More Briffa

May 30, 2008 at 7:56 pm (Alternative Medicine, Anti-Vaccination, Bad Science, Briffa) (, , , , , , , , )

 

Dr John Briffa is involved in an interesting discussion on his blog. In a response to a comment I made that included a link to MMR – The Facts he wrote “In the link you supplied under ‘How do we know that MMR is safe?’, we are informed that…” and went on to paste several bullet points. Which weren’t on the page I’d linked to. This is the page: http://www.mmrthefacts.nhs.uk/library/sideeffects.php and it contains data on the number of children suffering from the effects of contracting measles compared with the number of children suffering from the side-effects of the MMR vaccine. Having quoted from a different page than the one I had linked to, Briffa then used this quote to back up this statement:

The first three bullet points tell us how widely and for how long it has been used (this is no different from saying ‘billions of people have crossed roads over the past 50 years’ – it tells us NOTHING AT ALL about safety – NOTHING).

True – the first three bullet points he copied and pasted told us nothing about safety. The page I actually linked to, however, did tell us something about safety and it used scientific evidence to do so. To paste information from a different link to the one I was using to demonstrate my point is fundamentally dishonest and I think it tells us something about the way Briffa argues. I’m not the only person who has picked up on Briffa constructing ‘straw men’ – here is another example. Here’s more of Briffa’s responses to my comments:

You’re right, the arbitrary nature of p-values is not a ‘secret’, but you’d be surprised just how much this fact is not fully understood or appreciated by those with no scientific training (like the majority of the readers of my site, I suspect). So, nothing wrong with pointing that out, I reckon.

Fair enough. He hasn’t explained p-values though. If his readers don’t fully understand or appreciate the arbitrary nature of p-values then perhaps they won’t fully understand or appreciate p-values themselves. If Dr Briffa is going to educate his readership perhaps it would be better to do a more thorough job and explain what p-values are before he tells people that they are arbitrary (which, apparently, therefore means scientific findings are arbitrary).

What I think happens in the real world is that when a scientific study pronounces a finding that is said to be ‘statistically significant’ or not, is that people interpret that to mean that a drug works or doesn’t or a vaccine is safe or not. And what I’m saying (if this wasn’t absolutely clear in the post) is it’s not like that: because the cut-off for what we determine to be ‘significant’ is arbitrarily set. This may be obvious to you. But as I pointed out above, I actually don’t think it’s obvious to everyone.

If people interpreted statistically significant scientific findings as showing that a drug worked relatively well or that a vaccine was relatively safe then I think they would probably be right to do so. Missing out the word ‘relatively’ and making safety and efficacy absolutes makes a big difference, and I don’t think that p-values being arbitrary is that important a factor in this – scientific evidence would be nuanced and safety and efficacy relative rather than absolute even if we had p-values that had somehow been determined unarbitrarily. If the public, as Briffa seems to be claiming, are unable to understand that science is nuanced rather than black-and-white then I think it is a problem – and not one that is ameliorated in any way by the writings of Dr John Briffa.

You also appear to misrepresent me in suggesting that I have the opinion that science has no value. I don’t hold that view at all, and you would know if you spent just a few minutes trawling my site: it regularly cites scientific evidence.

I must apologise for any misrepresentation of Dr Briffa’s views (funny how he complains about that, when he quotes from a different source than the one I linked to). It just seems to me that there is a contradiction here. P-values are, apparently, arbitrary. This means that scientific evidence is arbitrary. The man who thinks these things then states that he regularly cites scientific evidence on his website. What I’m wondering here is how Dr Briffa decides which studies to cite. Does he cite the arbitrary ones that are deemed to be statistically significant according to those arbitrary p-values? Does he have a special way of sorting the studies himself according to how significant they are on the Briffa Scale? I just don’t understand how someone can claim scientific evidence to be arbitrary and then back up their scientific standpoint by pointing out that they regularly use scientific evidence. Just how arbitrary is the evidence Briffa uses?

So, for the record, I support the concept of science, but I’m no slave to it.

And I also know that one’s experience in practice (in the real world, with real people with their real problems) is important too.

So Briffa’s practice is based in the real world but science isn’t? Maybe I’m in danger of misrepresenting Briffa’s views here, but why would you repeatedly emphasise practice as being ‘real’ (three times in one sentence, and once in a previous comment I quoted) and not science unless you were trying to make some kind of point? The message Briffa’s readers are intended to take away must be, I presume, that science is somehow not part of the real world. Science could probably be summed up as ‘an organised system of knowledge obtained mainly from study of the real world, or nature’. Some may argue with that definition of science, but it most certainly is not divorced from the real world.

So, jdc, perhaps you’d like to share with us some of you clinical expertise. Or is healthcare, for you, an essentially ‘academic’ pursuit? Perhaps you can tell us….

Oh good, it looks like he’s setting himself up for an appeal to authority. Briffa’s clinical expertise clearly enables him to ignore: logic; inconvenient scientific evidence; scientific consensus on p-values and statistical significance. My lack of clinical expertise presumably precludes me from any discussion relating to medical science. Why is ‘academic’ in ‘scare quotes’ though? Is it because he doesn’t think academics are real or something? An indication of sarcasm? Does it indicate some kind of disdain for academics? I’m not sure, but we might come back to ‘academics’ later in the post.

First of all, you suggest that I believe MMR to be unsafe. Actually, I said no such thing. My point is, we can’t be sure that it is safe. Those two positions are not the same.

