Mathematic, Computer and Internet Solution to an Integration-Differentiation Problem of General Health Scientific Programs.  Intuitive & Qualitative Approach.

 

(First preliminary draft 11/10/00: Sixth version 02/07/01)

 

Rodolfo J. Stusser, MD

Clinical Biostatistics & Epidemiology Unit

Clinical Research Centre, 34 # 4501 / 45-47, Playa, Havana, 11300, Cuba.

[Associated to the  Plaza Community Polyclinic, Havana]

[email protected]

 

Abstract               

 

All sciences progress through differentiation-integration scientific programs. In any health scientific research of any program the data matrix of each research responds to a matrix of ideas. Both matrixes could be handled with the calculus of matrixes or other quantitative and/or qualitative mathematical tool. Eleven-million scientific abstracts of facts and hypotheses in the PubMed Internet database, are being searched by the support software qualitative system “ArrowSmith” of Swanson & Smalheiser of the University of Chicago, Ill, to discover new implicit, but unknown scientific hypotheses. The backward enlargement of the PubMed database from the year 1965 and its enrichment with other databases, could achieve about fifteen-million abstracts. The E-Biomed Project of the NIH, 1999, will allow the use through new Internet databases of the papers with the whole results. The present project has the aim to find a mathematical solution and software to the core scientific problem of the Integration Science Program for General Medicine, Nursing, Technology & Public Health. It has been firstly designed with 11 non-mathematical research & research training projects, to seek new integral hypotheses and principles.   

 

Antecedents

 

In the Viet Nam War, huge amounts of data were mathematically processed for the USAF (US Air Force), through mainframe computers to increase the exactitude and precision in the bombing of targets. The data matrix theory and algebraic calculus of matrices gave the algorithm for such success (1). [Personal communication of Spanish Antonio Gonzalez, leading lecturer in mathematics and statistics in the Havana University, National Centre for Scientific Research, 1968-75]

 

In 1977, I finished in our Institute for Health Development, the equivalent to a master in biostatistics thesis, on "Structure of Mortality Rates in Areas of an Oriental Region", using multi-factorial analysis with computerized calculus of correlation matrices (2). [Guided by the Mexican Thalia Harmony, leading researcher in neurophysiology and neurosciences in Havana University, National Centre for Scientific Research, 1969-77]

 

In the meanwhile, working in medical statistics in our Institute for Oncology & Radiobiology, I went in depth and understood the balanced rationalist-empiricist view of scientific research by the outstanding Argentinean Mario Bunge, physicist and world leading logician of science (3). [Guided by Cuban Ramon Ventoso, leading lecturer in physics and in logic of science, in Havana University, National Centre for Scientific Research, 1968-76]

 

In 1987, I finished in the latter institute, the equivalent to a Ph.D. thesis on "Unified Research-Control Forecast for the Cancer Problem in Cuba 1985-2000", using a new integrative approach for that times, using cancer statistics linear & non-linear forecasts to prioritise cancer research, prevention, control, and education. [Guided by Cuban Fidel Ilizastigui, Ernesto de la Torre, Zoilo Marinello, leading physicians in health education and research in Havana University, National Institutes of Health 1975-2001]

 

Problem

 

In the last 25 years, with the increasing use of computerized database systems ordering the research variables and subjects in data matrices, and analysing them with bi-variate and multivariate methods by means of the calculus of matrices, the core of the scientific & statistical design and analysis of biomedical & sociohealth research began to be seen operationally determined by a data matrix (4).

 

Moreover, it could be conceived that in health research design there is at least interaction of two matrices. A visible data matrix belonging consciously or not to a generally invisible but real matrix of ideas, which determines in the last instance the nature of the collection of variables and samples of subjects selected, and the possibilities of their statistical analyses. This mathematical picture deduced from the rationalist-empiricist nature of the scientific hypothesis, is according to this new approach the real heart of scientific research in the medical & health sciences (3).

 

In the 90s, organising and doing research the first five years in the staff of our pointer Plaza Community Polyclinic, and the last five years associated to it, I was very stimulated by the complex nature of the correlation between the scientific objects and hypotheses of the Primary Health Care specialities & generalities, to develop a series of methodological projects on "general medical principles & unified medical theory",  "necessary new research spaces for general & family medicine", and "unified approach to medical & public health scientific methodologies for introductory research training" since 1994.

 

The outstanding Hungarian emigrant Imre Lakatos, mathematician and world-leading logician of science, in the London School of Economy, UK, synthesized the theories about the progress of science behind him through the theory of the “succession of scientific programs” (5). Integrating this Lakatos' theory, with the differentiation & integration tendencies that appear in the progress of science stated by the outstanding Russian Bonifati Kedrov, leading world logician of science too (6), it could be understood better the development of health sciences.

 

In the last seven years, working in a nuclear medicine Clinical Research Centre, I restarted doing research in one of the most advanced high-technology transitional sciences of the moment in medicine: "clinical trials of monoclonal antibodies radio-labelled for radio-immuno-diagnosis & radiotherapy of some specific cancer sites", within other studies on diseases as coronary artery disease.

 

However, I continued designing "a unified approach to medical & public health scientific methodologies", "toward a better interrelation in scientific & statistical hypotheses formation", "health research policy and system research", "improvement of a known support system of discovery using Internet databases", and "human global social basic medical & health research projects to integrate with the human genome project".

