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December 18, 2019 By e-Patient Dave Leave a Comment

Principle 10: “The lethal lag time” – new knowledge doesn’t flow instantly to everywhere

Next in the series of fourteen foundation truths about Superpatients.

Yesterday in principle 9 we covered how long it takes for scientific journals to get around to publishing knowledge, once it’s been created. Until then, the knowledge bears no fruit. And if you’re one of the suffering people whose outcome may depend on that knowledge, it’s a problem.

It’s even worse, though – once it’s in a scientific journal it doesn’t necessarily get read by everyone who might need it. In his seminal e-patient white paper, “Doc Tom” Ferguson called this “the lethal lag time”: (See the mention of NLM Director Don Lindberg in Principle 3: “If I read two articles every night, after a year I’d be 400 years behind” – a number that’s now over 3,000 years.)

“The 17 years thing”

One of the first things I kept hearing in my travels as a speaker was “the 17 years thing” – “It takes 17 years for doctors to start using new knowledge.” That’s a shocker by itself, but there was a double irony to the conversation about it:

  • Nobody I talked to knew where that number came from! For scientifically trained people, it’s just weird to be quoting something with an unknown source.
    • In 2016 at a conference at Harvard Medical School, a famous doctor on a panel actually said, as a side remark: “Yeah, where did they get that from?? Anyone know?”
  • When I finally found the source (after three years of asking), it turns out the study actually says 17 years for half of doctors to start doing new things. So everyone was quoting it wrong!

Wow. (And this is the level of medical people who make a point of going to conferences, never mind people who don’t.)

The superpatient takeaway:

The lesson in any case is that if you’re at the fringe of medical knowledge, it’s absolutely valid for you to look around and see if any knowledge has been discovered that hasn’t reached your physicians.

Remember, you can’t blame them for not knowing everything – there are 7,000 new papers every day. The point is that it’s perfectly valid for you to be an information bloodhound, and your docs should welcome the effort.


Next: Principle 11: Beware “eminence-based medicine.”

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