Briffa’s position has been described by another commentator as boiling down to I’m not saying it does, I’m not saying it doesn’t, I’m just saying – which I have repeated here because I couldn’t have put it any better. Even something as ‘harmless’ as water isn’t safe if you ingest excessive amounts. We can’t ever be 100% sure that any substance is 100% safe. It would be ridiculous to think that we could be and any argument that rests on “we can’t ever be sure it’s safe” is surely doomed. We have to make judgements every day on the risks and benefits of all manner of things and sometimes science can help us to make better-informed decisions as to those risks and benefits – including the risks and benefits of vaccination.

So, jdc, you have drawn our attention to this ‘MMR – the facts’ site, and now perhaps you’d also like to comment on the robustness of the ‘evidence’ this site uses to pronounce MMR as safe, specifically with regard to autism (by the way, it was you that raised the autism issue, not I).

Firstly, the ‘evidence’ Briffa quoted wasn’t on the page I’d linked to. [Seriously – are ‘scare quotes’ meant to give a word pejorative meaning or something? What’s going on with ‘academics’ and ‘evidence’?] Secondly, although it was me who first referred to autism, Briffa’s post used a road accident analagy to state that vaccinations are not always safe and spoke of “a considerable body of people out there who believe (rightly or wrongly) that their child has been damaged by vaccination”. The most prominent groups that believe their child has been damaged by vaccination seem to be groups that believe vaccines cause autism. I think most people would probably think of autism when someone writes about vaccine damage and I’m surprised Dr Briffa (seemingly) didn’t expect anyone to mention autism in relation to his comments on vaccine damage. It seemed to me to be the obvious thing to mention. I know I said I was going to come back to ‘academics’, but Briffa gave a separate response to a second comment I had left on his blog and I might as well make it a separate post. Frankly, I’ll be slightly surprised if anyone is still reading at this point – this post has turned out to be slightly longer than I had intended.

78 Comments

  1. jdc325 said,

    Oh good. He’s now responded to a comment by Andrew of Apathy Sketchpad by saying there is “NO DEFINITIVE EVIDENCE THAT MMR DOES NOT CAUSE AUTISM”. OK, you don’t have to shout John. You may be right that there is not definitive evidence that MMR does not cause autism. Neither is there definitive proof that teddy bears don’t cause autism. What’s your point Dr B?

    Here’s Andrew’s comment and Briffa’s response is below.

    He also states that “the US Government recently looked at such evidence relating to just one girl (Hannah Poling) and concluded that vaccination had contributed significantly to her autism” – read Orac for more on the Poling case:

    So what does this mean? First, one thing that it doesn’t mean, contrary to all the P.R. over the last few days, is that the government has conceded that vaccines cause autism. Mitochondrial disorders of the sort suffered by Hannah are genetic in nature and rare, an estimated 5.7 individuals per 100,000 worldwide, and, as described well in this New Scientist article, the subset of these disorders that cause autism-like symptoms is even more rare. It is also known that children with mitochondrial disorders are prone to develop an encephalopathy in response to stress or fever that can cause them to regress.

  2. dvnutrix said,

    Is this shaping up to be a text-book example of Dr*T’s 5 As (and more) of empty argument? Although argument by quoting from a different page sounds like it takes the biscuit. Argument from artifice?

  3. John Briffa said,

    JDC325

    “To paste information from a different link to the one I was using to demonstrate my point is fundamentally dishonest and I think it tells us something about the way Briffa argues.”

    Permit me to explain. As you admit below, it was you who raised the issue of autism. I don’t have any issue with that, but it’s important in the context of what you’ve claimed above (about me being dishonest). You see, when I went to the page you linked to, it didn’t say anything about autism. No mention, not a word. So, I thought what I’d do is imagine I was a concerned parent and went to our Government’s site on MMR (the facts) to look for information about safety (which, as you know, was what we were discussing). I saw a link entitled ‘How do we know that MMR is safe?’ and reasoned that this is where most people would look for information on the safety of MMR (I mean it did have ‘safe’ in the title, after all). So, not so cloak and dagger and dishonest really, when you follow the logic. I could, but I won’t, have a hissy about the fact that you brought up autism and then linked to a page that did not mention it (even once).

    So, I put my hands up and admit that I referred to a page you did not link to. But I maintain I was not in any way trying to misrepresent you or mislead.

    Anyway, whether you accept this or, would you now like to comment on the contents of the page I did link to?

    If I’d seen it at the time, I’d also have linked to the page specifically about autism here: http://www.mmrthefacts.nhs.uk/library/autism.php
    Personally, I reckon it’s as useless and opaque as the page I originally linked to.

    “If Dr Briffa is going to educate his readership perhaps it would be better to do a more thorough job and explain what p-values are before he tells people that they are arbitrary (which, apparently, therefore means scientific findings are arbitrary).”

    Well, that’s obviously a matter of opinion, and not exactly crime of the century. I wrote the piece in a way that I reckoned would be understandable to all. The bottom line (and I haven’t heard from anyone who claimed not to understand the core message) is that what is deemed ‘statistically significant’ or not is determined by arbitrarily set criteria. Oh, and using those arbitrary criteria may cause us to miss what’s really going on, of course.

    “If the public, as Briffa seems to be claiming, are unable to understand that science is nuanced rather than black-and-white then I think it is a problem – and not one that is ameliorated in any way by the writings of Dr John Briffa.”

    And that’s a matter of opinion too. I made the claim that science is nuanced (as you call it), so one would expect I helped some people who see it as ‘black and white’ to see it more as it really is. How has that not ‘ameliorated’ the situation, exactly?

