In the United States, the federal government has long had a prominent role in funding science research. Be it the $30 billion a year or so that funds the National Institutes of Health or the $5 or $6 billion a year allotted to the National Science Foundation, the government funds a lot of basic and applied research, and this is in general a good thing. The number of discoveries and advances that have come out of this funding have well repaid the investment and much more. There is, however, a downside to this funding that’s a pretty obvious consequence any time the government funds anything, and that’s the possibility for lawmakers to meddle with science and try to dictate what science is funded. In other words, politically controlled science is a risk any time the government funds science. Fortunately, we have been very fortunate in the U.S. in that the lawmakers who founded the NIH, the NSF, and other agencies funding science to a large degree made sure that rigorous peer review controlled by scientists with the relevant expertise score and rank grant applications. Sure, there are programmatic considerations as to what sorts of projects are priorities for each agency, but by and large those considerations are devoid of direct interference by politicians.
I’m not saying that there aren’t exceptions. Perhaps the biggest and most blatant exception is one that is a frequent topic of this blog: The National Center for Complementary and Alternative Medicine (NCCAM). There was no compelling scientific rationale to carve out a center in the NIH devoted to the study of, let’s face it, mostly pseudoscience, nor were scientists and physicians clamoring for such a center. However, one very powerful Senator, Tom Harkin (D-IA), started the ball rolling by funneling some money to form the Office of Unconventional Medicine, which was later renamed the Office of Alternative Medicine. When then-NIH director Harold Varmus tried to rein in the OAM in 1998, Harkin responded by introducing legislation to make the OAM a full center. Thus was NCCAM born, and its current budget rapidly climbed to where it is now, fluctuating between around $120 and $130 million a year.
And don’t even get me started on Senator William Proxmire’s Golden Fleece Awards. They were the most ridiculously anti-intellectual and anti-science publicity stunt carried out by a politician for a sustained period of time that I can recall.
More recently, there have been other examples. Representative Darrell Issa tried to defund NIH grants already awarded through the regular peer review process because the research topics ran counter to his politics. Indeed, politicians try to insert their politics into government science policy all the time, particularly into climate science, reproductive medicine, and any other science that butts heads with politics or religious fundamentalism. Fortunately, such blatant direct meddling in the peer review process by a politician in the U.S. as what Issa attempted four years ago is, thankfully, relatively uncommon. Over the decades, there has been a fairly strong taboo against directly interfering in the peer review workings of the NIH and NSF, although periodically politicians try to make hay by attacking the NSF for funny-sounding science projects funded by the NSF or NIH.
It would appear to be a taboo that Meet Lamar Smith, a Republican Congressman representing Texas’s 21st district, wants to break, at least with respect to the NSF:
The new chair of the House of Representatives science committee has drafted a bill that, in effect, would replace peer review at the National Science Foundation (NSF) with a set of funding criteria chosen by Congress. For good measure, it would also set in motion a process to determine whether the same criteria should be adopted by every other federal science agency.
The legislation, being worked up by Representative Lamar Smith (R-TX), represents the latest—and bluntest—attack on NSF by congressional Republicans seeking to halt what they believe is frivolous and wasteful research being funded in the social sciences. Last month, Senator Tom Coburn (R-OK) successfully attached language to a 2013 spending bill that prohibits NSF from funding any political science research for the rest of the fiscal year unless its director certifies that it pertains to economic development or national security. Smith’s draft bill, called the “High Quality Research Act,” would apply similar language to NSF’s entire research portfolio across all the disciplines that it supports.
A draft of the legislation can be found here. The draft bill calls upon the director of the NSF to post a notice before funding a new grant a notice certifying that the the project funded by the grant:
- is in the interests of the United States to advance the national health, prosperity, or welfare, and to secure the national defense by promoting the progress of science;
- is the finest quality, is groundbreaking, and answers questions or solves problems that are of utmost importance to society at large; and
- is not duplicative of other research projects being funded by the Foundation or other Federal science agencies.
