The incidence and changes in incidence with time are unclear in the United Kingdom. The reported autism incidence in the UK rose starting before the first introduction of the MMR vaccine in 1989. However, a perceived link between the two arising from the results of a fraudulent scientific study has caused considerable controversy, despite being subsequently disproved. A 2004 study found that the reported incidence of pervasive developmental disorders in a general practice research database in England and Wales grew steadily during 1988–2001 from 0.11 to 2.98 per 10,000 person-years, and concluded that much of this increase may be due to changes in diagnostic practice.