    “What I’m wondering here is how Dr Briffa decides which studies to cite. Does he cite the arbitrary ones that are deemed to be statistically significant according to those arbitrary p-values? Does he have a special way of sorting the studies himself according to how significant they are on the Briffa Scale? I just don’t understand how someone can claim scientific evidence to be arbitrary and then back up their scientific standpoint by pointing out that they regularly use scientific evidence. Just how arbitrary is the evidence Briffa uses?”

    First of all, regrettably, there is no BriffaScale. However, I do think science has something to offer, as I said, and use it to clarify, inform or debunk where I think there is reasonable evidence. What’s reasonable? Well, that’s a subjective thing of course, like P-values, and much of science actually.

    On the subject of academics, clinical practice and the real world:

    Here’s my point: academics and scientists who don’t actually see patients don’t seem not to realise, sometimes, that when actually faced with a real live person (not a book or a scientific paper or a piece of tissue under a microscope), science does necessarily help much at all when making actual clinical decisions. You see, most of medical practice is not supported by good evidence (though that does not mean it cannot be helpful). Then we have the problem that science generally looks at groups of people, and what we know here may simply not apply to the individual sitting in front of you. Then we might even need to think about the wishes and desires of the patients (whatever the science shows). So, you see, after all that, I think it’s fair to say that a lot of the time, science really is a fat lot of good in clinical practice. And it’s clinical practice and good healthcare that I’m primarily concerned with (real people with real problems, as I said).

    So do forgive me if I ask about your clinical experience, because if you have none, then it demonstrates that you can’t really know what it’s like to advise people about health-related decisions in a way that is best for them (which is what doctors and other health professionals generally seek to do). By all means consider the science (as I said, I do too), but there’s a lot more to good medical practice than that (as, I suspect, most other practitioners will tell you too). Oh, and then there’s that seminal editorial in the BMJ that appears to hold clinical experience in high regard to when one is practising ‘evidence-based medicine’.

    You suggest I have disdain for academics, and you’re right, but not all of them, just some of them. Particularly those who presume to know what is good medical practice despite last having seen a patient decades ago or in some cases never having seen a patient at all. I don’t think that’s unreasonable, do you?

    “Briffa’s position has been described by another commentator as boiling down to I’m not saying it does, I’m not saying it doesn’t, I’m just saying – which I have repeated here because I couldn’t have put it any better. Even something as ‘harmless’ as water isn’t safe if you ingest excessive amounts. We can’t ever be 100% sure that any substance is 100% safe. It would be ridiculous to think that we could be and any argument that rests on “we can’t ever be sure it’s safe” is surely doomed. We have to make judgements every day on the risks and benefits of all manner of things and sometimes science can help us to make better-informed decisions as to those risks and benefits – including the risks and benefits of vaccination.”

    In the absence of definitive evidence to show that MMR does not cause autism, does it really seem a ‘well-informed decision’ to ignore or chastise or bully the countless parents who believe they witnessed their child regress into autism shortly after receiving the MMR vaccination? Wouldn’t the best thing to do be to actually undertake the relevant research, and be done with it?

    A little request, if I may. We had a debate going and now it seems you’ve decided to retreat to your own blog. Can I encourage you please to post responses to my last comments to you on my own site, so that we can continue the debate there? I mean, it does look as though we’ve left things hanging a bit.

    And one more thing: you tell us that the reason that you blog anonymously is because you are “…occasionally critical of the field my employers are involved in.” I’d really like you to clarify this for me, if you can. Is what you are saying that your employer is engaged in a business that is not aligned with your beliefs, ethics or morals? As I say, perhaps you can clarify.

  4. Mary Parsons said,

    jdc supplies a link to “How do we know that MMR is safe?” and you fail to use that material in your response but affect to ridicule something else and pass it off as his argument. You now claim that that is because it didn’t address autism. How very odd, it is not unusual for a response to refer to several strands of topic or argument and one might imagine that this doesn’t require a great deal of sophistication to understand. Your comments on this blog are examples of many threads.

    As for the rather charming invitation to repair back to your own site to “continue the debate there”, that would be superficially more attractive if you did not have a reputation for deleting comments.

  5. John Briffa said,

    Mary Parsons

    The reason that I didn’t use jdc’s link was, because (as I think I clearly explained above) it was essentially irrelevant to the topic. So, I linked to something I thought was more relevant. I might be a bit unsophisticated, as you claim, but that doesn’t necessarily make me the dishonest or deliberately misleading.

    With regard to the ‘deletion of posts on my site, for the record, I don’t delete comments. I do moderate comments, though, which means not everything gets posted (though practically everything does). That’s partly because some of it can be abusive, but primarily because some people raise what I regard to be points that are quite irrelevant to the debate, or attempt to post things so garbled and incomprehensible that it’s difficult to know what point they’re making at all.

    Now, Margaret, perhaps you can provide some evidence that I’ve deleted comments that you think deserve to have seen the light of day. It seems you’re attempting to besmirch my reputation, so kindly provide for us the evidence that supports your suggestion that I delete comments from my site.

  6. dvnutrix said,

    Mary, did you have Novella’s piece on Changing the rules of evidence in mind?

    My daughter, Julia, loves to play games and has a bit of a competitive streak. She can make any activity into a game and is adept at making up rules on the spot. When she was younger, like most children, she had a tendency to add to or change the rules on the fly – usually to ensure a favorable outcome for herself. “Oh, Daddy, I forgot to mention that the ball can bounce once and that still counts.”

    It was an opportunity for me to gently teach her that in order for rules to work everyone has to know what they are ahead of time and you can’t change them after the fact. Her smile told me that even at five she intuitively knew this already – that changing or making up new rules was not fair. What I was really teaching her was that she wasn’t going to get away with it with me, and by extension that it is socially unacceptable to mess with the rules to suit oneself.

