Course excerpt from Preventing Medical Errors in Nutrition & Dietetics

Fortunately, patients as well as professionals are increasingly holding clinicians responsible for the evidence base that supports their practice. This serves to intensify the requirement that professionals keep themselves up-to-date on treatments that are being offered, both those that are supported by scientific evidence and those that are not. In an article published in the American Journal of Speech-Language Pathology, Finn et al. (2005) offer a tutorial describing 10 criteria that may help clinicians distinguish between scientific and pseudoscientific treatment claims and is applicable to most health care professions.

Pseudoscience refers to claims that appear to be based on the scientific method but are not. The ten criteria for distinguishing between scientific and pseudoscientific treatment claims are:

1. Untestable: Is the treatment unable to be tested or disproved?
2. Unchanged: Does the treatment approach remain unchanged even in the face of contradictory evidence?
3. Confirming Evidence: Is the rationale for the treatment approach based only on confirming evidence, with disconfirming evidence ignored or minimized?
4. Anecdotal Evidence: Does the evidence in support of the treatment rely on personal experience and anecdotal accounts?
5. Inadequate Evidence: Are the treatment claims incommensurate with the level of evidence needed to support those claims?
6. Avoiding Peer Review: Are treatment claims unsupported by evidence that has undergone critical scrutiny?
7. Disconnected: Is the treatment approach disconnected from well-established scientific models or paradigms?
8. New Terms: Is the treatment described by terms that appear to be scientific but upon further examination are found not to be scientific at all?
9. Grandiose Outcomes: Is the treatment approach based on grandiose claims or poorly specified outcomes?
10. Holistic: Is the treatment claimed to make sense only within a vaguely described holistic framework?

Finn et al. (2005) emphasize that it is possible for clinicians to determine the validity of a new treatment claim and to understand the arguments about a controversial treatment. They must:

• First, be skeptical of success rate claims that are not supported by acceptable levels of scientific research or evidence. If a treatment is, in fact, ineffective, there is a cost to both the clients who did not benefit and to the professional (and profession) whose image may be tarnished.
• Second, resist adopting any treatment approach that is presented first to the public, rather than through established scientific channels. Bypassing scientific scrutiny is a serious issue because the media rarely raise the kinds of critical questions that scientists are trained to ask.
• Third, be wary about trusting their clinical experience as the sole basis for determining the validity of a treatment claim. Experience is a teacher. Neither clinical experience nor client report, however, serves as adequate protection against errors of bias and judgment.
• Fourth, keep in mind their responsibilities to clients, other professionals, and the public. It is each professional’s responsibility to determine whether a treatment claim is pseudoscientific and therefore should not serve as the basis for clinical practice, or scientific and therefore should serve as a basis for a well-supported clinical practice.

Preventing Medical Errors in Nutrition & Dietetics is a 2-hour online continuing education (CE/CEU) course that addresses the impact of medical errors in the practice of nutrition and dietetics offered by Professional Development Resources, a CPE Accredited Provider with the Commission on Dietetic Registration (CDR #PR001) and a provider with the Florida Council of Dietetics and Nutrition (#50-1635).