As Steve Novella points out, stripped of context, these criteria sound relatively reasonable, although I do disagree with him on one point. Specifically, I’m not that worried about criterion #3, the ban on duplicative research. Steve thinks it is a bad idea because replication of research is key to science and that there is a problem with defining “duplicative.” True enough, but it’s also hard to define “innovative’ and “significant,” but that doesn’t stop the NIH from requiring applicants to demonstrate why their proposals are innovative and significant. Steve has a point, but personally I don’t have a huge objection to #3. Besides, this draft proposal says “is not duplicative of other research projects being funded by the Foundation or other Federal science agencies,” not “is not duplicative of other research projects that have been funded by the Foundation or other Federal science agencies.” (Emphasis mine.) There’s nothing in the third criterion to stop the funding of confirmatory research projects, which is what Steve was concerned about. Indeed, nearly all research grants tend to build on research that has gone before, which means they are at least in part confirmatory. The intent of that criterion is more along the lines of preventing research projects that studying basically the same thing in the same (or a very similar) way from being funded at the same time by the government. “Duplicative research” can be a good thing in concept, but in the real world there’s nothing that says that, in these days of highly constrained research funding (and, believe me, I know how constrained it really is—something like the 6th percentile from the NIH, worse from many other agencies), the government should be funding duplicative studies when doing so would tie up money that could go to other promising studies that aren’t duplicative. It really is a zero sum game right now.
Besides, the real damage comes from criteria #1 and #2, which are a radical change from the NSF’s current guidelines, which ask reviewers to consider the “intellectual merit” of a proposed research project as well as its “broader impacts” on the scientific community and society. Again, on the surface, these two criteria don’t sound all that unreasonable. After all, does anyone seriously want to fund research that is not of the finest quality and doesn’t serve the interests of the U.S.? The devil is in the details of how you define the “finest quality” and what is in the interests of the U.S. Who would determine that? According to the bill, the NSF director would, but to whom does the NSF director report? Congress.
Trying to counter criticism that this bill is going to replace peer review at the NSF with the above three criteria, Smith has responded by trying to say that he’s really, really for basic science and just trying to add “accountability.” Accusing critics of “playing politics” (what else would they do, given that this is politics, and what is Smith himself doing but trying to inject more politics into science funding?), Smith fired back:
It is the job of Congress and the NSF to make sure that taxpayer dollars are spent responsibly. I support basic research, which can lead to discoveries that change our world, expand our horizons and save lives. For example, we should prioritize research projects like the brain mapping initiative that may help cure Alzheimer’s, autism, epilepsy, and brain injuries.
“The draft bill maintains the current peer review process and improves on it by adding a layer of accountability. The intent of the draft legislation is to ensure that taxpayer dollars are spent on the highest-quality research possible.
Which is rather curious. If he’s just adding three more criteria for funding NSF grants, “another layer of oversight,” as he puts it, then it’s hard to see how this will actually achieve the stated aim. Remember, if this law passes, the NSF would have to insert these criteria into its existing criteria and might even have to change its grant application structure to require applicants to insert sections addressing each of these issues. In other words, it’s not hard to visualize applicants in the not-so-distant future being forced to justify how their science “is in the interests of the United States to advance the national health, prosperity, or welfare, and to secure the national defense.”
Suspicion is also warranted given that Smith recently tried to pull an Issa and directly meddle in the peer review process, demanding the peer review reports and program officer’s synthesis of the peer review discussions of five NSF-funded grants. Not surprisingly, given Smith’s history, all of them are in the social sciences. Smith’s action inspired Rep. Eddie Bernice Johnson to write to Lamar Smith to complain. Her letter is worth reading in full, particularly her sarcastic rejoinder to Smith that no Chair of the Committee on Science, Space, and Technology has ever in her memory directly inserted himself into the peer review of individual grants, thus in effect claiming expertise in that area of science, pointing out:
Interventions in grant awards by political figures with agendas, biases, and no expertise is the antithesis of peer review processes. By making this request, you are sending a chilling message to the entire scientific community that peer review may always be trumped by political review.
Which is exactly the purpose of Smith’s bill. By forcing the director of the NSF to certify that each grant funded is in the interests of the United States, Smith is creating an opening by which politicians can justify engaging in interference with peer review by simply asking if a project meets criterion #1. Moreover, criterion #1 itself will ahve a chilling effect on whoever is NSF director because that director will not want to certify funded projects as meeting that criteria if he or she knows that Smith or one of his successors might object to the project. Worst of all, Smith’s bill would require the NSF’s oversight body, the National Science Board, to monitor the director’s actions and issue a report in a year, with the intent of ultimately applying the principles in the bill to other federal science agencies.
