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An Unwitting Proponent of Evidence Based Medicine
[By Dr. David Edward Marcinko; MBA, CMP™]
It is with some sadness that I leaned of the recent death of Donald F. Gleason MD, the Minnesota pathologist who developed the Gleason Scale for characterizing cancerous growths of the prostate gland. Of course, many of us recall first memorizing the stages of his classification scheme which is now used to predict the likely outcome of prostate cancer; in medical school.
The Gleason Scale
Lower scores are associated with small, closely packed glands. Cells spread out and lose glandular architecture as score increases [1 = well differentiated to 5 = poorly differentiated.
An Early Slow Movement
Unfortunately, like most quality advancements in medicine, the Gleason Scale was slow to catch on. But, in 1987, seven of the leading authorities in urology and oncology sent a letter to the Journal of Urology urging that it be applied uniformly in all publications on prostate cancer. Their recommendation was adopted and the scale quickly came into wide use. Today, four decades after establishment, the Gleason Score remains the “gold standard.”
Assessment
This adoption delay provides some unexpected insight into yet another instance of an agonizingly slow spread of evidence-based medicine [EBM, evidence-based dentistry [EBD] and evidence-based podiatry [EBP] etc, which still occurs. It unavoidably raises the question about the dissemination and diffusion of healthcare innovation today.
Conclusion
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Filed under: "Doctors Only", Alerts Sign-Up, Breaking News, Ethics, Quality Initiatives, Research & Development | Tagged: david marcinko, Donald Gleason, evidence based dentistry, evidence based medicine, evidence based podiatry, health 2.0, medical quality improvement, prostate cancer, urology | 2 Comments »
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