Our bedrock shakes but remains intact
This week's Apple a Day looks at the use of scientific literature in healthcare communications
Two seemingly unrelated stories that have had considerable airtime recently may have a very similar cause. The first concerns the recent outbreak of measles in California and the second is the revelation that dietary fat – even of the saturated variety – might not be the main villain behind cardiovascular disease after all.
Opposing camps formed immediately as each story broke. In the first case it was pro- and anti-vax campaigners and in the second assorted healthcare professionals and researchers who either jumped on the bandwagon or swerved to avoid it.
The subject matter is far from trivial in either case, with human lives being affected by decisions made under the influence of these loud public voices.
What troubles Apple a Day is that the underlying cause of this discord is scientific literature. As healthcare educators and communicators scientific publications – particularly those that are peer-reviewed and served up in prestigious journals – are our definitive reference sources. No advice or recommendation is made without a scientific citation to support it. However it appears this bedrock may be shaky.
The origins of the anti-vax movement largely stem from a publication by Andrew Wakefield in The Lancet in 1998 that linked vaccination to autism in some children. The study has since been discredited and the publication retracted – but not before the anti-vaccination movement was born. This week, the published trials that lead to the dietary guidelines that vilified fat and promoted carbohydrates in the 1970s and 80s were called into question and it has been suggested the evidence wasn’t strong enough to make those conclusions.
So where does this leave us? Should we stop worrying about finding evidence to support what we communicate because it can’t be trusted?
Absolutely not! Despite these confusing revelations we can be reassured the VAST body of published scientific is sound. With each publication, medical knowledge is advanced and it is through the (mostly) rigorous review and publication of decades of research – and the public health recommendations that stem from it – that we combat or prevent disease.
While we should learn from these cases and journals should re-assess their peer-review processes let’s avoid a knee-jerk reaction and continue to put our faith in The Literature.