Knowledge-system theory in society: Charting the growth of knowledge-system models over a decade, 1994–2003

The second half of the twentieth century saw the emergence of three knowledge-system models: Mode 2 knowledge production, the Triple Helix, and Post-Normal Science (PNS). Today, this emphasis on knowledge use is the focus of such important health movements as evidence-based medicine. Building on the methodological work of Shinn (2002) and the theoretical work of Holzner and Marx (1979), we conducted a bibliometric study of the extent to which the three knowledge-system models are used by researchers to frame problems of health-knowledge use. By doing so, we reveal how these models fit into a larger knowledge system of health and evidence-based decision making. The study results show clearly that although these knowledge models are extremely popular for contextualizing research, there is a distinct lack of emphasis on use of the models in knowledge utilization or evidence-based medicine. We recommend using these models for further research in three specific dimensions of health systems analysis: (a) differences in language use, (b) transformative thinking about health-knowledge functions, and (c) ethical analysis of institutional linkages.