This April the University of Wisconsin hosted a conference called "Science Writing in the Age of Denial." The conference set out to brief science writers on strategies to deal with skepticism toward and denial of evidence based discoveries (think: people hanging on to the fabricated link between vaccines & autism; denial of evidence that some cancer screenings and drugs don't work, and claims that proponents of evidence-based medicine are trying to "kill cancer patients;" vehement denial of climate change).
Gary Schwitzer, creator of HealthNewsReview.org, gave a keynote address entitled: "Cheerleading, Shibboleths and Uncertainty." Here are links to the video of his presentation and his slides.
'Shibboleth’ is a Hebrew term that was referenced in the Bible. In a story from the book of Judges, the word "shibboleth" is used to sort one tribe from another, and from that time the word has been used to mean a signal that members of a group give each other to show membership.
Mr. Schweitzer suggests that for some medical and journalism groups, unlimited advocacy for medical screening is a shibboleth. He describes these “cheerleading” groups as having a "cult-like advocacy for screening tests." His main example was the "media cacophony" that surrounded the release of USPSTF's revised breast cancer screening guidelines. His presentation contains other examples of screening shibboleths.
Gary's work, and the work of this conference, represents an important step toward evidence based medicine. It will be incredibly hard to get evidence used in medical practice until we get better at acknowledging and counteracting forces that will push back against any threatening or uncomfortable truth. As it stands, 25-40% of all that is done in medicine is not evidence based. If we want care that is safer, more cost effective, and patient centered we need to regularly stop and evaluate ourselves and what we have learned. Then we need to keep what is working, and have the courage to leave behind our shibboleths that don’t hold up anymore.