Friday, 24 May 2013

Hitting the sweet spot


In his landmark work The Structure of Scientific Revolutions Thomas Kuhn argued that far from being a well ordered and timely process, scientific advancement occurs in an erratic, opportunistic and even irrational manner often with no overt overarching dialogue.    The scientific community is just that, a community.  Ideas continuously flourish, grow and are put to the mill to make room for better fitting (or perhaps just better sounding) paradigms. So it may be worth asking, in the age of the meme driven global village, what hope is there for mere individuals to make ripples in a sea of convolution and hyperspecialisation?
Well, perhaps more than we think.  Contributing to scientific progress as a whole, far from becoming more unreachable for individuals or indeed small groups of interested individuals, may actually be becoming more attainable.  This is thanks to the widening array of easily accessible and evolving technologies which have, at present, outstripped our capacity to come up with innovative uses for them.
Echoing this idea, the BMJ, recently published a meta-analysis of several trials looking at the use of ultrasound as a guidance technique for lumbar puncture.  With the advent of portable ultrasound probes, novel uses are in abundance.  Screening for parkinsons disease, the management of shoulder dislocation and joint reduction to name a few.  One of the advantages of metaanalyses is that they clump together groups of similar studies to look at outcomes which may not be obvious in small studies or have the statistical power to be significant.  Through grouping the studies the authors were able to show that ultrasound guided lumbar puncture has a significantly lower failure rate and risk of trauma than unguided procedures.   A relatively simple finding which may forever change the way we perform this essential diagnostic investigation.
It seems that the chance of having a idea that is ripe for the times has never been better...

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