    Adults are really no different than children in our basic emotional makeup. We all want to change the rules to suit our own needs. The true difference is that as we mature we become more socially sophisticated; we become more subtle in our manipulations, and we develop the capacity to rationalize our wants and desires. We also learn that we are playing a bigger game – the social game. So we adhere to the rules of fairness, even if it means losing a competition, because we want to succeed at the more important game of socialization.

  7. Evidencebasedeating said,

    heh JDC

    you could always ‘Do A Briffa’ sterilisation on your blog. If you’re not familiar with this approach – and why should you be even if you scan his blog – this is the technique

    Briffa sterilising entails:

    1. post what you think is an interesting perceptive piece -this may or may not be the opinion of your readers

    2. those who disagree with you post their comments. usually in the dozens

    3. Ooops! You rely on your blog to showcase your superior nutritional/medical/immunological knowledge

    4. wait a week. Post another article

    5. go back and delete said criticisms. Especially if they are from Registered Dietitians who actually know the subject you claim to be expert in- and who can run rings round your argument and quote clinical evidence you conveniently omitted, given they disagreed with your premise

    6. Do remember to remove also your sarcastic and ad hom replies to ensure new readers don’t cotton on to the fact you’ve edited your postings

    7. Briffa sterilisation complete! No harm done, hopefully. Wouldn’t want Big Corp or Worried Well to see how your comments are discussed by the experts in the field.. they may decide to look elsewhere for ‘Expert Nutritional Advice’. Perhaps using DietitiansUnlimited or SENSE……

    OOPS!

    forgot. JDC is one of the Bad Science Bloggers.
    Dr B – your comments will remain. For all to see and discuss.

  8. Mary Parsons said,

    Who is Margaret?

    However, that is what is rather so interesting about deleting comments. I am grateful to dvn for quoting Steve Novella which seems like rather an excellent example. I note that you have now shifted the goalposts to add on a rider about comments ‘deserving to see the light of day’.

    Oh dear, Dr Briffa. How many of us would escape the dies ire of your matchless judgment?

  9. John Briffa said,

    Evidencebasedeating

    “5. go back and delete said criticisms. Especially if they are from Registered Dietitians who actually know the subject you claim to be expert in- and who can run rings round your argument and quote clinical evidence you conveniently omitted, given they disagreed with your premise

    6. Do remember to remove also your sarcastic and ad hom replies to ensure new readers don’t cotton on to the fact you’ve edited your postings”

    Please do supply some evidence of this – we have google cache after all, so it shouldn’t be difficult for you to come up with some. Or maybe you’ve printed some examples out. Any evidence of this, any at all, will do and I’ll hold my hands up.

    May I also suggest that the comments you’ve made might be viewed as defamatory in a court of law. And that there has been an instance of a judge in the UK forcing a site to reveal the identity of ‘libellous’ posters. So, while you post anonymously, this may not be as much of a protection as you might imagine.

    So, will you provide the evidence for your assertions, or would you prefer to retract?

  10. John Briffa said,

    Mary
    Sorry about getting your name wrong.
    Please do see my comments to Evidencebasedeating above. They apply, broadly, to you too.

  11. jdc325 said,

    A tip for anyone who has experienced comments going missing: http://info.jkn.com/ is very useful as a way of keeping a record of comments you post on blogs and forums and it’s free to register.

  12. plh said,

    Well… – and I accept it may have been accidentally lost at some point in the posting process too, but thanks to Emacs’s paranoia, and just out of interest, and at the risk of abusing jdc’s hospitality, here is the possibly abusive, irrelevant, garbled or incomprehensible comment I made 4 days ago on Dr Briffa’s blog:

    “The road safety analogy is inappropriate and the imaginary study is not a sensible one. When you cross the road you are either hit by a car and injured by it or you are not. When you are hit by a car and immediately afterwards you have injuries, they were almost certainly caused by the accident. This observation combined with police and hospital records mean that it is already known (effectively for certain) that the probability of being injured by a car while crossing the road is not zero. A sensible study would be a *measurement* of the rate of such accidents – not a *test of the hypothesis* that crossing the road is safe. Once you are injured in such an accident, studies showing that the probability of being hit by a car and injured while crossing the road is very small have absolutely no bearing on the matter and no doctor would be stupid enough to fail to recognise this.

    The situation with vaccines is very different. When you have a vaccination jab, it either causes some injury or it does not. However, when you develop some non-trivial injury after a jab, you cannot be at all sure what caused it and unless the exact cause can be determined in your case, studies showing that there is some probability of such an injury from other, possibly unknown, causes combined with studies showing that jabs don’t seem to contribute much if anything of an additional risk have a great deal of bearing on the matter. Your doctor might say that your injury could have been caused by the jab but that it is very unlikely.

    Crossing the road enables you to get on with your life and jabs give you protection against other more likely causes of serious injury. They are worth the very small risks they entail. What is so problematic about that?”

  13. John Briffa said,

    JDC325

    Would it be too much to ask to answer the points I’ve put to you in my first comment above? I mean, isn’t that what the comments section of blogs is all about, really – debate. But if it’s all a bit one-sided and people don;t have their questions answer, it’s all a bit pointless, isn’t it?

    I was disappointed that you have chosen not to continue our discussions on my blog, but now you’ve picked up the thread here, you still remain silent with regard to my points and questions. Can I ask why? Or will you just answer them?

    Can I thank you for providing that link to jkn because now that posters have made potentially libelous accusations about me, it will help ensure the relevant posts don’t just vanish into thin air. Not that it would matter too much if they do, because I’ve printed them out for safe-keeping.

