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In 2001, when Pediatric allergist Gideon Lack asked a group of about 80 parents in Tel Aviv if their children were allergic to peanuts, only two or three hands went up. It was missing. Returning home to the UK, peanut allergy has quickly become one of the most common allergies among children. When he compared the allergy rates of Israeli children’s peanuts to the rate of Jewish children in the UK, the rate in the UK was 10 times higher. Was there anything in the Israeli environment — a healthier diet, more time in the sun — that prevented the development of peanut allergies?
He later realized that many Israeli children had started eating Bamba, a snack based on peanuts, as soon as they handled solid food. Can the initial exposure of peanuts be exposed? The idea never occurred to anyone, as it seemed to be wrong. For years, pediatricians in the UK, Canada, Australia and the United States have been telling parents not to give their children peanuts until they are 1 year old, as they believed early exposure increase risk of allergy. The American Academy of Pediatrics also included this advice in its child nutrition guidelines.
Lack and his colleagues began organizing a randomized clinical trial, which would be completed by 2015. In a study published in The New England Journal of Medicine, some children were given peanut protein in childhood, while others waited until the first year. Children in the first group had an 81 percent lower risk of peanut allergy before age 5. All past guidelines developed by expert committees may have inadvertently contributed to the slow growth of peanut allergies.
As a doctor, I found the results disturbing. Before I posted the findings, I advised a new parent that their little girl should avoid allergenic foods like peanut protein. Looking back, I couldn’t feel the guilt. And now if he had a peanut allergy?
The challenge for physicians and patients is that medical knowledge is always changing. Medical knowledge seems to be negative: “True … for now.”
Faculty of Medicine professors they sometimes jokingly say that half of what students learn will be obsolete by the time they graduate. This half is often applied to clinical practice guidelines (CPG) and has real consequences.
A CPG, usually performed by expert committees of specialized organizations, is available for diagnosing a patient for almost any ailment. While there are no instructions rules, are mentioned a lot and can be mentioned in cases of medical malpractice.
When medical knowledge changes, the guidelines change. Hormone replacement therapy consisted of gold treatment for menopausal women who are struggling with symptoms such as hot flashes and mood swings. Then, in 2013, a trial of the Women’s Health Initiative proved that therapy could be more dangerous than previously thought, and many guidelines were revised.
In addition, for many years, women over the age of 40 were asked to have mammograms every year — new data showed in 2009 that early routine examinations caused unnecessary biopsies without reducing the death of breast cancer. Regular mammograms are recommended for women over 50, especially once a year.
Medical reversals are taking place slowly after multiple studies have changed the old recommendations. Covid-19 has accelerated them, making them both more spectacular and more disturbing. Initially, it was introduced by some medical professionals as a coronavirus no worse than the flu, before describing much of its true severity. For a while, people were told not to bother with the mask, but then they were advised to try it double mask. Some countries do extending intervals between first and second vaccine doses. Of course, the state of the pandemic and the knowledge we have about it is constantly changing. However, over the last year and a half, we have been hit by doctors.
It is too early to say how these reversals will affect the way patients perceive the medical profession. On the one hand, seeing open discussions among medical experts can lead to an understanding of how people develop medical knowledge. It can also cause persistent skepticism. In 2018, researchers analyzed data from 50-year surveys on confidence in medicine. In 1966, 73 percent of Americans reported trusting “leaders in the medical profession”. By 2012 that number had dropped to 34 percent – in part because the authors invented it because there was no universal health care system.
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