Finally, there would be an effect on research that would be more insidious than political censorship, and, as before, criterion #1 is the key, where it has to be certified that each funded project must be “in the interests of the United States to advance the national health, prosperity, or welfare.” A clearer demand for only research that promises rapid, short-term translation into useful products I can hardly imagine.
This is a huge issue in medical research that scientists have complained about for years, if not decades, namely the NIH emphasis on “translational” research; i.e., research that leads directly to treatments or diagnostic tests. Here’s the problem. Translational research requires a robust pipeline of basic science findings to “translate” into treatments. Most of those basic science findings will lead to nothing, and it’s very difficult to know ahead of time which ones will bear fruit in the form of improvements in treatment and which ones will not. Hindsight is 20-20, but trying to guess which lines of research will lead to cures in advance is almost impossible. Such guesses tend to be more a matter of luck than science, and the complaints of scientists who think their work is so innovative are often sour grapes.
I’d like to finish with an example of the sorts of problems opening the door to direct political meddling in the peer review process could lead to. Imagine, if you will, an antivaccine politician. Oh, wait. You don’t have to. There was Dan Burton before he retired, and there still is Darrell Issa, who threw an antivaccine last hurrah for his good buddy Burton last November in the form of a Congressional hearing on autism that gave full voice to antivaccine loons. Then, yesterday I received an e-mail pointing me to this “call for action“:
Please click on the Take Action Link above to send a message to your member of the House of Representatives asking him or her to co-sponsor House Resolution H.R.1757, The Vaccine Safety Study Act. This bill directs the National Institutes of Health to conduct a retrospective study of health outcomes, including autism, of vaccinated versus unvaccinated children. The NIH adamantly refuses to do any study that compares health outcomes in these two groups. You have to wonder why.
The bill was introduced several days ago by Rep. Bill Posey (R-FL) and is co-sponsored by Rep. Carolyn Maloney (D-NY), who has long championed this cause. As a bi-partisan effort, we are optimistic that H.R. 1757 can move the House in a positive direction, if we make a strong effort to support this bill.
Now many of you are probably thinking, “Why would we expect the NIH to do an honest study?” That is an excellent question. But at the very least supporting this bill will help educate the house on the shoddy methods that are standard operating procedures in the vaccine industry.
The introduction of the H.R. itself is accompanied by a statement by Posey that’s chock full of antivaccine tropes and broadsides against the CDC. Amusingly, the bill itself demands that the each investigator of this study:
- is objective;
- is qualified to carry out such study, as evidenced by training experiences and demonstrated skill;
- is not currently employed by any Federal, State, or local public health agency;
- is not currently a member of a board, committee, or other entity responsible for formulating immunization policy on behalf of any Federal, State, or local public health agency or any component thereof;
- has no history of a strong position on the thimerosal or vaccine safety controversy; and
- is not currently an employee of, or otherwise directly or indirectly receiving funds from, a pharmaceutical company or the Centers for Disease Control.
One notes that requirements #3 through #6 pretty much destroy any chance the NIH would be able to find an investigator who meets requirement #2.
The whole study is, of course, utterly pointless, and I’ve explained in my usual inimitably nauseating detail why such a study would be very expensive, potentially unethical depending on design, not justified by science, and highly unlikely even to show what antivaccinationists want it so show, given the numbers of unvaccinated children that could be enrolled. It would be a complete waste of money.