    Evidencebasedeating and Mary Parsons
    I’m asking again for you to please provide the evidence for these assertions you’ve made about me deleting posts, or retract them.

  14. Kev said,

    Google cache could not possibly pick up comments so quickly. Unless your site happened to be fully indexed at the time the comments were made, its simply not possible.

  15. John Briffa said,

    Any evidence will do, Kev, any…

  16. John Briffa said,

    Jdc325

    I note you have still not replied to me, and neither have Evidencedbasedeating or Mary Parsons regarding their allegations that I delete comments on my site.

    Now, if anyone were to come here and peruse the comments, you might imagine that they’d find the title BriffaWatch quite curious. I mean, what with the anonymous blogger responsible for the site seemingly refusing to answer my perfectly reasonable questions, and other individuals making accusations about me they, to date anyway, have been unable to substantiate.

    You may not need me to tell you this, JDC325, but as the publisher of these allegations, it’s you who is ultimately responsible for them. Are you genuinely happy to sit back and do nothing? Perhaps you’ll at least answer this question.

  17. openmind said,

    There’s a fine line between moderation and censorship. I was v. annoyed at a number of my comments being deleted on this thread:

    http://www.drbriffa.com/blog/2007/02/26/347/

    Briffa said above that he would remove comments that were “abusive”,”irrelevant to the debate” or “so garbled and incomprehensible that it’s difficult to know what point they’re making at all”. I don’t have a record of my comments but they were certainly not in any of those categories.

    In that particular post Briffa said that “Partly as a result of Catherine Collins’ above, I have taken the decision not to allow posts that do not seem to further the debate or add constructively to it.” It’s his blog and he can do what he likes, but it left me with the feeling that my comments had been deleted because they were in opposition to his views. Perhaps if he has a record of the whole thread he could publish it to let others decide?

  18. John Briffa said,

    openmind

    And there’s a big difference between deleting and not allowing, right? And no, this is not a semantic issue. One means the comment went up and then was taken down (as evidencebasedeating has claimed explicitly) and the other means simply not allowing the post. So, to be clear, which are you accusing me of here, and if it’s the former, can you provide any evidence for this?

  19. openmind said,

    I do not have any proof but to the best of my recollection the comments I made were posted and then taken down.

  20. openmind said,

    And just to be clear about this, I’m not accusing you of anything. As I said, it’s your blog, you can do what you want with it.

  21. John Briffa said,

    openmind
    Actually, yes, you are accusing me of something – deleting your comments on my blog. Which, may be viewed as something that besmirches my character, professionalism, honesty and integrity which is – potentially defamatory. And it seems now you’re getting a bit vague about what it was I am supposed to have done.
    So, I’m going to ask you again, is your claim that I deleted your posts on my site?

  22. openmind said,

    As I have no proof of you doing that then I am not claiming or accusing you of doing that.

  23. John Briffa said,

    openmind
    That’s not how the law sees it, I’m afraid.

  24. plh said,

    The judges I know would most likely see your allegations against Mary and openmind as vexatious. I’m sure your lawyer has already advised you of the benefits of choosing your targets wisely, Dr Briffa.

  25. draust said,

    Dr B

    All these repeated references to “defamatory” “the law” “potentially libelous accusations” “a UK judge forcing a site to reveal the identity of ‘libellous’ posters” are rather unnecessarily threatening, surely? For many here they will, I think, conjure up the attempt by Patrick Holford some time back to use a solicitor’s letter involving the threat of M’Learned Friends to stop people saying mean things about him, or criticising his published statements.

    Given your comments here and on your own blog that you are about open debate, waving the “lawyer card” again and again might seem.. a touch odd.

    On a different tack, you keep referring to “definitive evidence” that MMR does not cause autism. Can I ask you a question, since you asked me one on the other thread? What level of scientific evidence would you accept as “definitive” in this context? It is clearly impractical, as well as unethical, to do lots and lots of invasive investigations on every child whose parents think the child’s autism was secondary to vaccination, even if there were a test that would prove it either way. If the epidemiology doesn’t satisfy you as to the lack of linkage, what would?

  26. draust said,

    Re. the Hannah Poling case, mentioned in the first comment on this thread, there is a discussion of this by various participants (including Dr Briffa) over at the Left Brain/Right Brain autism blog.

  27. Evidencebasedeating said,

    Dr B
    “Why is the dietary advice given to diabetics so often so woefully inadequate?”
    your post of 3rd October
    Google cached and copied 6th October 2007

    compared to current “Why is the dietary advice given to diabetics so often so woefully inadequate?”
    accessed just now.

    compared and contrasted. The following posts were deleted from the trawled version captured and saved on 6th October 2007 – both have been reinstated on the current version

    post 12 Chris says:

    well actually I would not like my kids to be discussed on here and used to promote someone else.
    It is rather difficult to comment on the diet Rx for that child because you have only given very general info! That is not a cop out either – very sweeping statements. I do think however your comments re diet and diabetes are just generalisations.
    October 4, 2007 @ 5:39 pm

    In addition:

    post 38: Jasmine Challis says:

    ‘Vegetables are essentially carb, are they not’ – not : by and large, if we are looking at accuracy most are mostly water with a carb content of 2-5g per 100 grams. The exceptions are obviously potatoes/sweet potato/beetroot etc where there is up to 15g or so sugars/starches per 100g. Many diabetics find that fruit has an impact on blood sugar levels greater than that of other low GI carbs. Many people struggle to implement advice as it was actually given first time around. It is very easy to criticise and sensationalise. You imply that carbs are bad and do not in your original statements mention GI nor that there is a huge range within the ‘families’ of cereals/breads etc. May be you did explain this to the family, I wasn’t there so I can’t comment. Protein is an expensive alternative to carbohydrate but I guess the family can afford the portions required – tho whether a small child could eat enough is a separate issue. Presumably you will monitor his growth on this diet on a regular basis to ensure he continues to grow adequately.

