A primer on evidence-based medicine
I haven't talked much about evidence-based medicine. You see, despite medicine being a science, there's quite a lot that medical professionals don't know. For hundreds of years, healing was considered an art. And while there's a fine line between an art and a science (the arts once encompassed mathematics, physics, and everything we consider today to be "science"), we can safely say that medicine has become a science over the last 200 years, and especially in the last century. With the advent and subsequent wide application of the scientific method, the "arts" have become what we know today as the sciences.
In theory, anyway.
The truth of the matter is that in practice, medicine is as much an art as it is a science. There are many reasons for this. Chief among them is that doctors (in primary care, at least) typically treat a variety of conditions in a variety of patients. They often rely on their memory and past experiences to help them make what they hope is a good decision.
Of course, medicine changes quickly. Very quickly, actually, especially in this day and age of information technology where huge amounts of data can be gathered and processed relatively easily. Novel approaches to finding new drug candidates for myriad conditions, as well as discovering and cataloging receptor sites in the body and on pathogens has resulted in an information overload. We have huge amounts of information stored that hasn't been processed yet that could yield medical breakthroughs hithertofore unknown. One cannot possibly keep all of this emerging information in their head, nevermind the torrent yet to come. And frankly, as a patient, I wouldn't want one to even try.
Yesterday I spoke about electronic prescribing. Perhaps I may have sounded a little down on technology, but in reality, I'm not. I'm a technophile. I love what technology has given us in the way of scientific, cultural, and medical advancement, and I'm looking forward to seeing what it brings us in the future, though I don't believe it is the be-all and end-all of medicine.
If last century belonged to physicists, I think this next one is going to belong to the life scientists: chemist, biologists, doctors, and bioinformaticists. We're going to see some breathtaking breakthroughs, and it will be, to put it bluntly, impossible for a mere mortal to keep up with without some reference help.
Books are great, but they're awkward. In the next 3-5 years you're going to see the emergence of EMR systems combined with integrated therapeutic suggestions based on a diagnosis that the doctor comes up with. It will likely offer multiple courses of action to take, based on a patient's profile. (Age, weight, overall health, health insurance formulary, and maybe even genetics somewhere even further down the road.) It's an interesting time to be in the healthcare field, especially if you love technology.
Basically, we're going to see the scientific method applied to medicine in practice as well as it is in a controlled environment.
On a somewhat related note, expect to see more use of placebo to keep patients happy, and most important, healthy. I have not written anything about placebo, and how it's indirectly used all the time, but I will sometime in the future. (If for no other reason than I'll need to, simply so I can reference it for other articles.)
In fact, if I were an entrepreneur — I aspire to be, though I don't have the resources yet — I'd get someone young and talented with programming ability, and work on an integrated EMR/therapeutics database that could run on a PDA, sync with a computer, send prescriptions to your local pharmacy of choice, and stay up-to-date with the latest clinical findings via Internet syncing. We're almost there — there are software packages that do some of these things, but not all of them. (I'd also work on a clinical pharmacy software package for specialists which would work on tailoring regimens for difficult patients that take into account the myriad variables involved in working out the (complex) pharmacokinetics, but that would likely be secondary, and I'm really rambling now so I'll stop there…)
I plan to reference, and perhaps even amend this post in the future when I talk about evidence-based medicine.
[tags]Medicine, pharmacy, evidence-based medicine, science, technology, bioinformatics, computing[/tags]
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[...] I love to see this stuff, and (as you might have guessed) the article was the catalyst for me gushing about the impact of technology on the future of medicine in my primer on evidence-based medicine. Instead of Willey having to rely strictly on his experience and memory, the computer kicks out the latest information that he can use for his patients. [...]
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