Of course, this sort of law could be passed regardless of whether Smith’s draft bill ever becomes law, but it requires mustering all the usual votes necessary to pass any law. Anything short of a law would not compel the NIH to do such a study, and such a law would be very difficult to pass. Now imagine if powerful committee chairs could start meddling in the peer review process of NIH grant applications. If it is widely known that powerful lawmakers want a “vaxed-versus-unvaxed” study, then the process becomes easier. All that is needed is for an investigator or two to submit NIH grant applications, have them rejected, and then let antivaccine lawmakers start mucking around in the peer review process, making it known that they consider such a study to be in the national interest. Why not? Remember Representative Dan Burton, who retired in January after 30 years in the House? A supporter of quackery and a rabid antivaccinationist who thought nothing of abusing his power in the cause of promoting quackery and the myth that vaccines cause autism? Or Dave Weldon, a physician and Representative Dave Weldon of Florida, who was in the House of Representatives for fourteen years and, unfortunately, believed in the “autism epidemic.” He also apparently believed in the thimerosal-autism link, to the point of promoting highly dubious studies and attacking decent studies on the subject. Then there’s Representative Bill Posey, who, of course, is the sponsor of the H.R.1757. He’s also been invited, along with Dave Weldon and Dan Burton, to appear as part of a Congressional panel on autism, at that quackiest of autism quackfests, Autism One.
So is it so far-fetched to imagine politicians using Smith’s opening to meddle more openly in peer review? Maybe. But I don’t consider it as far-fetched as it should be.
Over the decades, through both Republican and Democratic administrations, Republican and Democratic control of Congress, a taboo against lawmakers directly interfering in the scientific peer review process as practiced at the NIH, NSF, and other federal science agencies has existed. The system has served us well. No one is arguing that the system can’t be improved, least of all me, but Smith’s way is not the way. It is a path to direct political interference in scientific peer review.
59 replies on “Politics versus scientific peer review”
One of the problems with being a public servant working in the health industry is that I see a lot of political wasting of health funding; here in Australia this generally means health facilities for politically sensitive areas, regardless of whether there’s actually a sensible demand for them.
However, we Australians are facing the real possibility of a conservative nutbag running the country come the September elections, a man who has a track record of using his political power to interfere with health/scientific issues that his religious dogma disagrees with. So I really understand where you’re coming from Orac, it bothers me a lot as well.
is in the interests of the United States to advance the national health, prosperity, or welfare, and to secure the national defense by promoting the progress of science
Who decides what meets this criterion? This is an explicit demand for political interference in NSF research, cloaked in flag waving. I do not see any other plausible reading of that requirement. It would also be a way of preventing collaboration with researchers in other countries on a broader basis than is already done (apart from the “axis of evil” countries like Iran and North Korea, there is currently an explicit prohibition on using NASA funds to engage in bilateral collaborations with scientists in China, including publishing papers with co-authors physically located in China).
The main effect of criterion #2 would be to move the funding decision from the program officers, who currently decide (in consultation with peer review panels) which proposals to fund, to the NSF Director’s office. There are certainly issues with the current system, but this would make the problems worse. The Director would, if I’m reading this right, have to choose the best proposals from all areas. Without specific programmatic guidance (and the NSF as currently structured is designed to operate without such guidance), there is nobody qualified to judge biology proposals against physics proposals against whatever else NSF currently funds.
Criterion #3 basically forces NSF to put all of its eggs in one basket regardless of the importance of the topic. Fear of being scooped by a rival lab is one of the motivating factors in research, and this rule would ensure that research groups funded by NSF would not face such pressure from other US groups.
I think I’d attach a boilerplate paragraph to each funding approval, stating in effect “As it is in the best interests of our nation we remain competitive with other nations in scientific research, continue to take a leadership role in science and technology and therefore be able to successfully compete for and employ the world’s best scientific minds, funding this study is in the interest of the United States being able to effectively advance the national health, prosperity, or welfare, and to secure the national defense.”
Not sure I buy this one. It’s more likely a sop to fiscal conservatives who might object to the meddling with the NSF peer review process to assure them that this bill will save money. In reality, most federal agencies already discourage the funding of duplicative research. The problem is, of course, what defines “duplicative” research. Also, as I said above, in this highly constrained research funding environment, it really doesn’t make sense to fund proposals that are too similar to each other if you’re trying to get the biggest bang for your research buck. Of the three criteria in Smith’s bill, I find this ban on “duplicative” research to be the least objectionable, depending on how “duplicative” is defined.
If we’re going to adopt this criteria for the NSF, to avoid duplicative effort and save money, wouldn’t we save even more it to all government sponsoredresearch projects?
Let’s see how the politicians like it when they have to tell aerospace lobbyists for companies operating in their district “Sorry, can’;t help you–another company is already researching our next generation tactical fighter. Can;t have the work duplicated. BTW, I’ve got an election coming up, can I count on your financial support?”
