INOS 2008: Ethical
Science or Something Else?
L.F.
DellÕOsso, Ph.D.
OMLAB Editorial #071107
Written: 7/7/07; Placed
on Web Page: 7/11/07; Last
Modified: 8/6/08
Downloaded from: OMLAB.ORG -- Click here for the PDF (Zipped archive).
Send questions, comments, and suggestions to: lfd@case.edu
For
almost two decades, I have supported and attended many INOS meetings all over
the world. In each of them, invited speakers were recognized authorities on the
topics of their presentations. However, in the program for INOS 2008 there has
been a radical departure that raises many questions and concerns both about the
qualifications and objectivity of one invited speaker and a possible political
agenda behind the invitation. These questions and concerns were communicated to
the person responsible for the invitation and were ignored; I was summarily
informed that the invitation was a fait accompli. In order to evaluate this presentation, the members
of INOS and others in the audience deserve disclosure about the qualifications
and possible lack of objectivity of the invited ÒexpertÓ they are listening to.
In the interests of such disclosure, I will address both in this editorial.
Qualifications
There are many respected
scientists whose research in the field of Infantile Nystagmus Syndrome (INS,
aka CN) and its treatments is known to most members of INOS; some have decades
of experience and numerous publications of their results. Other, younger
scientists have also made significant contributions to this field. The person
chosen to speak on ÒDoes tenotomy work for CN and for acquired nystagmus?Ó does
not appear on this list by any objective criteria. According to his CV, he only
has two minor publications involving the actual recording and analyzing of INS
patients; they were both Òcase-reportÓ types of papers on a few atypical
patients with vestibular symptoms and oscillopsia that were studied in the lab
of David Zee. Their publication dates were 1985 and 1989; there have been no
publications of any INS studies conducted by him in the past 18 years. Why
then, was Lance Optican invited to give an address at the INOS meeting on a
topic in which he has no expertise and no apparent direct experience in
recording INS patientsÕ eye movements? It appears that he was chosen solely on
the basis of two papers published in Vision Research in 2003 (1,2). These papers are the crux of the matter. There are
two issues involved: 1) their scientific merit and 2) their history, detailing
the methods used by the responsible authors to acquire and use the data of
others during an ongoing masked-data NEI clinical trial (i.e., the possibility
of deception and bias). The first falls under ÒQualificationsÓ and the latter
under ÒObjectivityÓ
Scientific Merit
The major conclusions in the
respective abstracts of the above two papers were: 1) Òtenotomy surgery has no
effect, or only a quite small effect, on the waveform structure of CNÓ and 2)
Òtenotomy has no effect, or only a quite small effect, on the underlying
mechanism of the CN beats.Ó To many who read the abstracts, these carefully
worded (Òonly a quite small effectÓ) but unsupported conclusions cast doubt on the
positive findings of the masked-data NEI clinical trial of the effectiveness of
the tenotomy procedure. Most readers did not have the background to understand
the complex mathematics underlying both methods. First, neither of the two
methods (wavelets or dynamical systems analysis) was demonstrated to be sensitive enough to detect the NAFX-measurable foveation
improvements produced by tenotomy; not in those papers nor in any to be found
in the literature, before or since. Second, analysis of the papers revealed
serious methodological errors in the application of the analysis methods and in
the data handling; the responsible authors had limited experience in both.
Third, additional errors remained undetected until after publication of my
letter to the editor of Vision Research outlining the problems detected from
the papers alone and concluding that their poor methodology effectively
precluded and made moot the conclusions of the papers (3). OpticanÕs response letter (4) failed to persuasively address the methodological
errors but rather contained personal attacks not only related to the NEI
clinical trial but also, all of the prior work by my colleagues and me,
including the canines with achiasma and INS. None of these were the subject of
my letter. Specific rebuttal to the issues brought up in the response letter
may be found elsewhere (5).
With no foundation, he also questioned the objectivity of the NAFX and its
application.