 

This eleventh research project, was finished for the International Conference in Health Research for Development in Bangkok, October 2000, sponsored by the WHO, COHRED, GFHR, and World Bank. It was the last medical & non-mathematical research project of my "Integration Science Program for General Medicine, Nursing, Technology & Public Health", which can be found in: http://www.fortunecity.com/skyscraper/systems/1000/

 

Unfortunately, qualitative research in medicine, technology & public health have not been well seen since the jolt of the forties --when it was definitively accepted the statistical design & analysis in medical & health research. In nursing, it is more accepted. The utmost rejection is evidenced when qualitative research is used to solve general methodological problems of science. This has been manifested in the obstacles I have found, to publish the projects as are published the designs & rationales of population and clinical trials, and to obtain funds from international research agencies & foundations.

 

However, without this crucial conceptual obstacle, maybe I would not have conceived this preliminary, intuitive, and still qualitative mathematical, computer and Internet solution to the integration science program. 

 

Solution

 

In the last 20 years, took off the transcendental Internet information & high-technology communication system with its powerful HTML language, with many possibilities not used yet. The development of the huge Medline database in the US National Library of Medicine in Bethesda, Md, stimulated the outstanding American Don R. Swanson, leading scientific informatician of the University of Chicago in 1985, to create a research heuristic method using scientific results of abstracts as the scientific material object of inquiry (7).

 

Swanson together with the outstanding American psychiatrist Neil R. Smalheiser's in 1995, implemented a support system software in Unix named “ArrowSmith” to discover new implicit, but unknown scientific hypothesis in the Medline database, and other scientific databases in Internet (8).

 

The initial E-Biomed Project posted in Internet early in 1999 by the outstanding Harold Varmus, leading biomedical researcher, then still Director of the National Institutes of Health at Bethesda, together with Lipman, Brown, Kafatos, Gannon, Fauci, and others, stated the brilliant aim to post in Internet databases through a special system in the National Library of Medicine, all the referred and even non referred complete scientific papers in the 21-century. This historical utmost E-Biomed Project with the already existence of the ArrowSmith discovery system, originated some comments that I emailed to Varmus' office. 

 

One of the comments, out of some global scientific integration matters, was a proposal to Varmus on July 5, 1999, to include in the E-Biomed initiative, an enlargement of the extent of PubMed Internet data base. This could consist, in the one hand, in the inclusion in a transversal version the 1965-1999 review articles in full text. In the other hand, it could be in a longitudinal version embodying 100-150 or more words English abstracts of the papers published in Journals (including editorials) and books (using forewords) of the world until the 19 and even 18 century, to increase the ArrowSmith potency.  

 

Method 

 

With the above realities and prospects for the research of the world main scientific results as scientific material of a new type of systematic research in this Information Era, the logical hypothesis here is to integrate qualitatively some elements of the "differential and integral calculus" of Newton and Leibniz, into the framework of the "hyperspaces" of Riemann n-dimension geometry and Einstein space-temporal development, with an structural and functional "calculus of matrices", using the "hyperlinks" that gives the HTML language of Internet, with powerful computers, and high-tech. communications, in a new generation of support research system of discovery to solve:

 

1.         The inductive-like integration of the several results and principles of all the main differentiation programs in a few general medical, nursing, technological, and sanitarian integral principles of their interrelation in a axiomatic-like unified system for non-mathematical sciences,

2.         The deductive-like differentiation of hypothetical results from the general and integral principles of interrelation to new differentiation and integration programs,

3.         The inductive-like integration of the results of the biological and social differentiation programs of the human individual and family, for the general and family medicine, nursing, and technology.

4.         The inductive-like integration of the results of the latter results, including the human community and population, for the general public health,

5.         The inductive-like integration of the two latter results, including country and region of countries, for the global medicine, nursing, technology, and public health,

6.         The deductive-like differentiation of hypothetical results from the more general integral principles discovered in the latter integrations for new differentiation and integration programs,

 

Finally, the operation of the integration of the mixed matrices of data & ideas in the Internet bases of abstracts, to obtain general and special knowledge, will say the last word.

 

Expected Results

 

These new developments could begin to be in this 21-century the so desired high-technological substratum for the high-level scientific training and research of the general physician, nurse, technologist, and sanitarian researchers, and for a parallel and even more convergent progress of the general medical, nursing, technological & public health sciences in very complex integration problems stated for them, but not even began to be solved in the 20-century yet.

 

Feasibility

 

Nevertheless, to be able to start this research, it would need a great international collaboration with high-technology communications, multi-disciplinary teams of very open physicians, nurses, technologists, sanitarians, natural and social scientists, logicians, mathematicians, computer scientists, and Internet scientists, and a very open scientific infrastructure and environment similar as the one that has the Santa Fe Institute, in New Mexico, USA.

 

References

 

1.      Defares JG, Sneddon IN. An Introduction to The Mathematics of Medicine and Biology. Havana: Science and Technique, 1964.

2.      Morrison D. Multivariate Statistical Methods. II ed. New York: Mc Grow-Hill Books, 1976.

3.      Bunge M. Scientific Research. Strategy and Philosophy. Havana, Science and Technique, 1969.

4.      Samaja J. Conference in Scientific Methodology. Workshop of Latin American PAHO/WHO Experts, Havana, 1989.

5.      Lakatos I. Falsification and the methodology of scientific research programmes. In Criticism and the Growth of Knowledge, edited by I. Lakatos, and A. Musgrave. Cambridge: Cambridge University Press, 1974.

6.      Kedrov BM. Classification of Sciences. Moscow: Progress, 1973.

7.      Swanson DR. Migraine and magnesium: Eleven neglected connections. Perspectives Biol & Med 1988;31:526-556.

8.      Smalheiser NR, Swanson DR. Using Arrowsmith: a computer-assisted approach to formulating and assessing scientific hypotheses. Comp. Meth. Prog. Biomed. 1998;57:149-153.