    Now, I don’t have my own blog/website/showcase but i do recognise that of postings sometimes take time to insert – especially if you’d like to vet them for abusive or vindictive comments. Yet neither comment appears offensive, and Google cache trawling listed comments time and date stamped beyond theirs – very odd. In addition, omission of Chris’s comments from the October version makes the comment from ‘Sue’ (post 12 on cache, post 13 on current version) seem a tad odd – complaining about ‘being off the mark’. It all makes sense now the posts are restated

    I hope Openmind has correctly quoted you above as stating “I have taken the decision not to allow posts that do not seem to further debate or add constructively to it” – I’m sure you will challenge Openmind if they have attributed wrongly.

    How interesting that your comments in this instance were directed toward Catherine Collins, who is a dietitian. Jasmine Challis is a dietitian, and Chris infers from previous posts to be a dietitian. Are you suggesting that the views of the only legally recognised nutrition profession in the UK are incapable of ‘adding constructively’ to your opinions of nutrition and health?

    Would you prefer dietitians who had their comments ‘manipulated’ in a similar way to verify their experiences on this site? Or is this double example sufficient proof of manipulation when taken with plh’s ‘missing in post’ submission (above)?

    fyi I use the moniker ‘Evidencebasedeating’ for a reason.

  28. jdc325 said,

    Dr Briffa is complaining that his “character, professionalism, honesty and integrity” are being defamed. I believe the correct word is ‘criticised’. As I wrote in my post:

    To paste information from a different link to the one I was using to demonstrate my point is fundamentally dishonest and I think it tells us something about the way Briffa argues.

    Incidentally John, I note that on your blog a poster states that certain other blogs and forums prevent dissenting voices from posting comments. As you have responded to the poster’s comments you must be aware of them. Can you explain why you feel able to accuse me of hosting libellous comments on my blog and remind me that I am ultimately responsible for them, yet you feel quite happy to let similar comments sit side-by-side with yours on your own blog?

  29. jdc325 said,

    John “I have never claimed that my work is evidence-based” Briffa seems to be upset that I have misrepresented him in suggesting that he has “the opinion that science has no value. I don’t hold that view at all, and you would know if you spent just a few minutes trawling my site: it regularly cites scientific evidence.” If his work is not evidence-based, then why is he so keen to claim that he regularly cites scientific evidence?
    Here

  30. pv said,

    When caught with one’s trousers down, invoke the law. Seems to be a bit of a trend among the sCAM/NUTribollox floggers. In fact it’s a well known tactic favoured by crooked politicians and businessmen the world over.

  31. draust said,

    If you are all wondering where Dr B has disappeared to, he is buys picking a fight (and coming off rather worse) with Anthony over at Blacktriangle.org.

  32. jdc325 said,

    Thanks for the link Dr Aust. I’ve started a collection here: Briffa – as bad as Holford

  33. evidencebasedeating said,

    Dr B (post #9)said:

    “Please do supply some evidence of this – we have google cache after all, so it shouldn’t be difficult for you to come up with some. Or maybe you’ve printed some examples out. Any evidence of this, any at all, will do and I’ll hold my hands up”

    Still waiting for a reply/ apology.

  34. jdc325 said,

    Thank you EBE for the evidence you posted. Let us hope that Dr Briffa is true to his word and ‘holds his hands up’. As a man of character, professionalism, honesty and integrity he will surely do so.

  35. Dr Aust said,

    Methinks Dr Briffa is too busy taking up the sword of bluster against the dragon of evidence-based scorn. Check out:

    I was going to write about beta-carotene and sunburn but

  36. Evidencebasedeating said,

    More tedious Sermon-from-the-Bundt

    Oh, I forgot. He Dislikes Carbohydrates

  37. bill said,

    Briffa calls you an intellectual collosus-

    Which you are compared to him.

    What a maroon!

  38. jdc325 said,

    Thanks for the kind words Bill, but I’m not sure they are altogether accurate.
    Briffa is highly qualified. Compared to me. I definitely don’t think he is stupid – you need to be quite smart to achieve such a high level of obfuscation.

  39. Evidencebasedeating said,

    Dr B.

    “Dr John Briffa is one of the UK’s foremost experts in the area of nutrition and natural health. He is a prize-winning graduate of University College London Medical School, and also holds a BSc degree in Immunology and Biomedical Sciences. ”

    thus ‘qualified’ to comment on

    medicine
    immunology
    biomedical sciences

    Spot the glaring omission.

  40. bill said,

    jdc
    you certainly are much better at making a coherent argument than Briffa.

    I find it hard to believe he has any special knowledge of immunology after reading his MMR
    blather.

  41. PJ said,

    So what are Briffa’s professional qualifications as a doctor? He tells us all he is so much better able to comment on medical matters because of his clinical practice, but he doesn’t appear to have any qualifications in medicine after his medical degree 18 years ago – no professional memberships (e.g. MRCP) or further training is listed on his website and he is not listed on the GMC specialist or GP registers (although he lists himself as a GP when corresponding with the BMJ in 2005).

    So what special clinical knowledge does he have over and above, say, a ‘nutritionist’?

