JAY LEVY: Got Some 'Splainin' to Do

I sent this email to Dr. Jay Levy, co-author of the recent XMRV-negative paper published in Science last week:

I’m a science reporter and blogger on CFS Central.  I read this quote by you on Bloomberg today [Tuesday, May 31], and have a few questions about it:

“When that paper came out I was totally surprised and suspicious,” Levy said today in a telephone interview.  “Who knew there would be pressure on the government to do these expensive studies? I’ve never been around anything quite so dramatic and misleading and misunderstood for so long. There are financial ramifications, and medical and health ramifications.”

• Why were you “surprised and suspicious” when the 2009 Mikovits study was published?
  

• What do mean by “dramatic and misleading and misunderstood”?  Are you talking about CFS or XMRV or something else?
  

• What financial, medical and health ramifications are you referencing?
  

• On another note, the groups that funded your study are not listed by name. Sources have informed me that the HHV6 Foundation helped fund the study. Is that correct?
  

I would appreciate a response by end of business Friday.

Levy didn't reply.

 

SAVE ME FROM STEVEN SALZBERG (Part 2)

It's not going to stop
'Til you wise up 

Yesterday, I responded to Dr. Steven Salzberg's diatribe in Forbes against XMRV and Dr. Judy Mikovits.  Today Salzberg responded to me, and then I to him.

Salzberg:

"Ah, the Galileo gambit! Thanks Mindy, for illustrating a classic logical fallacy. You compare Mikovits to Galileo – the implication being that if the “establishment” disagrees with a scientist, then that scientist much be a brilliant revolutionary thinker. At the same time you would imply that those of us who disagree with Mikovits are just too dumb or too stubborn to understand her new ideas. Sorry, not falling for it. (See Orac’s discussion, http://scienceblogs.com/insolence/2006/08/the_galileo_gambit_1.php, or the RationalWiki, for more on this gambit.)

"And about replications: yes, there are multiple studies that attempted to replicate Mikovits’ result, and they all failed. Neither Mikovits nor you gets to dictate what a “replication” is. The whole point is that these are independent studies, which means the scientists conducting them get to decide how best to test the original claims. The peer-review process then evaluates whether or not the follow-up studies are worth publishing."

CFS Central reply:

No, Steven, that’s not what I was implying. I’m not saying that Judy Mikovits is right and the other researchers are wrong. What I am saying is that no one will know the truth until her study is replicated precisely.

What I’m also saying is that the history of science–and everything else for that matter–is filled with outside-the-box thinkers who were right but who were excoriated by a myopic status quo. Could this be the case with the Mikovits finding? Only time will tell.

That is one reason why, in my view, people shouldn’t be so quick to judge. The late physicist and science historian Thomas Kuhn, who authored the groundbreaking book The Structure of Scientific Revolutions in 1962, believed the lag between the emergence and acceptance of new ideas is natural and inevitable. Change, he postulated, can come about only after long periods of stasis because “frameworks must be lived with and explored before they can be broken.”

Compounding the inertia, and contrary to popular belief, Kuhn held that most scientists are not objective and independent thinkers. Rather they are rigid conservatives who do their best to implement exactly what they’ve been taught.

As far as these XMRV “replications,” clearly you haven’t read these studies carefully. Not one has been a bona fide replication. I’ve interviewed many of the authors of these studies for my blog, CFS Central, and they agreed that their studies weren’t replications.

For instance, Dr. Kate Bishop, the principal investigator of one of the British studies, said that a key reason her cohort didn’t adhere to the Mikovits protocol is that she believes it’s tougher to get a paper published when the experiment is conducted in exactly the same way as the original study.

Dr. Myra McClure, the principal investigator of the first British study, said that her study “was never designed to replicate [the Mikovits] study or to say, ‘Look how clever we are, and they’re wrong,’ she says. “It was simply an investigation to see if we in this country could detect this virus in our CFS patients that were homegrown here.”

To your point that “neither Mikovits nor you gets to dictate what a ‘replication’ is,” consider cracking open a 9th grade science book. In Biology, by Stephen Nowicki, published by McDougal Littell in 2008, the author explains what a replication is:

“Scientists repeating another person’s experiment must be able to follow the procedures exactly and obtain the same results in order for the experiment to be valid. Valid experiments must have

• a testable hypothesis
• a control group and an experimental group
• defined independent and dependent variables
• all other conditions held constant
• repeated trials”

Got it? All conditions must be held constant for the experiment to be valid. That’s the definition of a replication, not what you decide, or what I decide or what any researcher on the planet decides.

And a replication is certainly not, as you claim, a free-for-all in which “scientists conducting them get to decide how best to test the original claims.” When you change things up, you introduce variables that may account for a different result.

Once again, I urge you to sit down and read the XMRV studies carefully before making judgments.

Scene from the movie Magnolia. Aimee Mann wrote the accompanying song, "Wise Up."

STEVEN SALZBERG'S PSEUDOSCIENCE

You look like a perfect fit
For a girl in need of a tourniquet

Today Forbes' Dr. Steven Salzberg joined the XMRV naysayers, penning the piece "Chronic fatigue syndrome: virus hypothesis collapses further."  Salzberg took a step further, labeling Dr. Judy Mikovits a "pseudoscientist." He's the same Steven Salzberg who doesn't believe there's an autism epidemic but does believe that acupuncture is nonsense. Surely a front-runner for columnist Keith Olbermann's Worst Person in the World award, Salzberg is not exactly an outside-the-box thinker. 

