This free Information Age Education
is edited by Dave Moursund and Bob Sylwester, and produced by Ken
Loge. The newsletter is one component of the Information Age
Education (IAE) publications.
All back issues of the newsletter and subscription information are
In addition, five free books based on the newsletters are
available: Education for Students’
Futures; Understanding and
Mastering Complexity; Consciousness
and Morality: Recent
an Appropriate 21st Century Education;
and Common Core State
Standards for Education in
This is the 15th IAE Newsletter
in a series on Credibility and
Credibility and Validity of Information
Part 15: Medicine
Emeritus Professor of Education
University of Oregon
The discipline of medicine applies biomedical sciences, biomedical
research, genetics, and medical technology to diagnose, treat, and
prevent injury and disease, typically through pharmaceuticals or
surgery, but also through therapies as diverse as psychotherapy,
external splints and traction, prostheses, biologics, and ionizing
radiation (Wikipedia, n.d.).
The definition given above is often called standard medicine or
standard care. Complementary and alternative medicine (CAM) is the
usual term for medical products and practices that are not part of
standard care (Complementary and alternative medicine, n.d.).
In the United States, more than one-sixth of the yearly total gross
national product is now spent on health care. The estimated expenditure
for year 2015 is about $10,000 per person. In total, our medical
expenditures now exceed $3 trillion a year! It is appropriate to ask
about the credibility of people who offer health care and advice about
It is also appropriate to ask about the validity of the practices they
employ, the information they use, and also the proved effectiveness of
the medicines they dispense. The health care system is governed by a
huge number of laws, rules, and regulations. Nevertheless, it has its
share of unethical and/or poorly prepared practitioners and ineffective
My 8/27/2015 Google search of the term quack medicine produced nearly 3.9
million results. The short message is, “Let the buyer beware.” As an
example, think about the innumerable ads you have viewed and read about
weight loss programs. Many people continue to want to believe in a
magic pill or magic program for weight loss. My personal belief is that
if there were a safe, easy-to-use, and not overly expensive
“treatment,” it would be well supported by good research and widely
available. So far, no such luck.
Throughout this health care system, people make decisions based on the
knowledge and beliefs they have, and the information resources they can
access. This newsletter takes a brief look at the credibility and
validity of the information that is used to make health care decisions.
The goal is to help you—an individual reader—to make better decisions
and to better appreciate the complexities inherent to any health care
system. Of course, we hope you will share your increased knowledge with
your students and others.
Comparing Health Care and Education
Most readers of the IAE newsletters are educators. As educators,
we realize that education is both an art and a science. The art is
displayed by millions of individual human teachers in their day-to-day
interactions with their students. The science comes from a substantial
amount of education and cognitive neuroscience research. Substantial
progress is occurring in implementing some of the science of teaching
and leaning via computerized, intelligent teaching machines. IAE
published a seven-newsletter series comparing health care and education
in 2010 (Education and Health Care, parts 1-7, 2010).
As you read this current newsletter, consider the parallel between the
art and science of education, and the art and science of health care.
Think about the complexities of improving either of these gigantic and
Medicine Is Not an Exact Science
Although the “science” of medicine is large and growing, medicine is by
no means an exact science. Moreover, the problems that medicine is
addressing are very complex. The daily media has made this clear in its
coverage of cancer, Alzheimer’s and other dementia, autism, Ebola and
other viruses, etc.
While most of us would like to believe that a magic pill, shot,
vaccination, or other similar treatment will always work for each of
these health problems, that definitely is not the case today. Nor is
this apt to be the case for a great many years to come.
We do have some very effective preventative treatments. Quoting from The History of Vaccines (n.d.):
immune systems, however, are different enough that in some cases, a
person’s immune system will not generate an adequate response.
That said, the effectiveness of most vaccines
is high. After receiving the second dose of the MMR vaccine (measles,
mumps and rubella) or the standalone measles vaccine, 99.7% of
vaccinated individuals are immune to measles. The inactivated polio
vaccine offers 99% effectiveness after three doses. The varicella
(chickenpox) vaccine is between 85% and 90% effective in preventing all
varicella infections, but 100% effective in preventing moderate and
severe chicken pox.
For various reasons, some people want to opt out of having their
children vaccinated and/or receive other forms of medical treatment.
These people make a decision based on their knowledge and beliefs, yet
this knowledge may well be based on information that is not valid. If
enough children in a certain locality fail to receive a particular
vaccination such as the MMR vaccine, a local epidemic is possible. So,
we have a medical, religious, legal, and political conflict between the
good of the many versus the rights of the individual.
Here is a somewhat similar example. Those of us who have grown up
depending on the effectiveness of antibiotics are dismayed by the
current growing ineffectiveness of widely used antibiotics (Boseley,
4/30/2014). Our misuse and overuse of some of these antibiotics has led
to this decline in their effectiveness. Quoting from the article:
resistance is a major threat to public health, says the World Health
Organization (WHO). It is no longer something to worry about in the
future, but is happening now and could affect anybody, anywhere, of
"Without urgent, co-ordinated action by many
stakeholders, the world is headed for a post-antibiotic era, in which
common infections and minor injuries which have been treatable for
decades can once again kill," said Dr Keiji Fukuda, the WHO's assistant
director general for health security.
Decision Making Under Uncertainty
Because medicine and medical treatments are by no means an exact
science, the decisions made at every level of medical care can be
thought of as being decision making under uncertainty.