  42. wilsontown said,

    And don’t forget, we are all nutritionists. Even Ben Goldacre’s dead cat Henrietta.

    http://www.badscience.net/?p=131

  43. draust said,

    I would guess that the “immunology” probably means he did a final yr B.Sc. taught course unit in it, and did some project work in an immunology lab, as part of the Intercalating degree year. For those that don’t know, in Intercalated degree schemes medical students do the final yr of a (basic science) B.Sc. degree – e.g. in Biomedical Sciences – in between two years of the five-yr medical course – usually yrs 2 and 3, as in Dr B’s case.

    Dr B’s sole paper, which he lists on his profile linked by jdc above, is certainly in experimental immunology and could be the product of some project work, and/or an elective stint later in the medical degree. It is from 1989, so not too long after his B.Sc. year (86-87).

    As to Dr B’s experience in conventional (hospital) medicine, I have never seen him say anything about how many years of it he did before heading out to private practice. He certainly did the year as a House Officer, since he has full medical registration with the GMC, but whether he did anything beyond that (i.e. as an SHO) it is impossible to tell from anything I have read by or about him.

    Incidentally, seeing the dates of Dr B’s degree, I reckon I could quite easily have taught him in my days as a (PhD student) practical class demonstrator. Amazing how these things work out.

  44. Evidencebasedeating said,

    Promised apology/ hands-upping
    Day 4
    still waiting

  45. Evidencebasedeating said,

    still waiting

  46. draust said,

    Dr Crippen over at NHS Blog Doctor has now done a post on Dr Briffa here

  47. ben goldacre said,

    hi john briffa,

    scanning this discussion, your accusations of defamation and libel seem to revolve around the question of you deleting comments from your blog, or not.

    i feel i should take this opportunity to point out that you have deleted my comments from your blog, and on a matter in which i was simply pointing out that you were factually wrong. you claimed last year that the METEOR trial had been positively covered in the media (let me be clear that i’m no supporter of the overprescribing of statins). i was clear that you were simply wrong in your assertion about media coverage. all you could come up with to defend your claim that the METEOR trial had been flatteringly covered in the media was the press release. you continued to reinforce your error in the comments. you then announced your intention to delete further comments on the subject.

    http://www.drbriffa.com/blog/2007/03/30/hailed-meteor-trial-results-not-as-stellar-as-we-are-led-to-believe/

    i think there are times when one could argue it is fairly reasonable to delete comments (eg dreary ad hom abuse i suppose) but it strikes me that silencing people when they point out that you are factually incorrect is probably not one of them. looking back at the page briefly today, i see one of your fans has now posted to say how delighted he is that i was “nudged into silence” and unable to answer your brilliant points.

    i’m afraid your behaviour in this regard struck me as pretty ridiculous, and i ceased to consider you worth engaging with.

    i should add i also think it’s fairly disappointing that out of all the fascinating pharmacovigilance issues out there you’ve chosen to court popularity by casting doubt on the safety of MMR, in 2008.

  48. ben goldacre said,

    incidentally i should be clear, since dr briffa is threatening legal action, and clearly has the resources to do so, that all i know is this: i submitted comments, which challenged dr briffa’s view, they did not appear, and dr briffa announced he would be deleting comments which challenged his view, so i can only assume they were deleted. i’ve not had a problem submitting comments elsewhere, or indeed on that site (although i remember there was a long wait for them to be accepted by dr briffa).

  49. Evidencebasedeating said,

    (affect Geordie accent for maximum effect)

    ‘Day eight in the Big Wait House’

  50. draust said,

    I see the embryonic form of a Beckett-esque drama:

    “Waiting for Briffa”

  51. jdc325 said,

    Why are we here, that is the question. And we are blessed in this, that we happen to know the answer. Yes, in this immense confusion one thing alone is clear. We are waiting for Briffa to come.

  52. draust said,

    Waiting.

    Pause

    For Briffa.

    Long pause

  53. wilsontown said,

    We have time to grow old. The air is filled with our cries.

  54. jdc325 said,

    I even pointed Briffa in the direction of the evidence of his deletions (comment on Briffa’s blog), but it seems he has not yet had time to ‘review the evidence’.

    I maintain that I have NEVER deleted posts. Now, please permit me some time to check the evidence, and get back to you. It may take a day or two, because I am seeing patients this afternoon and lecturing tomorrow. But I will look into it. Would that be OK?

    Heh – Briffa’s estimate of ‘a day or two’ turned out to be as accurate as Briffa’s claims on MMR.

  55. Evidencebasedeating said,

    I’ll be waiting all day
    I’ve be waiting all year
    For you it’s true
    He’s been beaten
    Might have brought it on himself
    So he stopped reading
    Every book on mental health
    But alls not lost in this tangle like no other

    Long days are almost here
    Faded signs for you
    I’ll be waiting all day
    I’ve be waiting all year
    For you it’s true

    Take this dose and go
    Whiskey warm September
    The faded sign will show
    That he still remembers

    Long days are almost here
    Faded signs for you
    I’ll be waiting all day
    I’ve be waiting all year
    For you it’s true

    Waiting all day
    Waiting all year

    I’ll be waiting all day
    I’ll be waiting all year

    courtesy of Silverchair (http://en.wikipedia.org/wiki/Silverchair)

    drums—fingers—on—table—waiting—just waiting — for —John—Briffa’s—apology—

  56. openmind said,

  57. draust said,

    Hmmm. Interesting response from Dr B.

    For those that can’t be bothered clicking:

    “The claim is I’ve deleted comments. Yet, the ‘evidence’ suggests that comments that were not there at one point are there now.

    In other words, this is not evidence of comment deletion at all. “

    So it appears the files must have been in limbo.

    But how did they get there?

    And does it not count as deleting if you don’t fully cleanse and scrub afterwards?

