Open Questions

Open Health Screening Program

Why It Is Open Accounts differ on the founding moment: one traces organized periodic screening to the Life Extension Institute, formed in the United States in 1913; another dates its annual-examination program to 1914; still others point to individual physicians recommending periodic examinations decades earlier. No single year is treated as canonical across sources.

What Would Settle It A history-of-medicine source that traces the specific institutional and professional-society record (AMA recommendations, insurance-industry practice, the Life Extension Institute's own founding documents) closely enough to fix a defensible first year, rather than a secondary account repeating an approximate date.

Expertise Needed History of medicine, public health history

Question posed in United States Centers for Disease Control and Prevention Official Site.

Open Sanitation

Why It Is Open Sanitation as a practice has no single point of origin. The Wikipedia article attests independent ancient sanitation systems, including the Indus Valley Civilization's Bronze Age water supply and sanitation (3300 to 1300 BCE) and ancient Rome's Cloaca Maxima sewer, built between 800 and 735 BCE, with no founding year this atlas can honestly attest as the practice's single origin.

What Would Settle It A source specifically dating the origin of organized public sanitation as a practice (rather than any one ancient water or sewer system) would resolve this, or a scholarly consensus that no single origin year can be given.

Question posed in Wikipedia: Sanitation, Lead section.

Open Isolation (Health Care)

Why It Is Open Isolating patients with contagious disease is an old hospital practice with antecedents in historic fever hospitals and lazarettos. The modern CDC categories of isolation precaution were revised repeatedly (1985 to 1988, 1987, 1996) but the source reviewed gives no single origin year for the general practice of medical isolation.

What Would Settle It A source giving the specific year the CDC or an equivalent body first codified formal patient isolation categories, or a source dating the origin of the general hospital practice of isolating contagious patients, would resolve this.

Question posed in Wikipedia: Isolation (health care), Lead section.

Open Voluntary Counseling and Testing

Why It Is Open The Wikipedia article on voluntary counseling and testing describes the practice's method but gives no year for when it began as a named HIV testing and counseling practice.

What Would Settle It A source dating when voluntary counseling and testing for HIV was first named and adopted as a distinct practice, such as an early CDC or WHO guideline, would resolve this.

Question posed in Wikipedia: Voluntary counseling and testing, Lead section.

Open Integrated Vector Management

Why It Is Open This entity's own description states integrated vector management was adopted globally by the World Health Organization in 2004, but no source reviewed in this research pass could verify that year with a verbatim quote.

What Would Settle It The WHO's own Global Strategic Framework for Integrated Vector Management document, or a secondary source quoting its publication year, would resolve this.

Question posed in Wikipedia: Disease vector, Lead section.

Open Safe Household Water Storage

Why It Is Open The Wikipedia article on safe household water storage describes the WHO-promoted Household Water Treatment and Safe Storage approach but gives no founding year for the practice or the network that promotes it.

What Would Settle It The founding year of the WHO International Network to Promote Household Water Treatment and Safe Storage, or an equivalent primary source, would resolve this.

Question posed in Wikipedia: Safe household water storage, Lead section.

Open Fecal Sludge Management

Why It Is Open The Wikipedia article on fecal sludge management notes the term septage has been used in the United States since at least 1992 and that the UN declared 2008 the Year of Sanitation, but neither date marks fecal sludge management's own origin as a named practice.

What Would Settle It A source dating when fecal sludge management was first named and adopted as a distinct sanitation practice, distinct from the general practice of onsite sanitation, would resolve this.

Question posed in Wikipedia: Fecal sludge management, Lead section.

Open Menstrual Hygiene Management

Why It Is Open The Wikipedia article on menstrual hygiene management documents the history of commercial sanitary products (Kotex in 1920, Tampax patented in 1931) but these concern products, not the origin of MHM as a named global public health and development practice.

What Would Settle It A source dating when menstrual hygiene management was first named and adopted as a distinct global public health and development practice, such as an early WASH sector report, would resolve this.

Question posed in Wikipedia: Menstrual hygiene management, Lead section.

Open Incidence

Why It Is Open Incidence is defined by every standard reference as the count of new cases of a disease or condition arising in a population over a stated period, but the Encyclopedia Britannica overview cited on this entity and the Wikipedia article on incidence (epidemiology) both give the definition with no first use, no originating publication and no individual credited with introducing the term, unlike eponymous measures on this atlas such as body mass index (Adolphe Quetelet, 1832) and herd immunity (1894).

What Would Settle It A source tracing the term incidence, in its epidemiological sense, to a specific vital-statistics or epidemiological publication and naming when it entered standard use, or a scholarly consensus that the term developed gradually with no single point of origin.

Expertise Needed History of epidemiology

Question posed in Encyclopedia Britannica, Overview article (definition given, no origin claim).

Open Prevalence

Why It Is Open Prevalence is defined by every standard reference as the proportion of a population living with a disease or condition at a given time, but the Encyclopedia Britannica overview cited on this entity and the Wikipedia article on prevalence both give the definition with no first use, no originating publication and no individual credited with introducing the term, unlike eponymous measures on this atlas such as body mass index (Adolphe Quetelet, 1832) and herd immunity (1894).

What Would Settle It A source tracing the term prevalence, in its epidemiological sense, to a specific publication and naming when it entered standard use, or a scholarly consensus that the term developed gradually with no single point of origin.

Expertise Needed History of epidemiology

Question posed in Encyclopedia Britannica, Overview article (definition given, no origin claim).

Open Case Fatality Rate

Why It Is Open The Wikipedia article on case fatality rate cited on this entity defines the measure, distinguishes it from the population mortality rate, and gives historical examples such as the 1918 influenza pandemic and rabies, but names no first use, no originating publication and no individual credited with introducing the term or the name case fatality rate.

