Scott's Parabola: A Cautionary Tale in Medical Innovation

Scott's parabola, named after British gynecologist J.W. Scott, describes the phenomenon in which new medical treatments, techniques, devices, or innovations are prematurely adopted into standard care, only to be abandoned after evidence of inefficacy or patient harm comes to light. After noticing this life cycle pattern in multiple medical innovations, Scott published his parabola not only to shed light on this phenomenon, but also to train physicians to recognize the cycle in their own practice. Innovations that follow Scott's parabola experience an initial "spark" characterized by early success and exaggerated anecdotal support, launching them onto the parabolic path. The treatment then undergoes a "rise" in popularity as it is hailed as a silver bullet, reaches its "vertex" when its use peaks and extends to the average consumer, and ultimately "drops" dramatically as harmful or ineffective outcomes emerge, often after many patients have already been adversely affected. Physicians and health care providers not only must be aware of this pattern but also should equip themselves with tools to avoid becoming contributors to it. Individual retrospection, critical review of clinical research, intentional patient-physician communication, and robust postmarket surveillance all play important roles in preventing the realization of Scott's parabola in the health care setting.