With regard to the proposed observational study of vaccination and autism – your previous column provides a reasonable statistical argument that it would not likely be of much value, though your claim that it would be “unethical” seems inexplicable. However, it was my understanding that a somewhat similar study had already been done, which compared autism rates in a large group of unvaccinated Amish children to those in the non-Amish population and found that the incidence was just as high in the former group as in the latter. I had thought that this was one of the stronger pieces of evidence exculpating vaccines. Perhaps for statistical reasons that’s not really true. Nevertheless, I fail to see how its publication could have been termed “unethical.”
It appears that I have happily violated this boneheaded aspect of the Iranian trade embargo on at least one occasion, so when their sinister forays into gravitational microlensing come back to haunt us, I suppose I’ll be taking the fall.
@jane – the “unethical” part has nothing to do with “retrospective studies” but the part where you would need to do a “prospective” study and start with a double-blind study of infants…..
It is pretty easy to see the issues around giving a couple of thousand (or a few tens of thousands) of infants either vaccines or placebos & then seeing what happens….
Well then… Turn-about is fair play so let’s lobby to only have scientists set the criteria for funding something like the congressional compensation budget!
Why can’t we invoke Godwin’s Law here? Wasn’t a lot of scientific research in Nazi Germany extremely politically motivated?
Lawrence – Of course the prospective study you describe would be unethical. However, the post above explicitly said that a retrospective study would be unethical, and the prior post where our host falsely claims to have explained why also discusses potential retrospective studies. I can’t imagine the rationale here, since retrospective studies involve no potentially harmful interventions. The desire to suppress a certain line of inquiry usually reflects fear that the results wouldn’t support a current dogma, but that doesn’t seem likely to be the motivation here, since it seems very probable that the study would find no effect related to vaccination and Orac surely knows that. Or perhaps it is merely asking the question that is unethical?
There does seem to be a mismatch there, yes. A prospective study would be grossly unethical. A retrospective study would simply be utterly pointless and provide no interpretable results, due to the relative scarcity of the completely unvaccinated and the NUMEROUS confounders inherent in this highly self-selected group, which could not be effectively controlled for.
IIRC Prometheus did a calculation once – if you enrolled every single entirely unvaccinated child in the US, and completely ignored the confounders, you’d only be able to detect some gargantuan relative risk – I want to say 10x, but my memory’s likely faulty on the exact number.
Thanks Narad! I didn’t think to look in the Wayback Machine. I was actually a lot closer to the actual number than I gave myself credit for, I see.
I based my original post on Prometheus’ post, elaborating on it:
I really wish that Prometheus’ blog was still live. It was such an awesome resource, and he was better at statistics than I am. It’s unfortunate that it exists now only in the Wayback Machine.
As for the “potentially unethical” bit, I tried to clarify by saying “potentially unethical depending on the design,” which is true. The ethics of such a study was not the main point of this post anyway, and I’d hate for a quickly written sentence that perhaps wasn’t as clear as it might have been to detract and distract from the main point of a nearly 3,000 word post.
I second your lament about Photon in the Darkness. Very easy to read explanations of very complex topics.
Prometheus and his commenters do make for entertaining reading. Since there are no animal studies or clinical trials of this issue, our evidence for the autism-related safety of individual vaccines has been derived entirely from retrospective studies. One doesn’t want to be seen suddenly saying that that kind of study is pointless. Prometheus seems to think that a cohort study including tens of thousands of totally unvaccinated children, a very rare demographic, would be the only possible methodology, but I disagree. He linked approvingly to a case-control study that pretty well showed no harm from the MMR vaccine, which used only a few thousand in each group. The question of synergy among individually harmless vaccines is more challenging, but I cannot believe, even if a cohort method were preferred over a case-control method, that a meaningful study would have to include tens of thousands of totally unvaccinated children. Comparing the maximally vaccinated to the moderately or minimally vaccinated should suffice to display some effect if number were the cause of harm. You would also not need to spend $1.5 million per 10,000 on exhaustive autism testing; you’d just need to get real-world diagnoses from existing records, as almost all retrospective studies and especially case-control studies do. For that matter, I have no idea whether such a study has already been DONE. Certain people are inclined to demand studies of things that have already been studied (e.g., shouldn’t temperature trends be corrected for the urban heat island effect?).