What Would Settle It A source tracing the term case fatality rate to a specific epidemiological publication and naming when it entered standard use, or a scholarly consensus that the term developed gradually with no single point of origin.

Expertise Needed History of epidemiology

Question posed in Wikipedia: Case Fatality Rate, Lead and Terminology sections (definition given, no origin claim).

Open Attack Rate

Why It Is Open The Wikipedia article on attack rate cited on this entity defines the measure and describes its use in outbreak investigation and epidemic planning, but names no first use, no originating publication and no individual credited with introducing the term or the name attack rate.

What Would Settle It A source tracing the term attack rate to a specific epidemiological or outbreak-investigation publication and naming when it entered standard use, or a scholarly consensus that the term developed gradually with no single point of origin.

Expertise Needed History of epidemiology

Question posed in Wikipedia: Attack Rate, Lead and Usage sections (definition given, no origin claim).

Open Community-Led Total Sanitation

Why It Is Open A systematic review of 200 studies concluded the evidence base on CLTS effectiveness is still weak, with little monitoring or evaluation of impacts despite large international funders backing the approach. A 2013 study of 116 African villages declared open defecation free after CLTS found that, using broader criteria, an overall slippage rate of 92 percent had occurred, and a 2018 study found little evidence for sustained sanitation behavior change as a result of CLTS.

What Would Settle It Long-term, controlled follow-up studies tracking latrine use, sustained open-defecation-free status and health outcomes several years after a community's CLTS trigger event, rather than short-term post-triggering counts alone.

Expertise Needed Public health and development economics, through long-term randomized or controlled evaluation.

Question posed in Wikipedia: Community-led Total Sanitation, Effectiveness section / Challenges and Difficulties section.

Open Dietary Goals for the United States (McGovern Report)

Why It Is Open The committee's own contemporaries, including the American Medical Association, argued the randomized-trial evidence available at the time was not conclusive; a 2015 systematic review of that era's trials (Harcombe et al., Open Heart) found they did not support the fat-reduction guidance. The guidance nonetheless anticipated later epidemiological findings that some public health bodies still endorse in modified form, so the historical evidence question and the current guideline question are not the same question.

What Would Settle It A historical consensus among nutrition scientists and historians of science on how to weigh the era's limited randomized-trial evidence against later, larger observational and trial evidence; this atlas records the dispute rather than adjudicating it.

Expertise Needed Nutrition science, history of science

Question posed in Harcombe et al. 2015, Open Heart: RCT Evidence Behind the 1977/1983 Dietary Fat Guidelines, Zoe Harcombe, Julien S Baker, Stephen Mark Cooper, Bruce Davies, Nicholas Sculthorpe, James J DiNicolantonio, Fergal Grace.

Open Publication of The Modern Rise of Population

Why It Is Open Thomas McKeown's 1976 analysis credited the mortality decline mainly to better nutrition, with hygiene and medicine playing later, smaller roles. Demographers disputed this from the moment it was published, and historians such as Simon Szreter later argued McKeown understated public health infrastructure, including water supply, sewage systems, housing improvement and vaccination. The balance of causes remains debated rather than settled.

What Would Settle It A reanalysis of period-specific, cause-specific mortality data alongside the timing of nutrition gains, sanitation infrastructure and medical intervention, with enough precision to separate their individual contributions, something existing historical records have not settled.

Expertise Needed History of medicine and historical demography

Question posed in Wikipedia: Thomas McKeown, Wikipedia, Legacy section.

Open Caloric Balance

Why It Is Open The mainstream energy balance model treats a caloric surplus as the cause of fat gain. The carbohydrate-insulin model, argued most fully by David Ludwig and colleagues in a 2021 American Journal of Clinical Nutrition paper, proposes the reverse: that a shift in substrate partitioning toward fat storage, driven by the insulin response to dietary carbohydrate, itself creates the positive energy balance rather than following from it. Kevin Hall and other researchers have published data its authors say falsifies the carbohydrate-insulin model, proponents disagree that the tests were decisive, and systematic reviews have not found the long-term weight-loss advantage for low-carbohydrate diets the model would predict.

What Would Settle It Controlled metabolic ward studies isolating substrate partitioning and hunger signaling from calorie intake, replicated across research groups holding competing positions, with pre-registered outcome measures both camps accept in advance.

Expertise Needed Nutrition science, endocrinology

Question posed in Wikipedia: Carbohydrate-Insulin Model, Lead and Scientific debate sections.

Open Quality-Adjusted Life Year

Why It Is Open Disability-rights advocates argue the QALY's own arithmetic discriminates: a treatment that moves a person with a permanent disability from a lower baseline toward the best health realistically available to them will almost always generate fewer QALYs than the identical intervention given to someone who can reach a full 1.0 score, so a strict per-QALY funding threshold systematically ranks disabled patients' care lower regardless of how much the treatment actually helps them. Health economists who defend the measure argue any health system faces a finite budget, that QALYs are the least-bad common currency for comparing wildly different interventions on relative value for money, and that the alternative, funding decisions with no explicit metric at all, is not more fair, only less transparent about the trade-offs it is already making. Both positions appear across the literature and in real policy: the United Kingdom's National Institute for Health and Care Excellence has used a pound-p

What Would Settle It A structured comparison of health outcomes for disabled populations under strict QALY-threshold rationing against outcomes under an explicit disability-weighted or equity-adjusted alternative, paired with a settled legal and ethical consensus on whether unadjusted QALY-based allocation itself constitutes disability discrimination or merely a value-neutral budget constraint.

Expertise Needed Health Economics, Disability Studies, Bioethics

Question posed in Wikipedia: Quality-Adjusted Life Year, Debate section.