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Let me re-state this: 80 percent of studies that are peer-reviewed and published are (or were), it seems, so utterly useless that no one ever cites them more than once.(In a follow-up study, estimates revealed that in the field of medicine, the percentage of papers without a single citation was about 46%; in the field of arts and humanities, an estimated 98% of papers go uncited.) OK, so let’s pause for a moment and regroup. The above observations lead to the inevitable conclusion that most (by volume) of the published work on Pub Med is barely fit to line the bottom of a bird cage.I mostly wrote about nutrition, but soon my interest in slightly more esoteric topics—such as lipidology—influenced what I wrote about.Over the last few years competition for my time and energy have resulted in blogging being at the bottom of the priority list, somewhere just above watching reality TV (which I don’t watch) and just below rec league bocce ball (which I don’t play).First, when I read/hear “thought leaders” (who shall remain nameless) claim to read all of the literature out there, I have to call BS. (For the reader who gets all verklempt hearing that most published research is nonsense, it might be helpful to read this article on the chicanery in the modern scientific publishing world.) It’s not lost on us that a heavily cited paper can be worse than useless and a thinly-cited one can be invaluable.A keen eye and good mental models can only get one so far.

One of the great joys of practicing medicine is the frequency with which a patient asks you a question you don’t know the answer to. If one is only willing to exercise 3 times per week, what should the workouts look like?My “work” obligations, even with the huge reduction I deliberately made in exercise time, made it too difficult for me to keep up. Today, my practice employs a team of research analysts who are not just exceptionally bright and voracious consumers of literature, but also people who are so naturally curious (arguably the one skill I can’t really teach) that when you give them a problem, it’s just a matter of time until our collective knowledge on the topic will be increased.The list of “To read” papers on my desktop was becoming an eyesore. Over the past year the volume of reports we’ve created—both in response to patient questions and our more elaborate proactive research agenda—has been impressive, though largely underused. We’ve even created an internal helpdesk to moderate, organize, prioritize, and keep track of our work.Every week I get asked, at least a dozen times, some variant of the following question: “Peter, I live in So-and-so and I really wish I could find a doctor who understands X, Y, Z. ” I usually don’t have an answer for them but I’m convinced there is a way to play for like-minded doctors and patients to find each other.When over 3,000 articles are published daily on Pub Med, and when the vast majority of the subsequent reporting on those articles appears dubious (at best), it pains me to even think of computing the signal-to-noise ratio people face when they want the straight dope on any given subject relating to their health.

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