Orac – Fair enough, though I still think you’d have to work overtime to make a retrospective study unethical.
They have, and it’s negligible, but that’s a totally unrelated topic.
answers questions or solves problems that are of utmost importance to society at large
Sounds like there is no place for research that *asks* questions, or *discovers* problems, or provides unexpected results.
If you have to predict in advance what results will come out of the research then it’s not research.
Comparing the maximally vaccinated to the moderately or minimally vaccinated should suffice to display some effect if number were the cause of harm. […] For that matter, I have no idea whether such a study has already been DONE.
Why yes, it has. Some blogger called “Orac” wrote about it.
All you really have to do to determine the sample size is to specify the confidence level, power, and requisite signal to convince the antivax lot that there’s no there there. For some reason, they tend to clam up when asked for these simple constraints.
Of course, some people (I won’t name names) get all huffy about cohort studies when they don’t say what they want them to say; but say they’re great when they agree with the results.
“Comparing the maximally vaccinated to the moderately or minimally vaccinated should suffice to display some effect if number were the cause of harm. You would also not need to spend $1.5 million per 10,000 on exhaustive autism testing; you’d just need to get real-world diagnoses from existing records, as almost all retrospective studies and especially case-control studies do. For that matter, I have no idea whether such a study has already been DONE.
Quite a few people have written on a recent retrospective study drawn from existing data addressing that question, including myself as it happens: http://sciblogs.co.nz/code-for-life/2013/04/29/are-too-many-vaccines-too-soon-harmful/
As herr doktor bimler pointed out, Orac has written on this too.
Have you hard of the Vaccine Safety Datalink? They use the medical records of some large health maintenance organizations. Here is some of their research:
There is also the point that clinical studies can be very expensive, and like it or not, we have quite a ways to go in understanding the biochemistry of the cell. That having been said, I tell people that we are right in the middle of the golden age of biology, and it probably has another 20 or 30 years to run. We don’t even know all the interactions and subpathways, much less the details, kinetics, choke points, and possible therapeutic targets. It seems to me that identifying the key regulatory molecules allows a more efficient translational approach, because then it’s just a matter of finding the right repressors or activators.
Curiously, I recently saw some very good work (using computer simulation of one known regulatory molecule) that was done by a high school student and presented at our state science fair finals. It looked at potential binding sites in one peptide based on an analysis that looks at different conformations as the structure shifts. That tells me that biological science has come a long way very quickly, and it’s critical to keep funding basic research, allow for some translational research, and equally critically, fund some research that is in the in-between place, like that science fair project.
I don’t think that research scientists as a whole have been very good at the art of politics. Adding another 20 or 30 billion dollars a year to the NIH budget would be equivalent to a small part of the military budget, or Medicare, or lots of other things, and it would attack the plague that people rightly fear even more than war. If the breast cancer activists want to be effective, why don’t they demand that congress fund as much research as we can generate, in the expectation that much will be without wondrous results, but some will be useful.
OT, but is it ever TRULY OT if etc etc:
Columbia Journalism Review discusses the history of vaccine denialists and links it to the way journalism is practiced. To wit, taking a “balanced” approach when balance is actually inappropriate, leads people to believe that there is a connection to autism when there actually is not.
The article gives credit to internet bloggers for exposing the issues.
OT but are anti-vax requests for additional studies that would be nearly impossible to manage ever truly OT @ RI,
I ask you sincerely?
Today @ AOA, Olmsted details the inspirational talks he attended near Washington:
AJW hosted a fundraiser with David Lewis and LKH spoke to parents about vaccination choice.
It seems that Andy is now citing a 1 in 25 rate for autism (?) which is ” set in stone”. DO adds that only the manipulations of the DSM and CDC can change it”.
Now it appears that the only way we can know the truth is by studying the effects of “multiple vaccines with multiple adjuvants and multiple viruses given at the same time”.
Olmsted quote starts at “only the manipulations…..”
Narad: requisite signal to convince the antivax lot that there’s no there there.
