The NewScientist recently blogged about C.P. Snow's idea of "two cultures": those trained in the sciences and those trained in the humanities. In this 1959 lecture, Snow proposed that a communications chasm between these groups hindered the effort to solve the world's problems with new technology. He concluded that the two groups essentially spoke different languages that made it impossible to identify common goals. Snow's lecture captured the proverbial differences in "left vs. right brains", and showed us that scientists need to be better at communication while non-scientists need to be more conversant in basic technical and scientific concepts.
Fifty years later, Snow's original idea that these "two cultures" are not communicating still holds true. In my work at various medical technology companies, I've often heard engineers and scientists complain that the business folks don't grasp the technical ideas. Similarly, those on the business side get frustrated with the engineer's or scientist's obsession with small inconsequential details, rather than stepping back and looking at the big picture.
How does this issue relate to The Decision Tree? In previous posts, we’ve talked about the necessary behavioral changes that individuals must make in order to put the concepts of The Decision Tree into practice -- and I realize that's asking for a lot. From collecting and analyzing your body metrics to increasing your medical/scientific knowledge, implementing your decision tree will no doubt be demanding. At the same time, both physicians and scientists should translate their work into insights that resonate with the general public. In a previous post, we talked about MedEncentive's interest in improving doctor-patient communication. Similarly, a better scientist-patient relationship will enable better health decision-making. This way the scientific professionals and general public could find a middle ground to address the rift described by Snow, thus bridging "the two cultures". More after the jump.So how do we improve communication between scientists and non-scientists? We (society) rely on scientists to push the boundaries of medical/scientific innovation and understanding. As a result, society puts a certain amount of trust in these people to ethically conduct research and get results. In return for the trust (and funds, via tax dollars sent to agencies such as NIH), I believe the public 1.) deserves to see the results via access to scientific publications, and 2.) is owed a reasonable explanation of what the research is all about.
The idea of sharing results publicly through "open" research is hardly a new thought. Currently, open research broadly refers to the fact that published data should be accessible to everyone, not just those who pay the fees to subscribe to the right journals. To solve this problem, journal article repositories are emerging, such as PubMed Central, to which authors must submit new articles (2008 onward) arising from NIH funded grants within 1 year of publication. A step even further is an organization such as The Public Library of Science (PLoS), which has been an open access publisher since its inception, and makes published research in medicine and biology available to all readers.
But what good is access when the research itself is beyond understanding? Scientists are terrible communicators, and as a scientist myself, I often struggle with papers or talks loaded with details and jargon. In science, understanding the details of one's own research, and being able to effectively express your idea and findings to others, seem to be two completely independent skill sets. I've seen scientific experts flounder when giving a presentation to people outside their area of expertise. I don't think anyone in the room doubted the speakers knew what they were talking about, but something was getting lost in translation, so to speak. The funny thing was, in many instances, the audience was filled with other scientists, only a different specialty than the speaker. So not only do scientists have trouble communicating with non-scientists, they also have trouble communicating with each other.
In scientific publications, the abstract of the article is supposed to be a summary of the study, but often the complexity of the paper simply carries through to this paragraph-long synopsis of the work. A better approach might be something such as PLoS Medicine editors' summary. These are readable summary statements written by the editorial staff that specifically address questions such as "Why was this study done" or "What do these findings Mean". These high-level summaries give readers a brief, but complete, overview of the study. Scientists should be able to write these types of summaries themselves. This skill would benefit a scientist's own career, since their work would reach a much larger audience.
Here's how these changes would benefit individuals: If someone has a risk for Condition X, they could find out if preclinical research studies identified new potential therapeutic targets. If your grandfather and uncle both died of Condition Y, you could be on the lookout for new biomarkers that might bear promise, and perhaps genetic links emerged between Conditions X and Y that warrant watching out for. People would be empowered with this information, simply by knowing that they understand the work on the leading edge of treatment of their relevant conditions, or how these findings could directly impact their life.
Reforming health care will demand the interaction of all people – left brains and right brains. We need everyone to grasp concepts in fields such as genetics, statistics, health nomenclature, and physiology -- at least enough to make proper decisions about their health. Therefore, transforming society into an evidence-based mindset will inevitably require the interpretation of newly published data. I believe the scientific community can aid the transition of the next-generation patient, but they just need a little nudge to start thinking about the ways they express themselves.