<ul><li>Communicating Science  </li></ul><ul><li>to the Public </li></ul><ul><li>Paul A. Offit, MD </li></ul><ul><li>The C...
MMR-Autism: Scientific Studies I Taylor, B, et al.  Lancet  1999;351:2026-29 Dales L, et al.  JAMA  2001;285:1183-85 Kaye ...
MMR-Autism: Scientific Studies II  Makela A, et al.  Pediatrics  2002;110:957-63 DeStefano R, et al.  Pediatrics  2004;113...
Thimerosal-Autism: Scientific studies Hviid A, et al.  JAMA  2003;290:1763-66 Andrews N, et al.  Pediatrics  2004;114:584-...
Defeating Epidemiology
The fallacy of balance
 
 
 
 
Epidemiological studies cannot detect rare events
<ul><li>“ Vaccines might cause autism in a small group of genetically susceptible individuals.” </li></ul>
Power of epidemiological studies <ul><li>Paralysis (GBS) and swine flu vaccine </li></ul><ul><li>Intestinal blockage and r...
Epidemiological studies don’t prove anything
Epidemiological studies and proof <ul><li>Flying like Superman </li></ul><ul><li>WMD in Iraq </li></ul><ul><li>Cigarette s...
Anecdote trumps epidemiology
 
The power of box “a” <ul><li>Disease No disease </li></ul><ul><li>Vaccine a   b   </li></ul><ul><li>No vaccine   c     d <...
Cultural Biases
The media defends the weak against the powerful
 
 
Players in vaccine-autism controversy <ul><li>If you care about children with  autism,  you support the notion that vaccin...
Players in autism controversy are miscast  <ul><li>Doctors and scientists who oppose notion that vaccines cause autism  ar...
The media loves mavericks
 
 
 
 
<ul><li>“ While Galileo was a rebel, not all rebels are Galileo.” </li></ul><ul><li>Michael Fitzpatrick </li></ul>
The media falls into the single-study trap
Wakefield, A.J., et al. Lancet 351: 637-641, 1998.
 
The media doesn’t understand science
What Science Isn’t <ul><li>Science isn’t scientists or scientific bodies or accumulated knowledge </li></ul><ul><li>Scienc...
Explaining cause and effect
The Lay of the Land <ul><li>Belief Percent of population </li></ul><ul><li>Astrology 50 </li></ul><ul><li>ESP 46 </li></ul...
Conflicts of interest
Ad hominem attacks <ul><li>If you don’t have the data, discredit the messenger </li></ul><ul><li>Appeal to personal consid...
Easy appeal to toxic, environmental hell
 
 
 
 
 
Easy to scare people; harder to unscare them
 
Poor understanding of risk <ul><li>Scared of pandemic flu, but not epidemic flu; of radon, but not strokes and heart attac...
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Friday 1.15 Pm Paul Offit Current Events In Immunizations

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Friday 1.15 Pm Paul Offit Current Events In Immunizations

