Malpractice Methodology (New York Times OpEd by Peter Orszag)
Right now, health care is more evidence-free than you might think. And even where evidence-based clinical guidelines exist, research suggests that doctors follow them only about half of the time. One estimate suggests that it takes 17 years on average to incorporate new research findings into widespread practice. As a result, any clinical guidelines that exist often have limited impact. How might we encourage doctors to adopt new evidence more quickly?
If this is the case with health care overall, despite much progress over the last 30–40 years, imagine how worse it may be when we talk about brain health, when neuroscience and cognitive neuroscience are relatively more recent disciplines.
This is a key insight to keep in mind as we debate the value and limitations of innovative brain health solutions, especially those that are non-invasive and have no negative side effects: what matters most to actual human beings living today is how those tools and solutions seem to perform, based on best evidence, compared to alternatives available today — not compared to Platonic ideals about research and practice which may exist in our minds but not in the real, empirical world. Of course we then need to guide research so that we have better evidence in the future, but progress must occur in parallel and reinforce each other: progress in practice and in research.
The OpEd author then proceeds to defend malpractice reform as the primary way to do so. This may well be so with healthcare as a whole, but when we are talking about brain care I believe his next 2 proposals are more directly relevant: [Read more…] about Improving Brain Health Outcomes with Tech, Incentives and Comparative Effectiveness Research