30 August 2012

   Experimentation in Medicine

-   -  More often than not, when people think of science (and scientists), they imagine a person peering into his or her microscope, handling test tubes, or even performing vivisection. While the first two are modern methods, the last one (vivisection) was a procedure carried out even by the Patriarchs of present day Medicine. Hippocrates (c.460-370 B.C.E.),  Galen (c.129-200 B.C.E.), Avicenna (c.980-1037 B.C.E.), Maimonides (1136-1204 B.C.E.) had one thing in common: they didn’t have the scientific resources we have today. These grand men had to rely on unaided observation of the natural world. And yet, they have passed down a legacy for all researchers and students to build on.

   - Then, and now, workers in the medical community rely on heuristic methods of learning. Examination and discovery still are the crucial characteristics of the schools of scientific thought and deliberation. Not only that, these pioneers taught their principles to countless students, who in turn shared this wisdom to whoever was interested enough and who would put in long hours of study and debate. Observing, copying and then teaching scientific methods still echo in the halls of academia, laboratories and hospitals. Through vivisection and analysis, men and women of science have developed principles, pharmacopeia, and procedures for healing the everyday man.

Error Detection and Correction

   - As true as there was, and there is, discipline in education, there is also the necessary element of error detection and correction. We have heard of the acronym CLAYGO (Clean as You Go) used in workplaces where there is the tendency to spillage and disorder. In clinical trials there are sets of tests encompassing procedures that foster, not only drug development, but also that which generate safety and efficacy data.

   - Information about adverse drug reactions and other undesirable effects of drugs, and other therapeutic agents, are logged down and recorded in laboratory notebooks or computers for further analysis. Clinical and laboratory sciences still use heuristic methods, methods based on experience, problem solving, learning and discovery. Examples of this method include using a rule of thumb, an educated guess, an intuitive judgment, or common sense. In more precise terms, heuristics are strategies using readily accessible, though loosely applicable, information to control problem solving in human beings and machines.

Empirical Science

 - The word empirical denotes information acquired by means of observation or experimentation; and  empirical data are data produced by an observation or experiment. All scientific method must be based on empirical evidence, which means that all that all learning must be dependent on evidence or consequences that are observable by the senses. It is usually differentiated from the philosophic usage of empiricism by the use of the adjective empirical or the adverb empirically. The term refers to the use of working hypotheses that are testable using observation or experiment. In this sense of the word, scientific statements are subject to, and derived from, our experiences or observations.

Theory and Hypothesis

 - A theory denotes an act of rational thought or idea based on guided knowledge; some might call this a guess or other intuitive process. As such, a theory is an intelligent process and not just conjecture or whim. Once a theory is held in the mind, it goes through the phase which is called hypothesis, which requires the  method of substantiation or proof. While the terms theory and hypothesis are used interchangeably, they are not the same. Once a hypothesis is formulated, it takes the character of working hypothesis: a framework for subsequent investigation. Null hypothesis in science involves formulating and testing hypotheses, assertions that are capable of being proven false using a test of observed data. This typically corresponds to a general or default position. For example, the null hypothesis means that there is no relationship between two factors or phenomena. One thing comes to mind though, that, causation and correlation are not the same, and both are matters to be differentiated in a further study. All the data that is collected is put through a battery of statistical analysis, thereby giving importance, or negating the influence of a certain element on a given phenomenon.

     - Whether it be digital or medical information, error detection and correction (or, debugging) play a vital role in the integrity of the whole system. Workers have to communicate their observations and analyses in a clear manner. Communication channels are of paramount importance from the beginning of a project or study and throughout the whole process. Everybody has a role to play, and since the weakest link is many times unnoticed, diligence in procedural details is necessary. From the study protocol, and all the way to the statistical analyses, communication and coordination are keys to the study’s success. And of course, everyone on the team must have done their prior review of eminent literature, whether books, journals, or medical notes.

   - The next time you take an aspirin, think of the man who first  learned that the willow tree bark made his friends pains and fever go away...

  - Fernando Yaakov Lalana, M.D.

   "To study the phenomenon of disease without books is to sail an uncharted  sea, while to study books without patients is not to go to sea at all.”

Sir William Osler (1849-1919)
 British (Canadian-born) Physician

No comments:

Post a Comment