  1. 1. <ul><li>Communicating Science </li></ul><ul><li>to the Public </li></ul><ul><li>Paul A. Offit, MD </li></ul><ul><li>The Children’s Hospital of Philadelphia </li></ul><ul><li>The University of Pennsylvania School of Medicine </li></ul>
  2. 2. MMR-Autism: Scientific Studies I Taylor, B, et al. Lancet 1999;351:2026-29 Dales L, et al. JAMA 2001;285:1183-85 Kaye JA, et al. Brit Med J 2001;322:460-3 Madsen KM, et al. N Engl J Med 2002;347:1477-82 Peltola H, et al. Lancet 1998;351:1327-8.
  3. 3. MMR-Autism: Scientific Studies II Makela A, et al. Pediatrics 2002;110:957-63 DeStefano R, et al. Pediatrics 2004;113:259-66 Farrington CP, et al. Vaccine 2001;19:3632-5 Fombonne E, et al. Pediatrics 2001;108:e58 Taylor, B, et al. British Med J 2002;324:393-6
  4. 4. Thimerosal-Autism: Scientific studies Hviid A, et al. JAMA 2003;290:1763-66 Andrews N, et al. Pediatrics 2004;114:584-91 Herron J. Pediatrics 2004;114:577-83 Verstraeten T, et al. Pediatrics 2003;112:1039-48 Barbaresi W, et al. Arc Ped Ado Med 2005;159:37-44 Schecter R, et al. Arch Gen Psychiatry 2008;65:19-24
  5. 5. Defeating Epidemiology
  6. 6. The fallacy of balance
  7. 11. Epidemiological studies cannot detect rare events
  8. 12. <ul><li>“ Vaccines might cause autism in a small group of genetically susceptible individuals.” </li></ul>
  9. 13. Power of epidemiological studies <ul><li>Paralysis (GBS) and swine flu vaccine </li></ul><ul><li>Intestinal blockage and rotavirus vaccine </li></ul><ul><li>Low platelets and measles vaccine </li></ul><ul><li>Omnibus Autism Proceeding </li></ul>
  10. 14. Epidemiological studies don’t prove anything
  11. 15. Epidemiological studies and proof <ul><li>Flying like Superman </li></ul><ul><li>WMD in Iraq </li></ul><ul><li>Cigarette smoking and lung cancer </li></ul>
  12. 16. Anecdote trumps epidemiology
  13. 18. The power of box “a” <ul><li>Disease No disease </li></ul><ul><li>Vaccine a b </li></ul><ul><li>No vaccine c d </li></ul><ul><li> Risk in “vaccine” group = a /a + b </li></ul><ul><li> Risk in “no vaccine” group c/ c + d </li></ul>
  14. 19. Cultural Biases
  15. 20. The media defends the weak against the powerful
  16. 23. Players in vaccine-autism controversy <ul><li>If you care about children with autism, you support the notion that vaccines are the cause. Lawyers, politicians, fringe scientists, and journalists care. </li></ul><ul><li>Doctors, public health officials, mainstream scientists and pharmaceutical companies don’t care. </li></ul>
  17. 24. Players in autism controversy are miscast <ul><li>Doctors and scientists who oppose notion that vaccines cause autism are standing up for the little guy </li></ul><ul><li>Those who claim that vaccines cause autism hurt children by providing false hope, proffering dangerous therapies, and diverting limited resources </li></ul>
  18. 25. The media loves mavericks
  19. 30. <ul><li>“ While Galileo was a rebel, not all rebels are Galileo.” </li></ul><ul><li>Michael Fitzpatrick </li></ul>
  20. 31. The media falls into the single-study trap
  21. 32. Wakefield, A.J., et al. Lancet 351: 637-641, 1998.
  22. 34. The media doesn’t understand science
  23. 35. What Science Isn’t <ul><li>Science isn’t scientists or scientific bodies or accumulated knowledge </li></ul><ul><li>Science is a way of thinking about or approaching a problem </li></ul><ul><li>Although scientists get it wrong all the time, science is enormously self-correcting; but fluidity of science can be disconcerting </li></ul>
  24. 36. Explaining cause and effect
  25. 37. The Lay of the Land <ul><li>Belief Percent of population </li></ul><ul><li>Astrology 50 </li></ul><ul><li>ESP 46 </li></ul><ul><li>Witches 19 </li></ul><ul><li>Aliens already landed 22 </li></ul><ul><li>Commune with dead 42 </li></ul><ul><li>Ghosts 35 </li></ul>
  26. 38. Conflicts of interest
  27. 39. Ad hominem attacks <ul><li>If you don’t have the data, discredit the messenger </li></ul><ul><li>Appeal to personal considerations rather than logic or reason </li></ul><ul><li>CDC, AAP, individuals under fire </li></ul>
  28. 40. Easy appeal to toxic, environmental hell
  29. 46. Easy to scare people; harder to unscare them
  30. 48. Poor understanding of risk <ul><li>Scared of pandemic flu, but not epidemic flu; of radon, but not strokes and heart attacks; of dioxin, but not French fries; of plane travel, but not car travel; of MMR vaccine, but not measles; and of thimerosal-containing influenza vaccine, but not influenza. </li></ul>

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