The Normailzation Heuristic: how an untested hypothesis may misguide medical decisions

Here is an article that may be of interest written by two perspicacious young fellows:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN2-4VP175C-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0067dfb6094ecc27303ccd6939257200


In this article, we describe how the general clinical hypothesis that "normalizing" abnormal laboratory values and physiological parameters will improve patient outcomes is unreliably accurate, and use historical examples of practices such as hormone replacement therapy, and the CAST trial to buttress this argument. We further suggest that many ongoing practices that rely on normalizing values should be called into question because the normalization hypothesis is a fragile one. We also operationally define the "normalization heuristic" and define four general ways in which it can fail clinical decision makers. Lastly, we make suggestions for empirical testing of existence of this heuristic and caution clinicians and medical educators to be wary of reliance on the normalization hypothesis and the normalization heuristic. This paper is an expansion of the idea of the normalization heuristic that was mentioned previously on this blog.