Double Checking

Scientific knowledge accumulates one paper at a time, but a single report published in a professional journal is not the final word on any issue. Scientists take great care in reporting their methods, results, and conclusions so that others can judge the work for themselves, possibly repeat the experiment or follow up on the subject. After years - sometimes decades - of experimentation, the scientific community may reach a consensus on a given topic. Or they might remain locked in controversy. In the face of scientific uncertainty, how do scientists or policy-makers decide what to do?

"Should each physician keep track of every study? That's a big task," says Dr. Tim Carey, co-Director of the Evidence-Based Practice Research Center (EBRC) in Durham, N.C. "Evidence-based practice and medicine is a way to address that by looking in a critical and unbiased way at all of the evidence around a particular question and arriving at an answer."

Dr. John Longhurst attempts to measure acupuncture's affect on blood pressure.

Carey and his colleagues at the EBRC help scientists, professional societies, insurance companies and policy-makers cut through controversies. EBRC Scientists have reviewed the effectiveness of treatments for treatments for pre-term labor, speech and language tests in early childhood, the use of aspirin in the prevention of heart attack, screening techniques for diabetes and blood lipids, and - currently - treatments for a childhood respiratory disease.

As in other scientific endeavors, EBRC scientists start with a question, then rule out all the research that doesn't specifically answer that question.

"We find it's important to spend a fair amount of time and effort refining the question. That's true of any research," says Carey. "These systematic reviews are a lot like doing clinical study, but in stead of studying patients, we're studying articles."

Once the question has been narrowly defined, EBRC scientists comb through thousands of research papers, eventually culling perhaps as few as 20 to 40 to review. The researchers then summarize each study's conclusions and weigh the evidence, based on the scientific integrity of the paper. Every research question will lend itself to different experimental methods, but, according to Carey, good scientific studies have several elements in common.

"Clear question, robust methods, good measures, well-applied statistical techniques, and clear descriptions," he lists.

Once each paper has been judged on these criteria, EBRC can then make recommendations to policy-makers working on health-care legislation or to insurance companies looking for the most cost-effective procedures to cover.

Dr. Eric Small compares the data generated in his clinical trial.

Over the last several centuries, the modern scientific method has served humanity extremely well. In industrial nations, modern medicine has added decades to our life spans, and technology has increased the quality of our lives immeasurably. Still, faith in our human senses leads some to trust compounds and practices not yet subjected to the rigors of modern science. Some alternative medicines and therapies could very well be effective and useful. But until more scientists do more research, no one can say for sure.

Web Site:
The Art of Renaissance Science
Visit this illustrated site to learn more about Galileo and the connections between art and science in the Renaissance.

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