The perspective that a body of knowledge is settled or broadly considered to be proven, is not exclusive to a particular science, but occurs widely. As described in the January 2023 issue of the journal Medical Care, health services research is not immune to this phenomenon. Thomas Kuhn warned in The Structure of Scientific Revolution, that in what he referred to as normal science, it is the current paradigms that hold substantial sway over scientific disciplines. These paradigms provide the structure by which scientists go about finding out new knowledge to fill in the accepted framework of understanding. Evidence consistent with the paradigm is accepted as verification that the theory or paradigm is correct while anything contrary is questioned as to its authenticity. Thus, current paradigms of normal science may persist in the face of accumulating anomalies until it is not possible to dismiss or otherwise explain them away.
A paper in the December 2022 issue of the journal Neurology indicates that disease terminology should convey an accurate and understandable picture, ideally with corresponding prognostic, therapeutic, and pathophysiologic utility. Optic neuritis refers to an inflammatory optic nerve process related to multiple sclerosis or other identifiable autoimmune diseases of the CNS. Recently, salient clinical features distinguishing optic neuritis have been identified, highlighting the need for diagnostic precision superseding crude binary classifications of "typical" vs "atypical" optic neuritis. The authors propose elimination of the term "atypical optic neuritis" since the "itis" modifier is often erroneous and the term may instill a false sense of diagnostic security in the clinician, implying a more definitive diagnosis and resulting in therapeutic delays or administration of therapies with deleterious effects. Considered more broadly, current inconsistencies in terminology act as barriers to research and development of the good practices required for effective provision of rehabilitation and assistive technology (AT). According to Issue 8 in 2022 of the journal Disability and Rehabilitation: Assistive Technology, information exchange among all participants in the AT value chain can only become interoperable when terminology standards for concepts, terms, and definitions are established and used. The development of more precise terminology in health care should be instrumental in producing more settled rather less settled science.