A Letter by Dr. Jon Poling regarding a “highly relevant potential source of bias”
October 4, 2008 by Kristina Chew, PhD
Filed under Health
While the evidence refuting a vaccine/mercury link to autism continues to pile up, a connection between them seems to have become lodged in the public consciousness, as the recent survey on attitudes about autism from Florida of Institute of Technology suggests. One case that has attracted a particular lot of attention was that of a girl from Georgia, Hannah Poling. Back in March, it was reported that the government had conceded that Hannah’s “pre-existing mitochondrial disorder…. was ‘aggravated’ by her shots.”
This decision was widely, widely discussed and the question repeatedly raised about how common mitochondrial disorders are in autistic children. One study cited was a 2007 article, Epidemiology of autism spectrum disorder in Portugal: prevalence, clinical characterization, and medical conditions. Another article cited was published in 2006 was Developmental Regression and Mitochondrial Dysfunction in a Child With Autism, whose authors were Jon S. Poling, MD, PhD, Richard E. Frye, MD, PhD, John Shoffner, MD, and Andrew W. Zimmerman, MD. In other words, the father of Hannah Poling, Dr. Jon Poling, was an author of a study about mitochondrial dysfunction and an autistic child. However, nowhere in the 2006 article was it mentioned that Dr. Poling is the father of the child discussed in it, or that he, his wife and daughter are petitioners in Poling v. HHS (Case 02-1466V), a pending Vaccine Injury Compensation Program (VICP).
On the October 3rd Neurodiversity weblog, Kathleen Seidel reports on a “remarkable trio of letters” regarding the 2006 article. These letters have been published in the current issue of the Journal of Child Neurology (JCN). Writes Seidel:
In his letter, Dr. Poling defends the quality of the report, explains his failure to reveal his status as the father of the child described in it, and maintains that the details of her case were disclosed without his consent.
Our report was fair and accurate, adhering to the highest standards. [My daughter’s] name was withheld to protect a 6-year-old child. A third party subsequently leaked, without our knowledge or permission, my daughter’s identity and the government’s concession report to the media. In hindsight, I agree that I should have declared my daughter’s identity in a separate letter to JCN. I apologize for that omission. [emphasis added]
Defending his failure to disclose his status as a VICP petitioner, Dr. Poling cites the long delay in case processing and his minimal input, and asserts that publishers’ disclosure requirements have already impeded the free flow of “promising leads or discoveries” involving researchers’ family members.
Seidel also traces the events that followed after the announcement of the government’s concession in the case of Hannah Poling. A literal “storm of publicity”—”carefully orchestrated,” as Seidel notes—ensued, with “a press conference, appearances on Good Morning America, Larry King Live and Cable News Network, and interviews with USA Today, The Atlanta Journal-Constitution and other national media outlets, by Dr. and Mrs. Poling, [vaccine-injury lawyer Clifford] Shoemaker, [David] Kirby, Dr. [Mark] Geier, and others. Experts on mitochondrial disorders have met to discuss what is known about mitochondrial disorders and autism.
Go here to read Seidel’s narrative. As she notes in regard to the 2006 Journal of Child Neurology (JCN) article, “Dr. Poling withheld information about a highly relevant potential source of bias while collaborating with his child’s doctors on her case report.” And,
…….a recent Scientific American article quotes the opinion of Dr. Shoffner — a leading authority on mitochondrial disorders — that Dr. Poling has “mudd[ied] the waters” with unsupported public speculations about the percentage of children who might be susceptible to mitochondrial dysfunction, and the likelihood that vaccines might trigger such dysfunction.
When the Editor-in-Chief of a journal writes an article titled “The Appalling Poling Saga” about the undisclosed conflict of interest, it’s not small potatoes. Defense of non-disclosure or irrelevance to publication is not exactly helped by going on the media circuit instead of demanding that David Kirby retract the initial “leak”. While this specific article was not used in the VCIP case, it, and the standing of the journal were used in the court of public opinion to bolster what I believe was a calculated media campaign.
Brumback, R.A. (2008). The appalling Poling saga. Journal of Child Neurology, 23, 1090-1091.
“media linkage of the published article to the legal outcome implies scientific support from JCN for this legal opinion. Of course it is possible to view this media exposure along the lines of the quip: “There is no such thing as bad publicity—just publicity.” However, in order for journals to maintain credibility with the scientific community and the general public, it is essential that any conflicts of interest be clearly identified…no written statement can substitute for honesty, good faith, and integrity on the part of authors.”
Frye, R.E., Zimmerman, A.W., & Shoffner, J.M. (2008). Conflict of interest statement concerning “Developmental Regression and Mitochondrial Dysfunction in a Child With Autism”. Journal of Child Neurology, 23, 1089-1090
“…In retrospect, a full disclosure of the relationship of the patient to the lead author and the submission of this case to the Vaccine Adverse Event Reporting System and the U.S. Vaccine Injury Compensation Program should have been made to the journal prior to publication…”
Poling, J.S. (2008). Correspondence on “Developmental Regression and Mitochondrial Dysfunction in a Child With Autism”. Journal of Child Neurology, 23,1089.
“A third party subsequently leaked, without our knowledge or permission, my daughter’s identity and the government’s concession report to the media. In hindsight, I agree that I should have declared my daughter’s identity in a separate letter to JCN. I apologize for that omission.”
As Kathleen Seidel noted in her blog post,
…With Developmental Regression and Mitochondrial Dysfunction in a Child with Autism, Dr. Jon Poling takes his place with Dr. Andrew Wakefield, Dr. Mark Geier and Laura Hewitson, Ph.D. in the ranks of researchers who have concealed relevant legal and financial interests in studies purporting to confirm a causal relationship between vaccines and autism.”
A very deep muddying of the waters indeed.
Kev also points out a significant piece of language in Dr. Poling’s Journal of Child Neurology letter over at LeftBrainRightBrain.
Hint: it has to do with “encephalopathy”, not “autism”.
No question he should have revealed that, um, association of interest. And no question, he knew that. Who, in his position, wouldn’t? And thus, we come to motive. What would be the real motive of not revealing that? It can’t be to protect his daughter, whom he paraded around on national television shows, by name, unconcealed. So what was the motive? Gosh, I just can’t imagine.
“Reality must take precedence over public relations, for nature cannot be fooled.” — Richard Feynman
“The first principle is that you must not fool yourself — and you are the easiest person to fool. So you have to be very careful about that. After you’ve not fooled yourself, it’s easy not to fool other scientists. You just have to be honest in a conventional way after that.”
Also Richard Feynman
Perhaps it might be said, a dive was taken for short-end results—–but the long-term outcome may be a different matter.
In the general media, all publicity may be good publicity, but professional journals don’t usually view it that way.
Mainstream peer reviewed medical journals don’t take kindly to being hoodwinked. I don’t think Polling will be publishing there again for a long time.
Joe
Pathophilia has a good write-up of the letters.