Wonder If: Our Patients Would Benefit From Disruptive Scientific Thinking

February 11, 2023




Brief Guide to the Post:

–  Black text in box = words from other authors
–  (Green bold text in parenthesis in box = our words)

Link to full Guide to Wonderments blog

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Our  Patients  Would  Benefit  From Disruptive  Scientific  Thinking  About  Precision  Ketogenic  Therapy?

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A century ago, medical papers were published describing the use of a ketogenic diet to reduce seizures. As more and more antiseizure medications became available, use of the ketogenic diet therapy for seizures decreased. In the 1990’s use of the ketogenic diet experienced a resurgence.  Today it is clear that some patients who do not respond adequately to other treatments experience improved seizure control with ketogenic therapy.  Yet details of the therapy vary widely from Keto center to Keto center.  Reading the following paper published in Nature on January 3, 2023, inspired several wonderments.

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Papers and patents are becoming less disruptive over time. 

M. Park, E. Leahey and R. J. Funk 

Nature 2023 Vol. 613 Issue 7942 Pages 138-144 

Accession Number: 36600070 DOI: 10.1038/s41586-022-05543-x 


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The paper summarizes our current understanding of how science moves forward:

Theories of scientific and technological change:

    • discovery and invention = endogenous processes
    • previous accumulated knowledge = future progress by allowing researchers to, in Newton’s words, ‘stand on the shoulders of giants’ (confirm or somewhat extend previous ways of thinking)
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What has been happening in science:

Recent decades have witnessed exponential growth in the volume of new scientific and technological knowledge, thereby creating conditions that should be ripe for major advances.

Yet contrary to this view, studies suggest that progress is slowing in several major fields

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What the authors did:

Here, we analyse these claims at scale across six decades, using data on 45 million papers and 3.9 million patents from six large-scale datasets, together with a new quantitative metric—the CD index12—that characterizes how papers and patents change networks of citations in science and technology.

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What the authors say they found:

We find that papers and patents are increasingly less likely to break with the past in ways that push science and technology in new directions. 

    • This pattern holds universally across fields and is robust across multiple different citation- and text-based metrics.
    • Subsequently, we link this decline in disruptiveness to a narrowing in the use of previous knowledge, allowing us to reconcile the patterns we observe with the ‘shoulders of giants’ view. We find that the observed declines are unlikely to be driven by changes in the quality of published science, citation practices or field-specific factors. 

Overall, our results suggest that slowing rates of disruption may reflect a fundamental shift in the nature of science and technology. (yikes!!!) 

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  • Wonder if we read more broadly and listened to more perspectives, our disruptive thinking about Precision Ketogenic Therapy would break with the past in ways that push science and technology in new directions.
  • Wonder if we focused on more precisely defining every detail of how Keto therapy is administered and more precisely monitored the effect of the therapy on each patient, our patients would benefit more from the therapy?
  • Wonder if we applied today’s principles of precision medicine to the decades old therapy, we could provide Precision Ketogenic Therapy (PKT) to our patients that would improve their lives with PKT provided in the right way, to the right person, at the right time?
Post by Paige Applegate