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  #1  
Old 10-06-13, 05:29 AM
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Scientific Knowledge in Medicine

Scientific Knowledge in Medicine is said to double every 7 years.
I graduated as a doctor 28 years ago, so there would have been a 16 fold increase in scientific knowledge relevant to medicine.

However- health outcomes are, if anything worse, not 16 times better.

Especially in the USA.

I would love to hear a cogent explanation of this, and for the explainer to explain to me why we still need "more research".
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Old 10-06-13, 07:37 AM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by Barliman View Post
Scientific Knowledge in Medicine is said to double every 7 years.
I graduated as a doctor 28 years ago, so there would have been a 16 fold increase in scientific knowledge relevant to medicine.

However- health outcomes are, if anything worse, not 16 times better.

Especially in the USA.

I would love to hear a cogent explanation of this, and for the explainer to explain to me why we still need "more research".

Because you never know what's round the corner

It's blind, the species is on a speeding motorbike on the wrong side of the road and a HGV is coming in the opposite direction.
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Old 10-06-13, 07:40 AM
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Re: Scientific Knowledge in Medicine

In the last few years, sheer volume of data (next generation techniques) have massively increased the volume of data we can collect - I'd have suggested 000s-fold over the last few years.

But the line between raw data in medicine and knowledge is tough to call.

The last paper I located was longer than all of the papers I cited in my thesis, including supplemental data.

Mad times.
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Old 10-06-13, 08:17 AM
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Re: Scientific Knowledge in Medicine

One, new scientific knowledge is not always (often) practical or concrete enough to apply to individual cases. Knowing how a peptide functions in vitro does not actually translate into new medicine right away (if ever).

Two, whereas science generally speaks to a statistical homunculus of a person that doesn't actually existing, but does give us an idea as to how the majority of people are likely to react to a given treatment, medicine is invested in the treatment of individuals, and is therefore more interested in individual differences than your run of the mill scientist.

Following from two above, a good physician will be willing to try interventions which produce effects for individual patients that are not easily measurable using traditional scienctific methods. While anecdote is a dirty word in science in general, the case study can be used to good effect in a clinical setting,

Finally, doctors are human beings. That means while a good number will be conscientious citizens who keep apprised of the latest developments, and read and keep up with the scientific literature, some have neither the time nor inclination to do so, and therefore wind up in a rut not dissimilar from the dedicated scientist who develops tunnel vision.

As for why the US lags so far behind other nations, well I don't think I can address that part of your question and stay within guidelines.

Last edited by TygerSan; 10-06-13 at 08:30 AM..
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  #5  
Old 10-06-13, 09:09 AM
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Re: Scientific Knowledge in Medicine

Why would you say that US lags so far behind other nations. The life expectancy of an American is far better than that of many others around the world. And it's definitely not due to healthy life-style (at least not from the limited knowledge of information I have from the Internet).
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Old 10-06-13, 11:04 AM
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Re: Scientific Knowledge in Medicine

There is no way that an algorithm can accurately predict "scientific knowledge in medicine." The nature of life science is that no outcome is final or 100% predictable, because of sexual selection, evolution, and changes in immediate environment that affect fitness. It is also the nature of science that new findings tend to produce even more questions that require answers.

If you look at epigenetics, you will see the expected pattern - the new mechanism is discovered; methods for measuring and reproducing the mechanism are developed; testing shows that the discovered mechanism is not only more complex than expected, but is also not the only mechanism involved in the outcome; methods for measuring and reproducing the other mechanisms are developed; mechanisms are discovered to be even more complex than originally thought (and recursive, to boot!) and that leads to a deeper understanding of how much more there is to learn about the mechanisms.

Scientific knowledge in medicine does not lie nice and neat on a chartable curve.
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Old 10-06-13, 01:10 PM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by Barliman View Post
Scientific Knowledge in Medicine is said to double every 7 years.
I graduated as a doctor 28 years ago, so there would have been a 16 fold increase in scientific knowledge relevant to medicine.

However- health outcomes are, if anything worse, not 16 times better.

Especially in the USA.

I would love to hear a cogent explanation of this, and for the explainer to explain to me why we still need "more research".

The USA leads the way in trying (and failing) to cure disease
- whilst in the background inequality (the greatest level of inequality of any developed nation)
- *actually* fuels disease.

It's like performing an experiment into how poison kills an individual, using a method which generates and disseminates that poison into the water supply of the populace.

Accept that we cannot cure and that we can prevent
- and we'll be able to create a world without disease.

