(This post was written by Patrick Sullivan Jr.)
For everyone following/participating in the debate about whether or not autism is actually mercury poisoning, one thing that seems to come up over and over, on both sides...the fight over who has the better evidence.
Dr. Donald Miller is a professor of surgery at the University of Washington School of Medicine. Dr. Miller emailed me an article he had written with Clifford Miller, Esq. called "On Evidence, Medical and Legal," which was recently published in Journal of American Physicians and Surgeons.
(For disclosure sake, Dr. Miller does believe there is a connection between mercury and autism. This was not the focus of this article, but there is a section about the mercury/autism connection. Pat, myself, and Jigsaw Health have no financial connection to Dr. Miller or Clifford Miller. There are a few of Dr. Miller's previous articles posted on JigsawHealth.com and he recently wrote a "blurb" for Pat's book.)
I'm still very much a novice in science and medicine, so I had a little trouble following the article. But after wading slowly through the medical and legal jargon, I came to what was a surprising conclusion:
Empirical evidence -- that which is anecdotal, but can be corroborated by witnesses and verified by a method called "challenge, de-challenge, re-challenge" -- carries MORE weight than epidemiological studies and randomized controlled trials (RCT) because these are subject to interpretation, which has the potential for corruption.
This didn't sit right with me at first. It just didn't feel right to hear that one "anecdotal" incident should carry more evidentiary weight than large studies. But as I read through it and thought about the parallel to the legal world, it made plenty of sense.
Here are several key quotes:
Science prizes objective certainty. For a hypothesis to be proved, or a theory to become theorem, the evidence supporting it must be irrefutable. But science does not uniformly adhere to this standard. Subjective opinions and consensus among scientists often supersede the stricture of irrefutability.
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The investigator's interpretation of the trials results is especially prone to bias. And, as seen in the NHS albumin meta-analysis, a study's source of funding can affect its results. Als-Nielson and colleagues found that RCTs [randomized controlled trials] funded by pharmaceutical companies are significantly more likely to recommend the experimental drug as the treatment of choice than are studies funded by organizations that have no financial stake in the outcome.
Chan and Altman reviewed 519 RCTs that were published in December 2000 and indexed in PubMed. They found that incomplete reporting of outcomes (described in the methods section but not in the results section) was common, and conclude that the medical literature of randomized trials represents a selective and biased subset of study outcomes. As one observer put it, "Epidemiological analysis is notoriously susceptible to misinterpretation, and even manipulation. Two sets of researchers can extract diametrically opposed results from the same data." The pharmaceutical and biotech industries now fund more than 60 percent of the RCTs that medical journals publish, which raises the concern that supposedly objective science is being turned into a marketing tool.
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In a legal case, lawyers organize the evidence they obtain to create a "factual matrix." Elements of information are corroborated and cross-correlated to present a consistent, linked set of facts. Law tests the reliability of the sources of information, in addition to testing the information the sources supply. It admits evidence from a broad range of sources, which include human witnesses, documents, and machine "witnesses" (material on computers, audio, and video).
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Editors can subvert peer review by selecting only reviewers who will reject papers that run counter to--or praise papers that support--the interests of journal's advertisers or its owners. Lines of independent research contradicting conventional wisdom can systemically remain unpublished.
Such hard-to-publish research may prove that what the scientific community generally accepts as correct is, in fact, wrong. Research follows the funding, resulting in a wealth of publications favoring the funding interests. This can have a disproportionate effect on the "weight" of evidence, especially for epidemiologic evidence in court.
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Pro-mercury/autism science vs. Anti-mercury/autism science -- One thing that we've continually seen from both camps is a war over scientific studies. Both sides have plenty of Pubmed citations. Both sides claim that the other side has all "junk science." The level of discourse is terrible and you will rarely, if ever, see either side concede any points at all. The whole thing might as well be a wash.
Interestingly, this continual battle over studies totally supports Dr. Miller's arguments. We have all found studies that support our position. So when one side argues for their studies, the other side digs into each and every study and says, "Well, they didn't control for this, That person had a conflict of interest, That journal's editors disagree with that theory, blah blah blah." It's the same thing every time. And this is an extremely accurate description of what it happening today across many different blogs and Yahoo! boards. (I'll admit guilt for participating.)
And yes, I do see the irony of my using a study to support my own position -- "You can't explain away empirical evidence. It's just a fact." But may I kindly remind the readers that I arrived at this conclusion a few weeks ago through logical deduction of the fact that autistic children were having amazing results through chelation.
If I understand the Dr. Miller's line of thinking, significantly more weight should be given to Kevin Champagne's story than to the epidemiological studies and randomized controlled trials that we all keep squabbling over. Or as Dr. Buttar so succintly puts it: (paraphrase) "It would be nice to know more about why this is working, rates of absorption, etc. But to the clinical side of the house, it matters not. TD-DMPS just works."
And it should be well noted by skeptics and supporters alike that Kevin's story is NOT unique. I am now personally aware of 5 separate instances (4 using TD-DMPS, 1 using TD-DMSA) where chelation is making a huge impact. To date, chelation -- removing mercury and other heavy metals -- has been the MOST effective biomedical treatment for autism.
BIG CORRECTION: I posted in a few places that 73% of 23,700 parents shared this experience. Well, I misunderstood the data. As the Autism Research Institute explains here, chelation is a relatively new protocol for autism and they've only asked this question of 324 parents. 73% of those 324 parents found it to make autistic symptoms better. 23,700 is their total number of survey participants since 1967. (We could argue stats, population data, survey methods, etc. all day long, but it still won't explain away Kevin Champagne's story or the 4 other people I know.)
It's time to pick our head's up out of the weeds.
And if anything, this article should help those parents who are safely using chelation protocols (TD-DMPS, oral DMSA) to defend why their own experiences should not be written off as "anecdotal" and un-scientific.