The NAFX has been used in the
Daroff-DellÕOsso Ocular Motility Laboratory for over a decade and its
sensitivity to waveform changes directly affecting visual acuity had been repeatedly
demonstrated and published for all waveforms in patients with and without
afferent visual deficits. It is applied to the fixating eye during intervals
free of recording artifact (e.g., blinks, switch of fixation to the other eye,
loss of attention/fixation, switch in fixation elsewhere, etc.). This is common
practice (indeed, essential) in eye-movement research and is easily done by any
one after some training and experience. The NAFX does require that the data be
accurately calibrated so eye
position is known. The efficacy of the NAFX has also been demonstrated by other
researchers applying it and obtaining results equivalent to ours; they used the
NAFX to predict visual acuities because it exceeded all other measures in correlating with visual acuity (6). Because of its accuracy in predicting visual acuity,
the NAFX has also been used to estimate post-therapy improvements in INS and
acquired nystagmus patients independently of any afferent deficits (7-9). To specifically ensure that the method was both repeatable and objective, not only was the NAFX analysis in the NEI clinical trial conducted on masked data but also on redundant masked data files that were sent to me for analysis. Optican failed to
report this critical information in either his papers or response.
Significantly, there was no such protection in OpticanÕs ÒplayingÓ (see below)
with our data; he also failed to report that he drew his conclusions from
unmasked data files whose only purpose was to uncover asymmetric aperiodic
alternating nystagmus.
OpticanÕs response letter
seemed to reveal ignorance of basic concepts involved in the calibration and
analysis of INS data; it is necessary to accurately calibrate data if one is to
analyze it properly. The additional errors revealed in the response
further invalidated both studies and, in response to a reviewerÕs specific request, were addressed in a subsequent publication
on the beneficial Òsmall-signalÓ effects of tenotomy (10). Optican and Miura indicated in their response that
they found it difficult to
calibrate the cleanly recorded search-coil data from our NEI clinical trial,
data that I easily calibrated despite being masked! It is not surprising that
such inexperience needed the shield of coauthors with some expertise in
recording and analyzing INS data; it is unfortunate that their expertise was
not evident in the papers. HertleÕs verbal warning that Optican and Miura
should not choose long, uncontrolled and artifact-filled files for analysis,
was ignored; he, and I, assumed that Optican and Miura accurately calibrated
the data they analyzed. Even if all of the methodological errors were corrected
and the same failure to find a difference occurred, the only supportable
conclusion that could be drawn from the wavelet paper would be that the method did
not detect the tenotomy-produced
waveform changes that were measured by the NAFX and resulted in improved visual
function. The authors could not conclude there were no changes. Unlike the
NAFX, wavelet analysis has never been proven to be a definitive measure of the
specific waveform changes in question; it has not been proven to be a measure
at all. From the dynamical systems analysis paper, The authorsÕ conclusion that
tenotomy does not appear to affect the underlying mechanism of INS applies only
if INS was caused by one mechanism; our data suggest that is not the case.
However, tenotomy was never claimed to have affected INS mechanisms but rather,
that it improved the resulting INS waveforms, a critical difference that also was omitted.
The bottom line is, those two
papers cannot even support the null conclusions of their authors because of the
apparently insensitive methods, applied in violation of their underlying
mathematical principals, coupled with improper data choices and failure to accurately
calibrate the data. I found them devoid of scientific value; they should have
been rejected on merit alone. Perhaps an analogy will help clarify the
scientific fallacy of the two papers. Consider if one used a Gieger counter to
measure the pre- and post-tenotomy radiation given off by the patientsÕ eyes
and found no difference. This is also a sensitive method designed for other
tasks. No careful scientist would conclude from such a null finding that
tenotomy did not affect the eye movements. In both my letter to Vision Research
and the Òsmall-signalÓ paper, my harsh (and, in the letter, intense) criticism
of the two papers in question concentrated solely on the obviously bad science
and did not expose the ethical problems raised by the surreptitious data mining
that enabled them (see below). Apparently, my expectation that demonstrating
their lack of scientific merit would suffice was misplaced.
