An "emerging" problem

Notably not good:

The increase in resistance of human pathogens to antimicrobial agents is one of the best-documented examples of evolution in action at the present time, and because it has direct life-and-death consequences, it provides the strongest rationale for teaching evolutionary biology as a rigorous science in high school biology curricula, universities, and medical schools. In spite of the importance of antimicrobial resistance, we show that the actual word "evolution" is rarely used in the papers describing this research. Instead, antimicrobial resistance is said to "emerge," "arise," or "spread" rather than "evolve." Moreover, we show that the failure to use the word "evolution" by the scientific community may have a direct impact on the public perception of the importance of evolutionary biology in our everyday lives.

This is the first paragraph of a study by Janis Antonovics and colleagues, who surveyed the use of "evolution" and other related descriptors (like "adaptation" and "selection") in biomedical papers related to microbial resistance. The evolution of drug resistance in microbes is one of the most important examples of evolution as applied to human lives -- aside from domestication, pathogens probably have the largest economic, medical, and practical impact of any evolving biological system. For this reason, one might expect that the importance of the unifying theory of biology should be rightly emphasized.

Here's why it is important:

A critical question is whether avoidance of the word "evolution" has had an impact on the public perception of science. To investigate this, we examined whether the use of the term "evolution" in the scientific literature affects the use of this word in the popular press, i.e., whether there is evidence for "cultural inheritance" of word use. We searched articles on antimicrobial resistance in national media outlets, such as The New York Times, The Washington Post, Fox News, and the BBC (Text S1). Our results showed that the proportion of times the word "evolution" was used in a popular article was highly correlated with how often it was used in the original scientific paper to which the popular article referred (Figure 2). This clearly shows that the public is more likely to be exposed to the idea of evolution and its real-world consequences if the word "evolution" is also being used in the technical literature.

In other words, if you use the word "evolution" in your article, the press will use the word "evolution" when they describe it.

The main concern raised in the article is that biomedical research doesn't tend to use the term "evolution" when studying the evolution of microbial resistance. That's an important concern to raise, which I think is readily explained by the fact that a small minority of biomedical researchers actually have any non-microbial experience in evolutionary biology.

This problem was also raised by Randy Nesse, Stephen Stearns and Gilbert Omenn in an editorial in Science last year:

Although anatomy, physiology, biochemistry, and embryology are recognized as basic sciences for medicine, evolutionary biology is not. Future clinicians are generally not taught evolutionary explanations for why our bodies are vulnerable to certain kinds of failure. The narrowness of the birth canal, the existence of wisdom teeth, and the persistence of genes that cause bipolar disease and senescence all have their origins in our evolutionary history. In a whole array of clinical and basic science challenges, evolutionary biology is turning out to be crucial. For example, the evolution of antibiotic resistance is widely recognized, but few appreciate how competition among bacteria has shaped chemical weapons and resistance factors in an arms race that has been going on for hundreds of millions of years. The incorrect idea that selection reliably shapes a happy coexistence of hosts and pathogens persists, despite evidence for the evolution of increased virulence when disease transmission occurs through vectors such as insects, needles, or clinicians' hands. There is growing recognition that cough, fever, and diarrhea are useful responses shaped by natural selection, but knowing when is it safe to block them will require studies grounded in an understanding of how selection shaped the systems that regulate such defenses and the compromises that had to be struck (Nesse et al. 2006:1071).

I think these little warnings are valuable, but I have a more positive outlook. For one thing, I know how many doctors and clinicians are reading this site regularly, finding out about new evolutionary insights on human history and health. Also, I see a much greater awareness in my courses of aspects of human variability that relate to diet and health, like lactase persistence variation.

Antonovics and colleagues' data also presents a hopeful trend: the proportion and research reports and grants that mention "evolution" has been increasing for the last dozen years. Part of this trend may be a growing ability to assess evolution with molecular markers, and the sheer proliferation of resistant microbes as a medical problem. The proliferation of resistant microbes is best combated with methods that recognize their evolution.

References:

Antonovics J, Abbate JL, Baker CH, Daley D, Hood ME, et al. 2007. Evolution by Any Other Name: Antibiotic Resistance and Avoidance of the E-Word. PLoS Biol 5(2): e30. doi:10.1371/journal.pbio.0050030

Nesse RM, Stearns SC, Omenn GS. 2006. Medicine needs evolution. Science 311:1071. doi:10.1126/science.1125956