Vaccines, Publications and Retractions

While not definitive, PubMed is a highly reliable index of the biomedical literature.  If you are interested in finding out about the current status of the vaccine literature, here are some helpful searches:

Clinical trials of vaccines (all) (11,070 publications as of 4/22/2015).

Clinical trials of vaccines (all) registered on ClinicalTrials.Gov (5,100 as of 4/22/2015)

Clinical trials specifically related to the MMR vaccine (116 publications as of 4/22/2015).

Articles about vaccines that have been retracted (19 publications as of 4/22/2015).

Clinical trial publications (all, not just vaccines) that have been retracted (3 publications as of 4/22/2015, note that the Wakefield paper on autism and the MMR vaccine is not listed here because it was a retrospective observational study, not a clinical trial).

All retracted publications indexed in PubMed (3,820 publications as of 4/22/2015).


In Defense of Mark Cuban

Mark Cuban recently suggested that people should be doing quarterly blood tests, a proposal for which he has been roundly criticized and even ridiculed.  His specific proposal may be off base, but there is not universal consensus that increasing the frequency of medical testing is a bad thing.  E.g. From Eric Topol
Much of the argument against increased testing frequency is prefaced by the assumption that a single abnormal result will trigger an expensive and morbid workup, but the reality is that if you are testing more frequently, you learn about fluctuations and variance.  Among physicians, the near universal response to a single abnormal test result is to repeat it.  If, as is usually the case, it comes back normal, you dismiss the abnormal result.  If it still comes back abnormal, you are much more confident that something is going on.
There are reasons to think that more frequent testing might be a good thing.  When on a diet many people check their weights daily. Do we really think our weight will change significantly in a day?  No, it is a quick inexpensive test.  Do people panic if their weight goes up or down a couple of pounds on any given day, no.  But the trend does provide useful feedback and motivation.  Back in the day of mechanical pedometers, activity tracking was strictly for geeks and not viewed as terribly useful. Now that smartphone and FitBits have made tracking convenient and widely accessible, we are realizing that activity tracking can be useful, perhaps especially so in managing chronic disease.
Transistors got so cheap because we make so many of them (8 trillion transistors a second!).  Medical tests remain expensive in part because we have locked in a low volume high cost mode of operation.  If we did daily cholesterol checks, the market would be there to support much lower cost higher volume solutions.  And yes, many people would learn that a donut in the morning really does play havoc with their blood lipids.
Medical testing is driven by  technology that is not all that different from what we use in computers. Opto-electronics, robotics, microchemistry, etc.  In the 1970s, a complete blood count (CBC) cost about $20 and a chem 20 panel was maybe $100.  If these tests had followed Moore’s law, falling in price by a factor of 2 every couple of years, they would now be so cheap that we would not even bother billing for them.  DNA sequencing has in fact blown Moore’s law away because it has gotten so cheap so fast.
Not saying Mark Cuban has proposed the magic bullet, but we need to explore the options that technology makes possible.