Mike Gillam, 8 April 2015
Associate professor of Stanford and Tufts, Dr. John Ioanaddis, shared his controversial research with The Atlantic in 2010 showing mistakes in traditional healthcare teaching. In his original research he looked at the top 50 most cited, presumably most respected, articles in healthcare and found that 40% of them had their findings changed or overturned completely.
When projecting the error rate to the rest of medical literature, Dr. Ioanaddis estimated that 90% of what was known in healthcare was wrong.
To many, his 2010 announcement seemed bold, yet in the short five years since his article, look at how medicine has changed.
- Cholesterol: The U.S. is poised to withdraw cholesterol warnings in diets. “Cholesterol in the diet need no longer be considered a ‘nutrient of concern’”
- Saturated Fat: A metanalysis from 21 studies and 350,000 people in the American Journal of Nutrition concluded there is no relationship between the intake of saturated fat and the incidence of heart disease or stroke.
- Carbohydrates: A cover story in Time magazine reported that for decades it was fat that villified as causing obesity, but new science reveals that carbohydrates are the cause.
- Salt: Several new studies have shown that it is not high salt diets that are the problem, low salt diets increase mortality.
The very pillars of nutritional teaching for decades has been shaken. For any trained clinician, reading the latest healthcare news is an exercise in rediscovering the importance of humility regarding the unknown in medicine and the thought known.
Perhaps even more importantly, this strongly suggests that our design for clinical decision support systems will need to support methods for continual updates to the knowledge base. The knowledge on which we stand is slippery sand and the terrain is changing every day.
What knowledge were you taught about medical care that has since been overturned?