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Mindmap von Niru Arunthavasothy, aktualisiert more than 1 year ago
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Erstellt von Niru Arunthavasothy
vor etwa 8 Jahre
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MMR & Autism - Madgen et al, NEJM 2002
- Research Question: MMR cause autism?
- Funded: Danish Research Foundation, CDC, National Alliance for Autism Research
- Year Study Began: Retrospective, 1991-1999
- Published: 2002 NEJM
- Study Location: Denmark
- Who was studied? All children born in Denmark Jan 1991-Dec 1998
- Who was excluded? Conditions associated with Autism: Tuberous sclerosis, Angelman syndrome, Fragile X, Congenital Rubella +emigration+death
- How many patients? 537,303 (82% received MMR, and 18% didn't)
- Outcome measured: which children received MMR, at what age vaccine administered
- Denmark Vaccination Schedule MMR: 15 months, 12 years (booster)
- Australia: 12 months MMR, 18 months MMRV (varicella)
- Identification of Autism: Suspected --> child psychiatrist --> registry, Method: check registry, date when diagnosis made
- Follow-up: monitored for autism to age 1 until end of study period (Dec 31, 1999, mean age at end of study 5 years)
- End point: rates of autism and rates of autism-spectrum disorders
- Results
- 82% of chidlren in study received MMR vaccine
- mean age of vaccination 17 months
- mean age of diagnosis was 4 years and 3 months
- prevalence of Autism among 8 year old's in study was 7.7/10,000 (0.08%)
- no clustering of autism diagnosis at any time interval after vaccination
- No association between age at which vaccine given and the subsequent development of autism
- 82% of chidlren in study received MMR vaccine
- Limitations
- Families with hx of Autism would not have vaccinated their kids due to published link between MMR and Autism
- Dataset did not contain the date when the 1st symptoms were noted, it is possible clustering of first symptoms post vaccination but NOT diagnoses (due to delay)
- Families with hx of Autism would not have vaccinated their kids due to published link between MMR and Autism
- Controversy
- Autism signs and symptoms: 2nd and 3rd year of life, shortly after giving MMR vaccine
- Wakefield et al, Lancet 1998, retracted 2010, stated series of children developed GI symptoms, and signs of Autism after MMR, FALSIFIED DATA
- AAP undertook a systematic review of all research vaccine safety and review failed to link MMR to Autism (MAGLIONE et al, Paediatrics, 2014)
- Autism signs and symptoms: 2nd and 3rd year of life, shortly after giving MMR vaccine
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