That world will be a world of equality of man.
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Old 10-06-13, 01:14 PM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by TygerSan View Post

As for why the US lags so far behind other nations, well I don't think I can address that part of your question and stay within guidelines.
Neither politics nor religion are involved

- just epidemiology.

-- highest level of inequality of any developed country

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Old 10-06-13, 01:18 PM
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Re: Scientific Knowledge in Medicine

So - as we know from Michael Marmot
- in a hierarchical system - it's the lowest level which become diseased.

So - we can be pretty sure that in more defined hierarchies (greater income inequality eg USA (relative to other so called developed nations))
- that there'll be more disease.

Simples.
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Old 10-06-13, 01:29 PM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by TygerSan View Post
One, new scientific knowledge is not always (often) practical or concrete enough to apply to individual cases. Knowing how a peptide functions in vitro does not actually translate into new medicine right away (if ever).

Two, whereas science generally speaks to a statistical homunculus of a person that doesn't actually existing, but does give us an idea as to how the majority of people are likely to react to a given treatment, medicine is invested in the treatment of individuals, and is therefore more interested in individual differences than your run of the mill scientist.

Following from two above, a good physician will be willing to try interventions which produce effects for individual patients that are not easily measurable using traditional scienctific methods. While anecdote is a dirty word in science in general, the case study can be used to good effect in a clinical setting,

Finally, doctors are human beings. That means while a good number will be conscientious citizens who keep apprised of the latest developments, and read and keep up with the scientific literature, some have neither the time nor inclination to do so, and therefore wind up in a rut not dissimilar from the dedicated scientist who develops tunnel vision.

As for why the US lags so far behind other nations, well I don't think I can address that part of your question and stay within guidelines.
What we need in medicine is something similar to LHC in physics.

Everybody who figures they're 'experts' in medicine
- to work out which experiments we actually have to do to combat disease.

And then do 'em.

Cept - we don't actually need to do any extra experiments.

The fine epidemiologist has nailed the mechanism of preventing all disease.
And the 'omicist has shown that there's no way that we're going to be able to artificially manipulate human physiology.

The magic bullet is generation of a global village in which equality of man is enforced.

The blunderbuss is everything to do with pharmaceuticals and surgery.

We are too complicated to fix - but really easy to maintain in perfect working order.

(di)Stress [from lack of free availability to the essentials of survival] -> oxidative damage -<- is all we need to understand
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Old 10-06-13, 01:43 PM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by Corina86 View Post
The life expectancy
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Old 10-06-13, 01:52 PM
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Re: Scientific Knowledge in Medicine

Don't really care about life expectancy - this is much more important:

ie healthy life years versus life expectancy
- strong correlation

- meaning lower life expectancy (See above) - also strongly correlated with disease throughout life.

http://www.oecd-ilibrary.org/social-...3896-graph5-en



ie years of healthy life versus life expectancy
- who wants to live through 75 years of pain

- from asthma/allergy/ADHD through back pain - into RA - dental bleeding covering obesity/diabetes/dementia/depression and anxiety into pain, and lots of it.

--- game over ---

You have not scored sufficiently to enter your initials on the high score table.
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Old 10-06-13, 01:54 PM
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Re: Scientific Knowledge in Medicine

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Old 10-06-13, 03:41 PM
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Re: Scientific Knowledge in Medicine

Nah! wrong graph ... ... need to find the info elsewhere ... ...
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Old 10-06-13, 03:55 PM
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Re: Scientific Knowledge in Medicine

Quote:
Originally Posted by Amtram View Post
There is no way that an algorithm can accurately predict "scientific knowledge in medicine." The nature of life science is that no outcome is final or 100% predictable, because of sexual selection, evolution, and changes in immediate environment that affect fitness. It is also the nature of science that new findings tend to produce even more questions that require answers.

If you look at epigenetics, you will see the expected pattern - the new mechanism is discovered; methods for measuring and reproducing the mechanism are developed; testing shows that the discovered mechanism is not only more complex than expected, but is also not the only mechanism involved in the outcome; methods for measuring and reproducing the other mechanisms are developed; mechanisms are discovered to be even more complex than originally thought (and recursive, to boot!) and that leads to a deeper understanding of how much more there is to learn about the mechanisms.

Scientific knowledge in medicine does not lie nice and neat on a chairtable curve.
The figure is an approximation that has been widely discussed within the profession. It will vary from year to year- but the increase has not been matched by outcomes.
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