Objectivity
We all presume an invited
speaker to a prestigious meeting is both presenting his data objectively and
that he followed the normally accepted protocols associated with ethical
science in acquiring and analyzing it. Unlike evaluating oneÕs qualifications
and publications, which are a matter of public record, detecting possible bias
is more difficult and proving it, almost impossible. However, deviations from
the norm, or actions that raise ethical concerns, are red flags that should
warn of the possible absence of objectivity, the foundation of scientific
inquiry. Knowledge of them requires responsible scientists to at least,
disclose them allowing more objective evaluation of the presentation.
History
After Rich Hertle and I
demonstrated (1998) and published (1999) the positive effects of tenotomy on
the nystagmus waveforms of a canine, we began to study the INS waveform changes
produced by tenotomy in humans. We recruited Bob Burnstine to provide another
clinical site and source of patients. It was during that time that the NEI
recruited Hertle from Philadelphia and, after he arrived there, we submitted
our protocol for a clinical trial of tenotomy. I provided the ocular motility
protocol and was the investigator in charge of performing all the motility
analyses; the NAFX evaluation of INS waveform changes was the primary
outcome measure, visual function
measures were secondary. It was
decided that the data would be masked. I was given assurances that the masking
would be carefully controlled to avoid any mislabeling of data. I was also
assured that during the time I would be masked from the data and we published
our results, no one outside of our research team would have access to our data.
That assurance was to be violated by Optican from early on in our clinical
trial and continue throughout its course.
At some point before the
protocol was approved (August 16, 1999), the NEI head (Carl Kupfer) attempted
to exclude me from the project, despite the fact that this project was based on
my prediction and subsequent demonstration of the beneficial effects of
tenotomy, was initiated before the NEI was involved, and required my expertise
in nystagmus analysis to provide the primary outcome results. Hertle prevented
this blatant attempt to hijack our joint work and place it entirely within the
NEI.
On April 19, 2001, while in
the middle of my masked-data analysis, Hertle sent me a SFN abstract prepared
by ÒK. MiuraÓ and ÒL.M. OpticanÓ at the NEI; they had accessed our unmasked
data and used it for a study of the dynamical systems analysis of nystagmus
waveforms pre- and post-tenotomy. The abstract was sent to Hertle and Ed
FitzGibbon with two extra places allotted for authors filled with Ò??????,Ó
prompting them to add their names as co-authors; this, despite the fact that
the work was done by Optican and Miura. Earlier, Optican had assured Hertle
that his interest was not in the effects of tenotomy on INS (the subject of the
NEI clinical trial) but in underlying mechanisms of INS. I immediately
protested this violation of the data- and patient-protection agreements that
ensured my participation in the clinical trial. I was assured: 1) Optican had
violated the NEI DSMC guidelines; 2) the improper behavior would be stopped;
and 3) Optican would not be allowed to submit the abstract. Indeed, he was
prevented from doing so. Optican claimed he was only Òplaying withÓ our data
(documented by email). I was then reassured that the data would not be shared
with any one until our publication of the results of the clinical trial. Thus,
during the three years I attended to the mind-numbing task of analyzing a
mountain of masked data, I was under the illusion that our data were being
protected by the NEI from unauthorized eyes, and use, until publication of our
results.