Below is my letter to the editor:

As a science reporter and blogger, I was disappointed to read Steven Salzberg’s article. Dr. Salzberg, if you’d sit down and read all the “replications” of the 2009 Science study in their entirety, you’d realize they’re not replications. 

The essence of the scientific method is reproducing precisely the methods and patient cohort of the original study, something most of us learn in 9th grade science. 

None of these so-called replications meet that standard. The Levy study didn’t replicate the methods of the 2009 Science study.  The Centers for Disease Control's study and the British XMRV studies examined patients with idiopathic fatigue and depression, not CFS, which is a neuroimmune disease that causes acquired immune abnormalities, including natural killer cell dysfunction--the CFS counterpart to HIV’s T-cell depletion.

CFS also causes seizures, abnormal brain scans, rare cancers and autonomic dysfunction, leading to abrupt drops in blood pressure upon sitting or standing.

Both the CDC’s study and the British studies weeded out anyone with neuroimmune or autonomic dysfunction. The work of Dr. Leonard Jason at DePaul University has established that the CDC and the British scientists are studying the wrong cohorts. 

Moving on, the Mikovits study found antibody reactions to XMRV in patients. You don't get an antibody reaction to a contaminant.  Morever, only 4 percent of controls in the Mikovits study tested positive for XMRV, while 67 percent of patients tested positive. If XMRV were contamination, one would expect an equal distribution. 

Science seems hell bent on consensus, but as Harvard-educated physician and medical thriller writer Dr. Michael Crichton once pronounced: “Let’s be clear: The work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right....”

Sadly, the history of science is replete with investigators who were discredited by the status quo but who were eventually proved right:  Galileo, Semmelweis, Pasteur, Ohm, Nott, Zweig and Rous, to name a few.

In 1982, Drs. Barry Marshall and Robin Warren discovered that H. pylori was the cause of stomach ulcers. In the early 20th century, there had been interest in an ulcer link to the spiral-shaped bacterium until a large 1954 U.S. study failed to find it in stomach biopsies, delaying the discovery for 28 years.

Whether Dr. Mikovits is right is anyone’s guess. But asking her to withdraw her paper before the truth is known is the antithesis of science.  Doing “replications” that aren’t bona fide replications is the antithesis of science. 

As far as patients taking anti-retrovirals, all drugs have risks, but several CFS patients I’ve interviewed have been helped by these medications.  Their natural killer cell numbers, for instance, have normalized and a few have largely recovered. Patients responding to anti-retrovirals would put a serious kink in the XMRV contamination theory, which is one reason some believe that these researchers are determined to get patients off them.

Given that physicians are now prescribing anti-retrovirals to healthy HIV-negative people in high-risk groups, I find it particularly unsettling that the researchers who’ve conducted these non-replication XMRV studies are admonishing desperate and dying CFS patients that they have to be wait for treatment. In fact, CFS patients have been waiting for decades; many have died waiting. There is not one approved drug for CFS--and none in the offing.  The government spends only $6 million a year on CFS, a million more than it spends on hay fever. 

Approximately one-third of the parents with CFS whom I’ve interviewed have children with autism. This is not chimera; there is a connection here.

Twenty years ago, the first evidence of a retrovirus in CFS patients surfaced at the Wistar Institute at the University of Pennsylvania.  Back then, the CDC refused to replicate the methods of Wistar’s Dr. Elaine DeFreitas. When the CDC couldn’t replicate her findings, the research died. Two decades later, it’s deja vu all over again.

I believe, Dr. Salzberg, that you’d do your readers a greater service if you would read the studies in their entirety and learn about the history of this disease, instead of spinning misinformation.

Letter in Response to WSJ Article

Last night the Wall Street Journal published Amy Marcus's article "Chronic-Fatigue Paper Called Into Question."  Here is my response:

As a science reporter and blogger, what I find most perplexing about the Science editors asking Dr. Mikovits to withdraw her study is that the jury is clearly still out. While some laboratories haven’t found XMRV in CFS patients, others have. The ones that haven’t found XMRV failed to replicate the methods and patient cohort of the original Science study, making their findings questionable. The laboratories that have found the retrovirus include a study by National Institutes of Health Lasker Award winner Dr. Harvey Alter and the FDA’s Dr. Shyh-Ching Lo. Their study found variants of XMRV in 86 percent of patients and 7 percent of apparently healthy controls. All the controls were blood donors, signaling a contamination of the blood supply.

In addition, the original Science study was coauthored by the Cleveland Clinic and the National Cancer Institute, both of which also found the retrovirus in CFS patients. Moreover, other laboratories have found the retrovirus in CFS patients but have not yet published their findings. And, finally, respected laboratories have found the retrovirus in prostate cancer patients as well, making the contamination theory less than likely.

Given that others have replicated Mikovits’ findings, given the high stakes in a population that has no treatment after 30 years of government neglect, given that many CFS patients have died from the disease and many others experience a living death, I find it problematic that Science has asked Dr. Mikovits to withdraw the paper.

Some see this move as the first step to shutting down current NIH-sponsored XMRV CFS studies, as the government did 20 years ago, when the first evidence of a retrovirus in CFS patients surfaced at the Wistar Institute at the University of Pennsylvania. Back then, the Centers for Disease Control refused to replicate the methods of Wistar’s Dr. Elaine DeFreitas. When the CDC couldn’t replicate her findings, the research died. Twenty years later, it’s deja vu all over again.

Science seems to be hell bent on consensus, but as Harvard-educated physician and medical thriller writer Dr. Michael Crichton once pronounced: “Let’s be clear: The work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right....”

Whether Dr. Mikovits is right is anyone’s guess. But asking her to withdraw her paper before the truth is known is the antithesis of science.