Normal statistics doesn’t go that high. We need some sort of transfinite statistics, something that could also measure “convince the Pope that there is no God” or “convince creationists the Earth is over four billion years old” or “convince pigs they can fly.”
The white elephant in this room is huge.
It’s May 2013, correct? And you’re talking about the harm of politics and (pseudo)science being intertwined? Odd that you omit the biggest and most powerful pseudoscientific sham going on today, which you and your many minions on here never include in your egocentric diatribes against any approach to human health that doesn’t jive with the modern medical paradigm.
Here’s a clue – their new “diagnostic” manual comes out later this month and it will be a proprietary commercial product literally constructed out of a secretive political process rivaling the unscrupulous partisanship of the United States Congress. Nevertheless, its contents will be presented to an ever-large mass of ignorant and uninformed people as the Bible is presented to Christians (ironically, the “bible” is its nickname) and used politically to undermine people’s constitutional rights (as recently demonstrated by New York state legislators reacting the Sandy Hook massacre). I’d say that warrants a bit more concern than some guy with a blog or radio show telling parents the flu vaccine will give their kid autism.
I’ll never take any of you people seriously in your admonishment of a comparatively marginalized contingent of “alt med” advocates until you clean out the huge and alarming stink that rests in your own house.
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@Fear, Fraud & Force
Oh, my, if only we could try to develop research-based objective criteria instead of relying on a subjective subset of a constellation of symptoms. Oh, wait:
I’ll never take any of you people seriously
I can live with that.
Oh, goody, it’s “Shitznoexplainia.”
The white elephant in this room is huge.
The conflation of cliches is entertaining. It is another kettle of red herrings!
Also entertaining: The conviction that the plans of a group of professionals to revise their diagnostic manual is such an outrage that everyone should blog about it, even an oncologist… everyone, that is, apart from FF & F.
I have both autistic / aspergers son and a son with mental health issues. I had a great interest in the development of the DSM-5 as it effects my family and others in our advocacy community. We followed the process closely. It was very transparent. They took great pains to debate out in the open. The constantly asked for public input. You can claim conspiracy all you want. The facts prove otherwise.
Forgive me the OT, but I would like to share this:
Would those article have a bigger circulation, perhaps they could do some good.
Today TMR re-plays an old post by Poppy in which she opines: ( reproduced to include caps)
“Autism” isn’t a psychological condition and shouldn’t even be in the DSM ( the bible of PSYCHIATRIC diagnosis). AUTISM IS A MEDICAL CONDITION. Faulty metabolism, heavy metal and toxic burden, food allergies, auto-immune dysfunction, viral injury, parasites, yeast overgrowth and GI issues to name a few.
To anti-vaxxers, the changes in the DSM simply reflect the medical establishment ‘covering its tracks’ after creating and exacerbating the “epidemic”.
Expect a great deal of rending of garments and gnashing of teeth when it appears, just in time for Autism One.
What’s going on here? First the pothead trolls shows up with another silly ‘nym and gets the ban hammer yet again, and now we have FF&F/Shitznoexplainia making a repeat appearance. Who will be next? Grandma Marsha? Dr. Smart/Medicien Man? the Thing itself?
@ Edith Prickly:
I would certainly relish entertaining troll fol-de-rol:
besides working with clients, I have become chief counsellor and motivator for several relatives/ cohorts who are recovering from / dealing with- surgery, PT, depression, work issues etc. a few of these have been simmering since autumn…
I could use hilarious nonsense to distract me from reality.
“Autism” isn’t a psychological condition and shouldn’t even be in the DSM ( the bible of PSYCHIATRIC diagnosis). AUTISM IS A MEDICAL CONDITION
Also in the DSM: Korsakoff’s syndrome [amnesia from thiamine deficiency in alcoholics]; alcohol withdrawal; various addictions; head injuries; Parkinsons; Huntingdons; Alzheimers; Pick’s dementia; vascular dementia; impotence. In fact it reads very much like a list of medical conditions.
I am sure that psychiatrists will heed Poppy’s advice on what they should and shouldn’t include in the DSM; and that because of their medical training, they should only deal with non-medical conditions. It is an amusing counterpoint to Szasz’s old argument that a behavioural description should not be considered as a psychiatric diagnosis until a medical cause is identified.
