole story that had not yet been widely seen and understood.
Do you think there’s more bad research out there?
I’m in no doubt at all that there’s a lot of bad science. There are people who feel it’s got so bad that one can’t really trust anything that’s in medical journals. I’m not really at that level. I think there’s some good science around, too. Telling the difference is what’s hard. There’s also the difference between bad science and fraud. I think there’s a great deal more bad science out there than there is fraud.
My instincts tell me that fraud on this scale in terms of the deliberate nature of it is probably quite rare, but there are lots of smaller misdemeanors and a lot of frank error that it is floating about in the literature and being repeated, incorporated into evidence and guidelines.
There’s the pharmaceutical industry, which we know is extremely adept at manipulating its information to get the result it wants.
Vast amounts of literature I think are extremely badly flawed.
Since Wakefield was called out, have you and other editors had to up your game?
However much journal editors up their game, I think fraud is always going to be extremely hard to detect. In other cases, frauds have been detected sooner, so I think this is unusual in having survived in the glare of full publicity for so long without being detected.
Were you concerned that putting MMR back in the spotlight could reawaken parents’ concerns?
Any mention of MMR and autism for some people will simply reconfirm their view that this is all a big conspiracy theory and that Wakefield is a maverick who is being crushed by the establishment. I have no doubt that’s not what happened. I think we have a maverick who has proved himself to be without integrity. The rest of the scientific establishment is pretty clear that there is no sign of a link.
It did occur to me this might trigger another decline in vaccination rates. I very much hope not. Even so, I don’t think one could have sat on this knowing it, and not have published it. In the end we felt there was no alternative but to make this known.