Press releases Monday 17 January to Friday 21 January 2011

Please remember to credit the BMJ as source when publicising an article and to tell your readers that they can read its full text on the journal's website (http://www.bmj.com).

• (1) Revealed: 48-hour "scramble" to discredit MMR concerns
• (2) Travel websites should inform people about malaria, say doctors

(1) Revealed: 48hour "scramble" to discredit MMR concerns, Medical establishment closed ranks to protect Wakefield

(Secrets of the MMR scare: The Lancet's two days to bury bad news)
http://www.bmj.com/cgi/doi/10.1136/bmj.c7001
(Editorial: Assuring research integrity in the wake of Wakefield)
http://www.bmj.com/cgi/doi/10.1136/bmj.d2

A series of denials and a failure to formally investigate allegations of misconduct in Andrew Wakefield's MMR research meant the public was misled for six years about the credibility of the 1998 Lancet paper by Wakefield and colleagues.

Dr Fiona Godlee, BMJ Editor in Chief, says the UK has consistently failed to take research misconduct seriously. She calls on the UK government to establish mandatory oversight of clinical research integrity within the NHS, as happens for publicly funded research in the USA.

In the third and final part of a special BMJ series, "Secrets of the MMR scare", investigative journalist Brian Deer reveals how the medical establishment closed ranks to protect Wakefield after he raised concerns with the Lancet in 2004.

Deer's allegations included possible research fraud, unethical treatment of vulnerable children, and Wakefield's conflict of interest through his involvement with a lawsuit against vaccine manufacturers.

Deer thought the editor, Richard Horton, would say that an investigation was needed. Instead he reports that "within 48 hours, and working with the paper's three senior authors, the journal was to publish 5000 words of denials, in statements, unretracted to this day."

The statements said that an investigation was undertaken by the Royal Free Hospital that "cleared Wakefield of wrongdoing."

But documents, emails, and replies obtained under the Freedom of Information Act reveal no formal investigation. "What emerges is merely a scramble to discredit my claims during the 48 hours after I disclosed the information," writes Deer. In short, "the accused were investigating themselves."

It took a further six years for the General Medical Council (GMC) to prove Deer's allegations, and for the Lancet paper to be retracted. During this time, public alarm over MMR continued, measles outbreaks occurred, and two UK children died from the disease.

"Were it not for the GMC case, which cost a rumoured £6m (€7m; $9m), the fraud by which Wakefield concocted fear of MMR would forever have been denied and covered up," argues Deer. The Royal Free Hospital and Medical School have since confirmed that they carried out no formal investigation. No doctor was interviewed, and no documents were generated.

In a written response to the BMJ last week, Professor Sir John Tooke, Vice-Provost at University College London said: "UCL takes any allegation of research misconduct very seriously, and we will certainly investigate those raised in the BMJ. This process will be subject to external scrutiny, in line with our procedures in this area." He added: "We are determined to learn from the mistakes made in relation to this case . . . Our objective is to continue refining a structure and processes which provide all reasonable safeguards whilst also facilitating the highest quality research for population benefit."

"This case reveals major flaws in pre and post-publication peer review," says Dr Godlee. "Allegations of research misconduct must be independently investigated in the public interest. But it's still too easy for institutions to avoid external scrutiny, and editors can fail to adequately distance themselves from work they have published and then defended."

An accompanying editorial by researchers in Seattle says Deer's articles reveal the urgent need "to fix a system that failed to protect human subjects and the public from the consequences of fraudulent science."

Contacts:
Fiona Godlee, Editor in Chief, BMJ, London, UK
Email: edickinson@bmjgroup.com
Brian Deer, Journalist, London, UK
Email: mail61@briandeer.com

(2) Travel websites should inform people about malaria, say doctors

(Letter: Travel websites should highlight malaria risks)
http://www.bmj.com/cgi/doi/10.1136/bmj.d271

Travel websites, especially those that offer 'last minute' deals, should inform people about the risks of malaria and the need to take preventative medication before travelling, say experts in infectious diseases today.

Their warning, in a letter to this week's BMJ, follows three recent cases of malaria in UK citizens returning from 'winter sun' holidays to the Gambia, where malaria is highly endemic.

They all used the same travel website. Two had made a late booking and all failed to take preventative drugs (chemoprophylaxis). Within two weeks of returning to the UK, they all presented to hospital with severe malaria.

Imported cases of malaria remain relatively common in the UK, say the doctors. The majority of malaria in the UK is contracted in West Africa (813 of 1,495 cases in 2009) and a significant proportion occurs in holidaymakers (57 in 2009).

They say that this risk could potentially be reduced if travel websites include explicit messages regarding the need for medical advice and effective chemoprophylaxis prior to travelling to malaria endemic areas.

"A warning about the need to allow sufficient time to organise these interventions may reduce the particular risk to individuals making late bookings," they conclude.

Contact:
John Widdrington, Specialist Registrar in Infectious Diseases, The James Cook University Hospital, Middlesbrough, UK
Email: john.widdrington@nhs.net

Emma Dickinson
Tel: +44 (0)20 7383 6529
Email: edickinson@bma.org.uk

Press Office telephone : 020 7383 6254 (Weekdays : 0900hrs - 1800hrs)
British Medical Association
BMA House, Tavistock Square, London WC1H 9JR

and from:

the EurekAlert website, run by the American Association for the Advancement of Science (http://www.eurekalert.org)
http://intranet.bmj.com/departments/dept-bmj/bmj-team-resources/web-team-resources/General_blogging_principles.doc