    For some reason Dr B’s love of the semantic shimmy reminds me of Bill Clinton claiming he had never had sex with Monica Lewinsky. Or Bubba’s famous discourse about “it depends what the meaning of “is” is”.

  58. jdc325 said,

    I think the point is that Briffa censors comments in a shifty, dishonest and essentially twattish manner. He seems to think the point is what ‘deletion’ means. He’s just not worth engaging with – he has no intention of ever debating anything sensibly, he just wants his readers to think he’s clever. His blog isn’t simply a blog – it’s also the John Briffa Debating Society and Briffa has won the ‘Debater of the Year’ award every year since its inception.

  59. Bill said,

    Well Dr. Briffa has now been joined by the drearily ubiquitous John Stone whose monomania drives anyone not similarly obsessed away, which offers him the opportunity to claim he has won.

  60. openmind said,

    Has anybody pointed out to Briffa that there is a wealth of anecdotal evidence suggesting that he deletes posts and that the claim cannot just be dismissed out of hand? To suggest that he has been vindicated with regard to post deletion is plain wrong and the evidence to the contrary is ‘shoddy’.

  61. jdc325 said,

    Quality stuff there openmind. Thanks for the giggle.

    PS – thank you everyone for the intelligent, witty, supportive, and insightful comments.

  62. Dr Aust said,

    “[John Briffa is] just not worth engaging with – he has no intention of ever debating anything sensibly, he just wants his readers to think he’s clever.”

    I think you just summed him up perfectly in one sentence, jdc, Though his colossal ego-driven need to be the cleverest, and his equally colossal lack of insight into it, make watching him intermittently amusing (in a depressing kind of way).

  63. Evidencebasedeating said,

    day 12.
    still waiting :(

  64. Evidencebasedeating said,

    day 15

    kicking heels in dust, aimlessly……………………………………

  65. jdc325 said,

    Oh dear EBE, it appears I’ve not been a very good host. I should have at least left you with some music.

    EDIT: In fact, if I think about it: The Wailers could serve us well here.

  66. Evidencebasedeating said,

    “I’m still waiting, I’m still waiting
    I’m still waiting, I’m still waiting for you
    Why oh why, why oh why? ”
    doobie doobie dwahhhh

    d18 btw
    :)

  67. Evidencebasedeating said,

    day – 24 – and – still – waiting – for – Briffa’s – apology

    btw, is that a misplaced apostrophe?

    waiting

    and waiting

    ……..

  68. Dyson said,

    So tired, tired of waiting,
    Tired of waiting, for you-oooo-ooo!

  69. pv said,

    It’s been fun reading this thread and I’m left with one question for Dr Briffa.
    Given the following:

    “Dr John Briffa is one of the UK’s foremost experts in the area of nutrition and natural health. He is a prize-winning graduate of University College London Medical School, and also holds a BSc degree in Immunology and Biomedical Sciences. ”

    how do such qualifications in any way demonstrate that Dr Briffa isn’t a money grubbing, attention seeking charlatan? After all many of those who work in the pharmaceutical industry are far better qualified than the august Saint Briffa, yet Briffa is quite happy to disparage them as he sees fit. I’m genuinely curious to see why he thinks the standards he applies to others, without much reasonable justification, shouldn’t be applied to him, with justification in abundance.

  70. Dyson said,

    Seems like Dr Briffa has been hoist on his own petard. He posted a blog where he criticises the practice of “Key opinion leaders” being paid by drug companies to give talks which might cast their products in a favourable light.

    Now it seems he is guilty of doing exactly the same thing.
    http://www.drbriffa.com/blog/2008/06/23/bmj-article-explores-the-cosy-relationship-that-drug-companies-often-have-with-doctors-considered-%e2%80%98key-opinion-leaders%e2%80%99/

  71. openmind said,

  72. jdc325 said,

    Unfortunately I am unable to view the furl page but having read through the comments on Briffa’s blog post it seems similar to his previous threads on MMR. Lots of blustering and refusing to answer questions. When asked for his interpretation of a quote on MMR, he responds by asking the questioner to define “the cat sat on the mat”. He’s more interested in playing silly games and point-scoring than discussing the issues at hand.

    [Comment #86 on the linked thread]

  73. AltMed Support for Wakefield Continues « jdc325’s Weblog said,

    […] in some MMR scaremongering of his own (Briffa’s original post), which I covered here, here, and here [note: the first of my blog posts includes links to many other blogs covering Briffa’s […]

  74. Legal Chill and Other Threats « Stuff And Nonsense said,

    […] have to say. Perhaps that is because it is easier to threaten someone when you know their identity. Here, Briffa is calling a comment someone posted on my blog ‘defamatory’ and pointing out […]

  75. HTML niceties | Holford Watch: Patrick Holford, nutritionism and bad science said,

    […] See, e.g., Former Visiting Professor Patrick Holford (see, e.g., Professor David Colquhoun or Holford Myths) or Dr Jon Briffa et al.. […]

  76. Glenn said,

    I only became aware of Dr Briffa A little while ago and was impressed with his arguments and advice on diet, particularly as they accord with my personal experiences in successfully losing weight. I am disappointed to read the above and am now less impressed. If you have a good case, there’s no need to manipulate the argument – you become your own worst enemy.

  77. Jono said,

    I’ve never had any truck with Briffa since he wrote in the Observer that drinking tap water can cause you to develop cancer without quoting any evidence to support the claim. I contacted that Observer and the journalist there replied to the effect that they wouldn’t believe anything he said about anything.

  78. jdc325 said,

    Haha, did he really? That’s brilliant Jono.

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