That illusion was shattered
when, about the same time as our
first publication demonstrating unequivocally the beneficial effects of
tenotomy on INS waveforms (11), the two companion papers discussed above appeared in
Vision Research authored by Optican and Miura plus both of their NEI
colleagues; the papers claimed that tenotomy had no effects on INS waveforms (1,2). Needless to say, I was shocked to learn that our
unmasked data had continued to be accessed by Optican during our NEI clinical
trial allowing choices of the data to be analyzed and to prepare these papers
to be submitted at about the same time as our first submission (his papers on
September 23, 2002 and ours on September 3, 2002). Thus, unknown to me and
despite his initial reprimand, Optican had access to the 880 records unmasked,
whose masked analysis took over 550 hours. Optican and Miura should have been
prevented from accessing and using our data. This, and his failure to wait
until publication of our results, was in direct violation of the NEI DSMC
guidelines and of their agreements with me. I believe that no one had the right
to give permission to access data in an ongoing study without the knowledge and
permission of all the scientists conducting the study. Furthermore, it is my
contention that no ethical scientist would either seek or accept access to
anotherÕs unmasked data without their knowledge and permission. Unlike the
above evaluation of the scientific merit of the papers, I cannot definitively
assign specific motive for these extraordinary actions; I do consider them an
attack on the integrity of all those who collaborated with me on the careful
INS research we have done for 40 years. I remain confident that the careful
work of those who actually study INS and tenotomy will survive this unprovoked
and baseless attack.
Conclusions
Bad science (that also was
the fruit of secretive and deceptive data mining) and questionable motives are
all that support this invitation; any underlying agenda remains only
speculation. The members of INOS deserve better. These objections, based solely
on the speakerÕs qualifications and abnormal behavior suggesting bias, should
be sufficient to preclude his speaking on the subject, the final content of the
presentation, notwithstanding. INOS should not reward either poor science or
questionable behavior and certainly not both. Each of us must decide personally
what, if any, action to take; I cannot support this violation of our trust. The
members of the audience at INOS 2008 now have access to the information
necessary to properly evaluate both the presentation (should they choose to
listen to it) and its source. The real victims of this unjustified invitation
are the conduct of ethical science and those patients whose physicians withhold
effective treatment under the mistaken impression that there is a
scientifically valid controversy about whether tenotomy really improves INS or
acquired nystagmus waveforms and, with them, visual function. There is abundant
proof already in the literature that it does both.
Acknowledgements
The author acknowledges the
contributions of the three Reviewers who helped ensure the veracity of the
facts presented herein.
References
1. Miura
K, Hertle RW, FitzGibbon EJ, Optican LM. Effects of tenotomy surgery on
congenital nystagmus waveforms in adult patients. Part I. Wavelet spectral
analysis. Vision Res 2003; 43(22):2345-56.
2. Miura
K, Hertle RW, FitzGibbon EJ, Optican LM. Effects of tenotomy surgery on
congenital nystagmus waveforms in adult patients. Part II. Dynamical systems
analysis. Vision Res 2003; 43(22):2357-62.
3. Dell'Osso
LF. Tenotomy and congenital nystagmus: a failure to answer the wrong question. Vision Res
2004; 44:3091-4.
4. Optican
LM, Miura K, FitzGibbon EJ. Tenotomy and congenital nystagmus: a null result is
not a failure, for "It is not the answer that enlightens, but the
question". Vision Res 2004; 44:3095-8.
5. Dell'Osso
LF. Responding to more than a response: tenotomy improves INS waveforms. OMLAB
Report 2007; #071107:1-12. http://www.omlab.org//Teaching/teaching.html
6. Sarvananthan
N, Proudlock FA, Choudhuri I, Dua H, Gottlob I. Pharmacologic treatment of
congenital nystagmus. Arch
Ophthalmol 2006; 124(6):916-8.
7. Tomsak
RL, Dell'Osso LF, Rucker JC, Leigh RJ, Bienfang DC, Jacobs JB. Treatment of
acquired pendular nystagmus from multiple sclerosis with eye muscle surgery
followed by oral memantine. DJO 2005; 11(4):1-11.
8. Wang
Z, Dell'Osso LF, Jacobs JB, Burnstine RA, Tomsak RL. Effects of tenotomy on
patients with infantile nystagmus syndrome: foveation improvement over a
broadened visual field. JAAPOS 2006; 10:552-60.
9. Wang
ZI, Dell'Osso LF, Tomsak RL, Jacobs JB. Combining recessions (nystagmus and
strabismus) with tenotomy improved visual function and decreased oscillopsia
and diplopia in acquired downbeat nystagmus and in horizontal infantile
nystagmus syndrome. JAAPOS 2007; 11:135-41.
