Healthcare: The Big Data Problem Of Medical Knowledge

RWJF Susannah Fox 

The above is a tweet from one of the amazing leaders I greatly respect, Susannah Fox (@susannahfox). I have been obsessing over this tweet since the 17th of October when I first saw it.

I at first wanted to jump to several different answers, but before doing so, I wanted to begin to understand the problem. To define it.

On a daily basis we hear about “Big Data” and healthcare. The next great breakthrough and impact will be in leveraging “Big Data.”

So how much data is out there? How do the “insiders” (meaning healthcare professionals, medical researchers, and physicians) manage all of this data? What kind of effort does it take to manage the medical information?

So the first thing to understand is what is the doubling time for medical knowledge? There is a paper written by Dr. Peter Densen entitled “Challenges and Opportunities Facing Medical Education” in the Transactions of The American Clinical and Climatological Association in 2011; 122: 48-58 (paper is linked here) that gives some insight into this first questions.

In 1950, it was estimated that the double time for medical knowledge was about 50 years. In 1980 it was about 7 years for medical knowledge to double. In 2010, it only takes about 3.5 years for the medical knowledge to double in size. It is estimated that by the year 2020, it will only take 73 days for the volume of medical knowledge to double.

That is a lot of medical knowledge. That is a lot for physicians, healthcare experts, healthcare lawmakers, and patients to try and maintain.

There is another paper published in the Journal of Medical Library Association from October 2005; 93(4): 499–501 entitled, “Growth and decentralization of the medical literature: implications for evidence-based medicine by Dr. Benjamin G. Druss, et al that examines the growth in articles published in MEDLINE. (paper is here)

A total of 8.1 million journal articles were published in MEDLINE between 1978 and 2001. Between 1978 to 1985 and 1994 to 2001, the annual number of MEDLINE articles increased 46%, from an average of 272,344 to 442,756 per year, and the total number of pages increased from 1.88 million pages per year during 1978 to 1985 to 2.79 million pages per year between 1994 to 2001.

Again, just trying to maintain the amount of literature in MEDLINE alone is a daunting task.

In yet one more journal article published in Journal of Medical Library Association Oct 2004; 92(4): 429–437 there is an article entitled, “How much effort is needed to keep up with the literature relevant for primary care?”

This paper (paper is here) demonstrated that there were 341 active journals at that time consisting of 8.265 articles. They estimated that there were around 7,287 articles published on a monthly basis.

In order for physicians to keep up to date on all of the publications, it would take them about 627.5 hours each month.

In an average month, say of 30 days, there are only a total of 720 hours. So if we take 627.5/720 hours, that would mean that a primary care physician would need to dedicate 87% of their total available time to reviewing and reading the medical literature. This doesn’t even allow a physician to sleep 6 hours a day, or to see patients. (Only 92 hours are left to get some rest and see patients)

So in a sea of medical literature burying our healthcare providers and healthcare professionals, how do we plan to make the information more applicable and readily accessible?

Great question.

Now since I understand the problem, I can begin writing that story tomorrow. Thoughts?

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek

~CancerGeek

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4 responses to “Healthcare: The Big Data Problem Of Medical Knowledge

  1. As a patient who tries to educate others about kidney cancer issues, I first check the date on any study, as there has been a revolution in 10 years. If the references in the study do not include VERY recent studies, and rely on older, often discredited studies, I assume that the authors are sloppy and not to be trusted as to their conclusions.
    Similarly, when I hear of doctors who fail to incorporate newer findings into their treatment options for their kidney cancer patients, I assume that they rarely treat such patients, or haven’t learned anything in the last ten years, They may or may not accept the newer data provided by their patients. That is the real test. If a doctor is willing to learn from his patients, he may also be willing to learn from the experts…I hope.

  2. How any doctor can keep up is beyond me. I remember how many nursing journals I had to read to keep up to date, and I left nursing in the late 80s. Maybe data sharing sites will be the wave of the future where doctors can go to see treatment and progression data from anonymous patients and decide on treatment from there. Something like Cancer Commons where patients voluntarily share their scans and treatment modalities.

  3. You might also find http;//smartpatients.com an interesting approach. As the name would indicate, we are a group of “smart” patients, though we did not start out that way. We are willing to share and learn from one another, and often pull new patients from the swamps. I am shocked several times a week to hear of inadequate or bad treatment, and worse yet, of doctors telling patients that there is nothing which can be done for them. Often that is simply because that individual doctor is not knowledgeable enough himself. Moreover, he simply can’t conceive of someone else knowing more and have more to offer. Fix that and the stats for all cancers will improve dramatically!

  4. Pingback: The Many Facets of Chronic Alcohol Abuse

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