@ herr doktor bimler:
Right, she is correct because we all know that the mind and the body are entirely separate.
Edith! Thou shalt not invoke the Thing!
My Batsh!t Censor blew out with the pothead troll, so you guys will have to handle the rest of the trolls. (I’m waiting for the repairman to reset the censor).
^ Sensor, not censor.
Regarding the DSM-V, I have mixed opinion over it (Darrel Regier shouldn’t host a pissing contest with Allen Frances and other critics) and I haven’t read much into RDOC but I’m more pleased about the last one than the DSM.
As far as autism DX goes, the DSM-V shouldn’t cause much changes in clinical practice.
[…] More (not particularly optimistic) thoughts on political interference with peer review. […]
Completely forgot about this post, here ya go minions:
@ Narad – I grew up in the projects and never imagined I could “mix it up” one day with the upper crust and their grandiose verbiage…work with me.
@ brian – That initiative is nothing but a hollow flourish meant to make fraud look like science. As it states: “Some will see RDoC as an academic exercise divorced from clinical practice.” That’s because there will never be any clinical objectivity to medical “disorders” that are defined by behaviors and thoughts rather than actual biopathology. Also, the futuristic stance of “duh, well we’re workin’ on scientific precision” is unfalsifiable B.S. that psychiatrists have been reciting in vein for decades. You can’t argue against that any more than an unconsenting psych patient can disprove that they’re “mentally ill.”
@ herr doktor bimler – You tell me what’s scientific about medical “disorders” or any other scientific concepts being voted into and out of existence at whim. Or am I mistaken and overlooked the chemists that have the power to vote elements out of the periodic table at their own political convenience? LOL, I think not.
@ Edith Prickly – Since you have nothing of substance to say about my initial response, why don’t I just join you in engaging in adolescent ad hominem attacks – your last name suits you well.
@ lilady – is there something specific I said that makes me “batshit” or are you just trolling yourself? Like Edith Prickly you seem to be nothing but a tired mascot for the shill that runs this blog.
@ Denise Walter – The mind isn’t considered a bodily organ, which is why there’s never any medical objectivity to what you call “SMI” so that retort of yours is rather flat.
@ Alain – Of course clinical practice will change – NO ONE WILL BE DIAGNOSED WITH “ASPERGER’S SYNDROME” anymore. Would it be considered sound medical practice for a group of oncologists to come together in a political crapfest and just decide to just not diagnose anyone with lymphoma anymore? What about the people already diagnosed with Asperger’s? Shouldn’t someone be on the hook for those misdiagnoses?
@ Kelly M. Bray – I’ll take Al Frances’ account of the process over some random lay person on a site that cheerleads for the medical establishment. Paula Caplan was an insider during the creation of DSM-IV and says in her 2012 Washington Post op-ed that there was political squabbling and poor research used then too, so since DSM-5 leaves most of the preceding manual’s contents in tact it’s still a sham on arrival. Also, using public input from lay persons into what’s supposed to be a medical diagnostic manual is preposterous and highlights exactly why psychiatry is a fraudulent profession. What kind of legit medical science uses **popular sentiment** to codify its diagnostic categories? No wonder my “mental hygiene” court appointment felt like a witchhunt.
Aww, what’s the matter FFF? Still butthurt that I outed your sockpuppet Off Meds on the Adam Lanza thread?
Diagnosing mental illness is sometimes difficult so we should give up trying entirely, pretend we have it right when the evidence suggests we do not, or perhaps just declare it doesn’t really exist as some suggest? Or do you have a different point to make?
@ Edith Prickly: You did out the FFF sock puppet on another thread. Great work !!
Thank you lilady – but I had an excellent teacher. 🙂
According to the ADI-R and ADOS, Asperger diagnoses are considered as autistic anyway with the only variable being early talking ability or not.
My opinion still stand, no change in clinical practice.
You tell me what’s scientific about medical “disorders” or any other scientific concepts being voted into and out of existence at whim.
Why? I am certainly not claiming that “medical disorders” are a “scientific concept”. I am just wondering why you don’t start your own feckin’ blog to wage your campaign, rather than whining at other people expecting them to push your barrow for you.