10. Wang
Z, Dell'Osso LF, Zhang Z, Leigh RJ, Jacobs JB. Tenotomy does not affect
saccadic velocities: Support for the "small-signal" gain hypothesis. Vision Res
2006; 46:2259-67.
11. Hertle
RW, Dell'Osso LF, FitzGibbon EJ, Thompson D, Yang D, Mellow SD. Horizontal
rectus tenotomy in patients with congenital nystagmus. Results in 10 adults. Ophthalmology 2003; 110:2097-105.
Although the information
contained in this paper and its downloading are free, please acknowledge its
source by citing the paper as follows:
DellÕOsso, L.F.:
INOS 2008: Ethical Science or Something Else? OMLAB Editorial #071107, 1-8, 2007. http://www.omlab.org//Editorial/editorial.html
Note: This editorial was originally numbered as #070707
(date written) and was corrected to #071107 (date posted) on February 7, 2008.
Comment (added 7/23/07)
On July 16, 2007, a link to
this Editorial was posted on the NANOSNET list (prompted by the posting of the
INOS 2008 link on the same list). As a result of that posting, the facts
contained in this Editorial are now known to over 300 (and counting) potential
attendees at INOS 2008. My obligation to provide full disclosure to the members
of NANOS was accomplished in two days (relying on Google alone may not have
accomplished that much in a year). Despite the fact that most of the
information in this Editorial is a matter of public record, the organizers of
INOS 2008 would not disclose it. Fortunately, what was to be disguised as an
objective scientific presentation from an "expert" will have neither
"controversy" nor "drama" (does INOS 2008 really need a
hawker?). I do not plan to dignify Optican's presentation with my presence. If
Optican's two papers or his Response are any indication, the person responsible
for that ill-advised invitation will have to be satisfied with misinformation
and possibly worse; that is what his decision will bring to those INOS
attendees who choose to attend that talk. My advice is, visit a winery or have
a big breakfast instead.
To my surprise as well as
that of others, my simple posting of links to an Editorial and a Report on
another site was construed as a "personal attack" by the NANOSNET
list maven, Preston Calvert, who proceeded to remove my ability to post further
information on the list. In contrast, my posting has appeared on other similar
professional lists with no negative reaction by the responsible list managers.
Apparently, Calvert wishes to censor any controversy, not only on NANOSNET but
also on other sites on the web. My Editorial and Report only present the
relevant facts and several of my opinions (clearly identified as such) and
contain no personal attacks. Despite this, he continues to mischaracterize both
and refused to reverse his decision (a decision that may be supported by others
on the NANOSNET committee).
My monitoring the NANOSNET
list was for educational (i.e., NANOS members') purposes only; that too, was
halted, since I no longer receive it. However, as a Fellow of NANOS, I shall
continue to monitor the list using other means and respond directly to NANOSNET
members who need accurate information on those subjects where I can provide it,
especially when a posting is in error. I regard this as my obligation to the
membership. Calvert also refused to post my side of this matter, claiming that
to do so would somehow "reiterate" my attack. It might also have
revealed the weakness of his position. He may disagree with my opinion regarding
to Optican's lack of credibility on this subject (unlike Optican's Response, my
Editorial does not contain comments on his other work) but Calvert is clearly
overreaching in trying to apply his rules to another site and is wrong to claim
"personal attack" where none exists.
Censorship hasn't worked in
the past and is no longer viable. We all appreciate the effort put in by those
who monitor web sites or organize meetings. However, we do not expect them to
abuse their positions or act with personal agendas to the detriment of their
organizations or membership. We certainly do not surrender our rights to hold
or express our data-based opinions, the essence of scientific discourse.
