ANALYSIS OF A MEDICAL RESEARCH CONDUCTED BY WAKEFIELD - Essay Example

Analysis of a Medical Research Conducted by Wakefield, Murch, Anthony et al ANALYSIS OF A MEDICAL RESEARCH CONDUCTED BY WAKEFIELD ET AL A group of scientists from various medical departments namely; medicine and histopathology, pediatric gastroenterology, child and adolescents psychiatry, neurology and radiology; performed a medical research that was later retracted. A J Wakefield was the leader in the medical research known as “ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in children”.

The research involved consecutively examining a series of children who experienced both chronic enterocolitis and regressive development disorder. The research incorporated 12 children, 11 of them being boys while only one was a girl. Additionally, their ages ranged from 3 to 10 years while their mean age was 6 years (Wakefield et al, 1998: p1). The methodology involved referring the 12 children who had experienced loss of acquired skills, diarrhea, and abdominal pain to a paediatric gastroenterology unit.

The children were put through various assessments namely; gastroenterological, developmental, and neurological. Moreover, when the children were under sedation, procedures such as; magnetic-resonance imaging (MRI), lumbar puncture, and electroencephalography, ileocolonoscopy and biopsy sampling were done on them. Continuing on, A J Wakefield et al established that, there was an association between gastrointenstinal disease and developmental regression (Wakefield et al, 1998: p1). The research in question was centered on studying children who initially experience normal growth, but later lost their acquired skills such as communication.

Consequently, they showed symptoms of gastrointestinal disease such as; diarrhea, abdominal pain, bloating and food intolerance. The study population that was selected by Wakefield et al for this medical experiment, entailed referrals from the department of pediatric gastroenterology. Moreover, the study population had a history of pervasive developmental disorder, intestinal symptoms and loss acquired skills. The research involved conducting clinical and laboratory investigations, histology; the researchers also acquired ethical approval and consent before commencing the procedures (Wakefield et al, 1998: p2).

Clinical investigations incorporated taking histories, neurological and psychiatric assessments, reviewing patients’ developmental records. The clinical investigations also comprised performing ileocolonoscopy while sedating with pethidine and midazolam, but that was after bowel preparation. Biopsy samples of paired frozen and formalin-fixed mucosals were extracted from the terminal ileum, colons, and the rectum. Video and still images were used to record the procedures, which were later compared to images taken during other paediatric colonoscopies conducted previously; a total of seven.

The indication that confirmed the procedure was on the right tract, emerged when the physician examined the videos and images, and reported that the terminal ileum had normal appearances. While still under sedation, the clinical investigations were concluded through performing; electroencephalography (EEG) on sensory evoked potentials and brain stem auditory, cerebral magnetic-resonance imaging (MRI), and lumbar puncture (Wakefield et al, 1998: p3). The laboratory investigations in the medical research entailed measuring the thyroid function, cerebrospinal-fluid lactate, and serum long-chain fatty acids.

The above procedures were aimed at excluding various causes of childhood neurodegenerative disease. Urine samples of 8 of children (randomly selected) were taken and urinary methylmalonic acid measured and later compared to 14 age-matched and sex-matched normal controls. The analysis of methylmalonic-acid zones from cases and controls, involved digitally scanning chromatograms on a computer (Wakefield et al, 1998: p3). Using two-sample t test, the researchers were able to compare the urinary methylmalonic-acid concentrations, which were both in the patients and controls.

Likewise, through spectrophotometric assay, the researchers were able to estimate urinary creatinine. When performing the histology, a pathologist (SED) was tasked with assessing and reporting the formalin-fixed biopsy samples of ileum and colon. For comparison, the researchers selected five ileocolonic biopsy series that were obtained from age-matched and site-matched controls; the reports showed that histologically the mucosa were normal. After clinical examination, the researchers discovered that the children did not have neurological abnormalities (Wakefield et al, 1998: p4).

Essentially, EEGs, MRI scans, cerebrospinal-fluid profiles were found to be normal. The children’s developmental records revealed a normal growth during early growth. The research established that the only girl in the sample developed slowly compared to her elder sister, and she had coarctation of the aorta. Subsequently, Wakefield et al proved that, in 8 of the children, the commencement of behavioral problems were associated with mumps, measles, and rubella vaccination. 5 of the children early on, had experienced an adverse reaction such as; convulsions, rash, delirium, and fever, after immunization.

From the research, the experimenters ascertained that, on a range of 1 to 14, the average number of days it took to experience behavioral symptoms after exposure was 6.3 days. The children had a negative antiendomyseal-antibody; also, after microscopy and serology enteric pathogens were negatively identified. The 8 children compared against the age-matched controls had a raised urinary methylmalonic-acid excretion. From the endoscopic findings, it was reported that, in 4 of the children, macroscopic colonic appearances were normal while the other 8 had abnormalities such as; loss of vascular pattern, granularity, lymphoid nodular hyperplasia, patchy erythema, and aphthoid ulceration (2 cases).

From the histological findings, 7 children had a lymphoid follicular hyperplasia in the terminal ileum. Wakefield and his team did not find a definite relationship between the endoscopic appearances and the histological results (Wakefield et al, 1998: p5). In conclusion, the researchers ascertained that children with developmental disorders had colitis and ileal-lymphoid-nodular hyperplasia. The medical research did not associate measles, mumps, and rubella vaccine with the syndrome. The elevated levels of urinary methylmalconic-acid indicated lack of vitamin B12 deficiency, which is crucial in the growth of the central nervous system.

This explained the children’s developmental regression (Wakefield et al, 1998: p5). The study identified that the occurrence of chronic enterocolitis was after immunizations against measles, mumps, and rubella. Reference Wakefield, A. Murch, S. Anthony, A. Linnell, J. Casson, M. Mallik, M. Berelowitz, M. Dhillon, A. Thomson, M. Harvey, P. Valentine, A. Davies, S. Walker-Smith, J. 1998. RETRACTED: Ileal- lymphoid-nodular hyperplasia, non-specific and colitis, and pervasive developmental disorder in children.

The Lancet, 351(9103), p. 6.