Suppose I am not feeling very well today. Should I: call 911; go to an
Urgent Care facility; schedule an appointment with my doctor; call a
friend and ask for advice; go to work anyway; just stay home and
continue to monitor the situation; or decide on some other action? One
approach is to think about the consequences of each of your possible
For example, suppose you know some of the symptoms of a heart attack,
and you think you might be experiencing some of these symptoms. Calling
911 might save your life. The decision you make will depend on your
accumulated knowledge and experience.
So, you first draw on information stored in your head. How valid and up
to date is it? Next, you think about accessing other sources of
information. For example, you may take your temperature and check your
heart rate. You may think carefully about your symptoms, and use the
Web or other information source to look up information on possible
meanings of these symptoms.
If the information resources you use are valid and you understand the
information they provide, you are apt to make a better-informed
decision. This observation supports the value of all students receiving
sufficient health care education so they can make effective use of
information resources that are generally available.
Growing Availability of Relatively Good Sources of Information
Many of us grew up with the medical help of Dr. Benjamin Spock (Spock, n.d.). Quoting from the reference:
Benjamin McLane Spock (May 2, 1903 – March 15, 1998) was an American pediatrician whose book Baby and Child Care,
published in 1946, is one of the best-sellers of all time. Its message
to mothers is that "you know more than you think you do."
Now we have access to many websites that are credible and strive to
provide valid information. Here is a short list in alphabetical order;
it is not intended to be a definitive list.
Part of your personal health care education,
and that of your students, should include learning to make use of
sources like these and/or others that you believe offer valid
information. They also should be sources that you can communicate with
effectively. IBM’s Watson: Part of the Future of Medicine
IBM’s computer system named Watson
is well known for defeating two human champion players of the TV game
Jeopardy in 2011 (Best, n.d.). Since then the hardware of this computer
system has been vastly improved, and large teams of researchers and
practitioners have been developing software and databases to apply this
compute power to a variety of problems.
The general ideas behind Watson learning to play Jeopardy
have been expanded into Watson learning to read and process both the
medical research literature and individual patient records. Today,
Watson is already showing its promise to significantly help in
improving our health care system.
The U.S. National Institute of Health reports that it is now processing
more than 700,000 new citable medical articles per year, and that its
total library now contains 21 million articles (NIH MEDLINE, 2015). The
current Watson medical system is designed to read and process such
literature. Its “intelligence” in processing this literature, and then
making use of it to analyze an individual patient’s records, is growing
Quoting from Putting Watson to Work (IBM, n.d.):
In fact, the amount of medical information available is doubling every
five years and much of this data is unstructured—often in natural
language. And physicians simply don't have time to read every journal
that can help them keep up to date with the latest advances—81 percent report that they spend five hours per month or less reading journals.
Watson uses natural language capabilities, hypothesis generation, and
evidence-based learning to support medical professionals as they make
decisions. For example, a physician can use Watson to assist in
diagnosing and treating patients. First the physician might pose a
query to the system, describing symptoms and other related factors.
Watson begins by parsing the input to identify the key pieces of
information. The system supports medical terminology by design,
extending Watson's natural language processing capabilities.
Watson then mines the patient data to find
relevant facts about family history, current medications and other
existing conditions. It combines this information with current findings
from tests and instruments and then examines all available data sources
to form hypotheses and test them. Watson can incorporate treatment
guidelines, electronic medical record data, doctor's and nurse's notes,
research, clinical studies, journal articles, and patient information
into the data available for analysis. [Bold added for emphasis.]
This is a truly amazing project!
Remember, medicine is not an exact science. The decisions that
health care workers and those receiving health care make can be thought
of as decision making under uncertainty. Through education, experience,
and drawing on valid sources of information, health care workers and
recipients can make better decisions. Through continuing research and
development, our health care system can continue to be improved.
It is clear that patients and health care professionals are becoming
more and more dependent on the use of computers in health care.
Eventually a person at home who has a medical care problem will be able
to talk (via voice) to a Watson-type computer system rather than
“merely” looking up information on the Web. That does not resolve the
issue of the credibility of the information source and the validity of
the information and recommendations it provides. This leads to a
question I frequently hear, “Who gets sued if something goes wrong?”
I find it interesting to ask the same question about our educational
system. It is quite clear that some children get a much better
education than others. While growing up, a child receives years of
informal and formal education at home, in the community, and at school.
On average, children growing up in poverty get a poorer informal and
formal education than those growing up in greater affluence (Moursund,
I find the average $10,000 per person per year of medical expenses
somewhat overwhelming. But, it now costs an average of more than
$11,000 per student per year for public precollege education. The U.S.,
like every nation, faces the problem of how to allocate its resources
in order to best meet the needs of its citizenry. The steadily growing
costs of medical care and education in the U.S. are cutting into the
resources available for meeting other needs of its population.
David Moursund is an Emeritus Professor of Education at the University of Oregon, and coeditor of the IAE Newsletter.
His professional career includes founding the International Society for
Technology in Education (ISTE) in 1979, serving as ISTE’s executive
officer for 19 years, and establishing ISTE’s flagship publication, Learning and Leading with Technology.
He was the major professor or co-major professor for 82 doctoral
students. He has presented hundreds of professional talks and
workshops. He has authored or coauthored more than 60 academic books
and hundreds of articles. Many of these books are available free
online. See http://iaepedia.org/David_Moursund_Books. In 2007, Moursund founded Information Age Education (IAE). IAE provides free online educational materials via its IAE-pedia, IAE Newsletter, IAE Blog, and books. See http://iaepedia.org/Main_Page#IAE_in_a_Nutshell.
We are using the Disqus commenting system to facilitate comments and
discussions pertaining to this newsletter. To use Disqus, please
click the Login link below and sign in.
If you have
questions about how to use Disqus, please refer to this help