LF Dell'Osso, PhD 7/23/07
Comment (added on
8/31/07)
Recently, Dr. Lance Optican
posted a letter to INOS members in which he denied the veracity of the
historical record detailed in OMLAB Editorial #071107 and in OMLAB Report
#071107. In response to his blanket denials, I can only reiterate that the
above-mentioned record is both accurate and well documented, as attested to by
Dr. Rich Hertle. The OMLAB documents stand as the only description exposing the
extraordinary measures taken by Dr. Optican to prematurely access data from an
ongoing masked-data, clinical trial to which he was not a participating party (which
he did not deny) and to use that
data, unmasked, (which he did not deny) to undermine the trial. In my opinion, his own
"inappropriately aggressive" and unethical actions violated the DSMC
rules under which the trial was conducted and the assurances made to me by the
NEI in return for my participation. Those assurance were in accordance with NIH
Policy [NIH Data Sharing Policy], that states no one outside the study would
have access to or use data until publication of the results by the
investigators conducting the trial (i.e., guaranteeing the right of "first
use" to those conducting a study). He did not deny accessing our data and publishing his papers before
our results were in press, as required by the above policy.
In his letter, Dr. Optican
continued to rely on the cunning sentence structure exhibited in his
unprofessional Response to my Letter to the Editor of VR; neither that nor
"neutrality" is an acceptable substitute for truthfulness. His
denials are aimed at whether or not his actions (which he did not deny), as documented in the Editorial and Report, actually
violated existing regulations. That is not for him to determine but for
objective committees that exist expressly for that purpose. Because of Dr. Optican, the literature
now contains two extraordinarily flawed papers on INS and a personal attack on
the integrity of the pioneering INS research performed in our Laboratory, the
Laboratory of Dr. Robert Williams, and on all of the scientists who conducted
that research. He squandered his opportunity for a "productive scientific
discourse" when he failed to respond to the scientific criticisms
contained in my Letter and instead, attacked my integrity and that of my work.
I urge any who wish to read his disrespectful Response to have an open copy of
OMLAB REPORT #071107 which provides a paragraph-by-paragraph exposure of the
many statements based on false premises or made without citing the relevant
conflicting information.
If Dr. Optican wishes to identify
specific statements in either the Editorial or Report that are "factually
in error" (his letter failed to identify any), he is welcome to submit them to me along with any
documentation he might have. I will then append them and my response to the appropriate
posted document. The OMLAB Editorial and Report are the only retrievable
documentation of both his extraordinary behavior and the fallacies contained in
his papers; they will remain so to prevent the misperception that Optican's two
papers were the product of an unbiased and properly conducted study into the
effects of tenotomy; the latter was accomplished by the NEI-sponsored Clinical
Trial conducted and reported on by Hertle et al. The flawed attempts by
Optican's two papers to deny the demonstrated positive effects on nystagmus
waveforms cannot be compared to the results of our carefully designed and
strictly supervised, masked-data analysis of INS waveforms. During the past few
years, I have been appalled by members of both the research and clinical
communities who cite this supposedly negative evidence of tenotomy's
effectiveness yet could not tell a wavelet from a ringlet. Those that cite
these papers after merely reading their overreaching abstracts do a disservice
to the careful research that has established tenotomy as both viable and
beneficial for nystagmus and, more importantly, to the patients who may benefit
from this revolutionary therapy. One needs only to read the many publications
that followed those in question to realize that new experiments documenting the
progress of the tenotomy procedure in both INS and acquired nystagmus have
already been conducted and reported.
Dr. Optican states that he
knows of no reason to accuse Dr. Carl Kupfer of attempting to hijack my work.
Dr. Optican was not a party to our Clinical Trial and would not have had reason
to be at the meeting where this took place. Dr. Hertle was and reported it
directly to me at the time it occurred; as a senior member of the research
team, I did have a right to know. Several years earlier, when discussing my
work with Dr. Williams on the achiasmatic Belgian sheep dogs, Dr. Kupfer
stated, "Nothing clinically useful will come from studying the eye
movements of dogs;" I believe history has proved him wrong.
