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Reinventing Clinical Decision Support: Data Analytics, Artificial Intelligence, and Diagnostic Reasoning

Book by Paul Cerrato · 3 quotes · Clinical Decision Support, Precision Medicine, Cartesian Thinking

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Reinventing Clinical Decision Support: Data Analytics, Artificial Intelligence, and Diagnostic Reasoning Quotes

“The US National Institutes of Health states: "There is a lot of overlap between the terms 'precision medicine' and 'personalized medicine.' According to the National Research Council, 'personalized medicine' is an older term with a meaning similar to 'precision medicine.' However, there was concern that the word 'personalized' could be misinterpreted to imply that treatments and preventions are being developed uniquely for each individual; in precision medicine, the focus is on identifying which approaches will be effective for which patients based on genetic, environmental, and lifestyle factors.”

“Although these digital tools can improve the diagnostic process and offer clinicians a variety of state-of-the-art treatment options, most are based on a reductionist approach to health and disease. This paradigm takes a divide-and-conquer approach to medicine, "rooted in the assumption that complex problems are solvable by dividing them into smaller, simpler, and thus more tractable units." Although this methodology has led to important insights and practical implications in healthcare, it does have its limitations. Reductionist thinking has led researchers and clinicians to search for one or two primary causes of each disease and design therapies that address those causes.... The limitation of this type of reasoning becomes obvious when one examines the impact of each of these diseases. There are many individuals who are exposed to HIV who do not develop the infection, many patients have blood glucose levels outside the normal range who never develop signs and symptoms of diabetes, and many patients with low thyroxine levels do not develop clinical hypothyroidism. These "anomalies" imply that there are cofactors involved in all these conditions, which when combined with the primary cause or causes bring about the clinical onset. Detecting these contributing factors requires the reductionist approach to be complemented by a systems biology approach, which assumes there are many interacting causes to each disease.”

“Since the 19th century, medicine has focused on specific disease states by linking collections of signs and symptoms to single organs.... Systems biology and its offspring, sometimes called Network Medicine, takes a more wholistic approach, looking at all the diverse genetic, metabolic, and environmental factors that contribute to clinical disease. Equally important, it looks at the preclinical manifestations of pathology. The current focus of medicine is much like the focus that an auto mechanic takes to repair a car. The diagnostic process isolates a broken part and repairs or replaces it.... Although this strategy has saved countless lives and reduced pain and suffering, it nevertheless treats the disease and not the patient, with all their unique habits, lifestyle mistakes, environmental exposures, psychosocial interactions, and genetic predispositions.”