Rodolfo J. Stusser, MD
Clinical Research Center, Havana, Cuba.
Since the 18-century, some medical scientists have been looking for unifying principles to make experimental and clinical medicine a unified science, encouraged by the model of the Newtonian physics.
In the 20-century, the unifying principles of informatics were discovered making the development of personal computers and of Internet possible. However, few investigations seeking the unifying principles of medical and health sciences were made, to assist in the hypothesis formulation beside empirical data.
An important breakthrough on discovery support systems, has been the Arrowsmith (Swanson & Smalheiser, 1994-5). It helps to evoke (and assess) novel scientific hypotheses, using the structure of relationships in the cross-speciality knowledge of Medline Internet database (and others).
Arrowsmith is an experimental set of interactive software and database search strategies by Internet, to which anyone can gain access to perceive implicit relationships and connections that may never have been made explicit in a published form. This brilliant idea of the 19-century was recaptured in a non-automated form in 1986.
It extends the power of PubMed (1966-1999-) conventional searches, based on the premise that results developed in one area of research can be of value in another without anyone being aware of the fact. It could also be used with Biosis, Embase, or Scisearch Internet databases. Arrowsmith unites the findings across specialities, from words and phrases of the titles of the PubMed records (10 million), helping the investigator to make a heuristic selection from lists of unknown interactions (B) and afterwards of causes (A), starting from a given effect (C). The output list C of a PubMed conventional search of the effect, is the Arrowsmith input. It is generally a disease or process not-well known. By probabilistic correlation and reduction through the lists B and A, the system should produce as output a new hypothetical factor of risk or protection, drug or health measure.
The target-search strategies use the categories or subheadings of Medline, allowing the finding of the new cause, cure or preventive measure. For instance: exogenous factors as deficiency states, dietary factors, poisons, toxicity, drugs; or intrinsic factors as the genetic one. Besides the etio-pathogenic, therapeutic and preventive approaches, other applications of Arrowsmith include: anticipating adverse drug reactions, identifying mechanisms by which agents modulate cellular or organismal responses, and identifying potential animal models for human conditions.
Although Arrowsmith uses a robust mathematical logic method, its present target-search strategies are still guided by empirical and simple concepts developed only with classification aims, from laboratory and clinical medicine sciences, as well as from public health sciences. Another problem is that these target-search strategies in use represent, each one in itself, above all, previous "hypotheses" about such categories of "hypothetical" risk or protective factors, treatments, or preventive measures, which should be found for the disease under investigation.
In addition, it is not clear yet, if all the types of causes, cures or preventive measures, necessarily can be subsumed under a more general search strategy. These problems have been stated by Arrowsmith's authors Swanson & Smalheiser. Finally, so far these specific search strategies only allow the discovery of hypothetical causal correlation of the bivariate type.
The Arrowsmith’s target-search strategies could be improved, if the unifying principles of the sciences of laboratory and clinical medicine, and of public health, could be found. With them the discovery of multivariate hypotheses, including acquired and inherited elements, within a more general search strategy, would be possible.
To search for the unifying principles of the sciences of medicine and health, which will strengthen the semantics and syntax of the Arrowsmith's target-search strategies.
The research will have two main phases and methods.
Phase I. The Achievement of the Principles. Crucial fragmented information of multiple specialties will be obtained through Internet facilities and synthesized by multinational cross-disciplinary teams of experts. An axiomatic-like research strategy will be used to obtain the unifying principles articulated within a general theory, by integrating clinical, laboratory, and health theories, through an unconventional induction.
Phase 2. The Improvement of the Strategies. The unifying principles, partial theories, and data, using non-orthodox ways of deductive-inductive inference will allow the structuring of more integral hypotheses. They will guide a better selection of the categories to use in the target-search strategies, to discover multivariate hypotheses, with a more general search strategy, using artificial intelligence tools.
The main unifying principles of the medical and health sciences, and the improvement of Arrowsmith's target-search strategies of new hypotheses, are expected to be obtained. They will allow an increase in their medical specificity, rationality and strength, and in the output by the system of multivariate hypothesis with acquired, genetic and other elements, within a more general-search strategy.
Arrowsmith could also work in the future in a more open frame, broadening all the current PubMed titles with ad hoc and post hoc abstracts of at least 100 words, as well as extending the database from 1965 to 1900 or even until 1800; completing one or two centuries of partial scientific ideas and results of medical and health sciences. It could also have the possibility in the future, to work with fragments of the discussions of the papers electronically published by the Project E-biomed Internet database (Varmus, Lipman, Brown, et al, 1999).
A main Kantian thesis, used in the physical sciences for three centuries, attempted the reconciliation of rationalism and empiricism in the methodology of science, saying that: while knowledge itself comes from experience, the mind uses reason to structure knowledge. If this thesis is true for all the sciences, then this project will achieve the improvement of Arrowsmith, once the unifying principles of laboratory, clinical and health sciences have been found.
REFERENCES.
-Brown J. The Elements of Medicine. Translation of the Elementa Medicine Brunonis, by the Author of the Original Work. The Sixth Edition. Fair Haven, Printed by James Lyon, Voltaire's Head, M,DCC,NCVII.
-Smalheiser NR, Swanson DR. Using Arrowsmith: a computer-assisted approach to formulating and assessing scientific hypotheses. Comp. Meth. Prog. Biomed. 1998;57:149-153.
-Stüsser RJ. Emergentist research strategy to formulate unifying principles, and medical and health integral hypotheses, to complement the reductionist research program. Persp. Biol. Med. (Under review)
-Swanson DR, Smalheiser NR. An interactive system for finding complementary literatures: a stimulus to scientific discovery. Artif. Intell. Med. 1997;9:183-203.
-Swanson DR. Intervening in the life cycles of scientific knowledge. Libr. Trends 1993;41:606-631.
-Swanson DR."Complementary Structures in Disjoint Science Literatures". In: Bookstein A, Chiaramella Y, Salton G, Raghavan VV, editors. SIGIR 91: Proceedings of the 14th Annual International ACM/SIGIR Conference on Research and Development in Information Retrieval, Chicago. New York: ACM Press, 1991:280-289.E-mails:
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