Curb enthusiasm for scientific breakthroughs

On 26 February 1998, the Royal Free Hospital School of Medicine held a press conference in London about an explosive paper in The Lancet, one of the world’s most prestigious medical journals. During the press conference, Andrew Wakefield told journalists that parents should not give their children the three-in-one measles, mumps and rubella (MMR) vaccine because his research had found a link with autism.

Next day, the story was front-page news and the MMR scandal was born. Despite Wakefield’s paper being retracted, and overwhelming evidence proving the vaccine is safe, the controversy led to falling vaccination rates and fatal measles outbreaks that last to this day.

The key ingredients behind the MMR controversy – sweeping health claims based on a journal paper, and a news media willing to amplify those claims without proper interrogation – still exist today. Last week’s story about a ‘breakthrough’ in birth defects and miscarriages has worrying similarities, though hopefully without such damaging consequences.

On Wednesday, the Victor Chang Cardiac Research Institute held a press conference to announce the results of a paper published in the prestigious New England Journal of Medicine (NEJM). Ahead of the conference, journalists received a press release saying “vitamin B3 can cure molecular deficiencies which cause miscarriages and birth defects” and anointing the study “one of the greatest discoveries in pregnancy research”.

The news media jumped on the story. Before the press conference had even finished, there were headlines proclaiming the study a “breakthrough” that will “save millions” and that “Vegemite could cure birth defects”, repeating the breathless language of the press release to millions of readers.

In one crucial way, the vitamin B3 and birth defects story is completely different from the MMR scandal. Wakefield’s fraudulent research was unethical and he was stripped of his medical license. There is absolutely no suggestion that the authors of this recent study have done anything unethical. But like that press conference back in 1998, the claims presented to the media last week were way beyond anything found in the journal paper.

The NEJM paper describes the discovery of rare genetic variants in families with multiple types of birth defects. The researchers discovered that these genetic variants prevent the normal production of a molecule called NAD which the body usually makes from vitamin B3. When pregnant mice with the birth defect-causing genes were given vitamin B3 (which, in case you were wondering, is found in Vegemite) they gave birth to healthy pups.

The discovery of a new cause of birth defects is undoubtedly a big deal. But huge questions remain, not least how many cases of birth defects in humans are down to a lack of NAD. As Professor Claire Roberts, an expert in pregnancy complications at the University of Adelaide, told me, “we don’t know if NAD deficiency is common, nor do we know if it is associated with miscarriage in women; at this stage it is a hypothesis”.

And while vitamin B3 supplementation prevented birth defects in mice, it is impossible to know whether it would do the same in humans, something multiple scientists pointed out to the Australian Science Media Centre. But in the rush to publish barely a single voice of caution could be heard.

Scientists are generally a circumspect crowd, so the temptation for journalists to trumpet a so-called ‘breakthrough’ is hard to resist. But strong claims need to be backed up by strong evidence. By not fact-checking dramatic statements, journalists are forgetting that scientists are humans too, and can be swept up in their own work.

Over the following days more scientists have spoken up, urging caution about overplaying the results of the study. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists released a statement saying “it is premature to claim a medical breakthrough” and that “without further controlled studies, this claim has the potential to do more harm than good.”

These are strong words. It may well turn out that the NEJM paper will become seen as a breakthrough in pregnancy research. But without further study it is too soon to tell, and too soon to give families the hope of a simple cure.

Last week’s headlines show that it is all too easy for a hyped-up press release to catapult dramatic scientific claims to the top of the news agenda without being properly interrogated. On this occasion there will probably be few consequences. But journalists need to be prepared for the next Andrew Wakefield who comes along if they don’t want to end up becoming accessories to something as damaging as the MMR scandal.