Whether Dr. Optican's actions
violated any data- or patient-protection agreement or NEI Data and Safety
Monitoring Committee (DSMC) guidelines (or severely bent them), is something
for others to determine. However, if the NEI's rules protecting a researcher's
or patients' data were not violated by Dr. Optican's accessing and using them
without obtaining my permission, especially after I specifically forbade
further access, a chilling message will have been sent to all researchers
considering collaboration with NEI employees. Such a result of Optican's
actions would be a disservice to the many ethical scientists at the NEI. Despite
his protestations to the contrary
in his letter to INOS members, Dr. Optican was reprimanded by Dr. Hertle at my
insistence and was told to cease and desist or the matter would be brought
before the DSMC; he elected to forgo that experience but only pretended to
comply. He was told specifically not to submit his Neuroscience abstract
and he did not submit it. Had he
ignored that directive, his actions would have immediately prompted a formal
charge of misconduct.
As pointed out in the
Editorial, Dr. Optican's own CV demonstrates his dearth of experience in
studying either INS or the effects of tenotomy. He should never have accepted
this ill-advised invitation to speak at INOS 2008 on a topic for which he has a
demonstrable lack of experience, expertise, and objectivity. There are at least
a dozen well-qualified scientists who could make a more well-informed
presentation and who will not carry the baggage Dr. Optican has inflicted on
himself.
As an Italian-American, I was
taught at an early age that respect was not a verb to bandy about but something
you demonstrate by your actions. For someone who, over the past six years, has
shown both disrespect and disdain not only for my and my colleaguesÕ
reputations for integrity, but also for ethical scientific behavior, data- and
patient-protection and the NEI institutional policy governing them, and full
disclosure to Journal reviewers (and ultimately to the readers of the published
material), his ÒrespectfullyÓ submitted self-serving request is pure chutzpah.
If Optican truly wishes to demonstrate his respect for ethical science, the
INOS membership, and for the INS research he has so unprofessionally maligned,
he should decline the invitation. As a Fellow of NANOS and an INOS member, I
urge him to do so.
LF Dell'Osso, PhD 8/31/07
Epilog (added on
8/6/08)
To express my opposition to
the heedless action of the INOS ÒcommitteeÓ responsible for an indefensible
invitation to a speaker with no expertise in the either INS recording,
calibration, analysis, or therapy, I chose to spend the month of June in
Sardinia (attending a wedding and lecturing on eye-movements) and southern
Italy (visiting friends and relatives while continuing my genealogical research
in Calabria, Basilicata, and Puglia).
Several objective scientists
who did attend the talk in question (instead of sampling the wines of the Napa
Valley, as I recommended) reported their impressions to me. They expressed
their disappointment at both the ÒunimpressiveÓ and ÒunbalancedÓ content of
OpticanÕs talk, the lack of alternatives to proven analysis methods, at least
one false statement about tenotomy, and his inability to satisfactorily address
the concerns and questions raised after the talk.
Hopefully, I can now close
this ugly chapter chronicling what the evidence suggests were politically
driven actions of some in our community of scientists with the satisfaction
that comes from the knowledge that I did what was necessary to educate the INOS
membership both to the insult to them embodied in the Optican invitation and
the unethical behavior that caused this problem in the first place.
The professional skeptics and
their minion have failed miserably to either: 1) demonstrate scientifically
that the tenotomy procedure does not benefit nystagmus patients or 2) provide a
viable alternative mechanism to the proprioceptive-control hypothesis. Perhaps
now objective and unbiased evaluation can continue of the data that has thus
far demonstrated the multiple beneficial clinical effects of the tenotomy
procedure and supported the proprioceptive-control hypothesis. I remain
confident that both the resulting paradigm shift in nystagmus surgery and the
renewed appreciation of the role of proprioception in eye-movement control will
emerge as driving forces in future contributions to both basic and clinical
ocular motor research. That is, and must be, the reward for scientific study,
as the search for Òultimate truthÓ is an endless one.
LF Dell'Osso, PhD 8/6/08