An additional basic science for clinical medicine: I. The constraining fundamental paradigms

Area of Science:

• Biomedical Research
• Clinical Decision-Making
• Health Services Research

Background:

• Traditional biomedical research paradigms prioritize mechanistic explanation and 'hard' data.
• These paradigms are insufficient for the scientific needs of patient care decision-making.
• Patient care requires a different scientific approach, emphasizing prediction and 'soft' data.

Purpose of the Study:

• To evaluate the limitations of current biomedical research paradigms for clinical decision-making.
• To identify the essential scientific goals and data types needed for effective patient care.
• To propose advancements in scientific methodology for clinical practice.

Main Methods:

• Conceptual analysis of existing research paradigms.
• Comparison of requirements for basic research versus clinical decision-making.
• Review of evidence generation in clinical practice and randomized trials.

Main Results:

• Biomedical research paradigms emphasize explication and hard data, which are not always optimal for patient care.
• Clinical decisions necessitate prediction and the use of 'soft' data, including personal and clinical phenomena.
• Randomized clinical trials are valuable but insufficient; unplanned clinical practice 'experiments' offer crucial insights.

Conclusions:

• Existing biomedical research paradigms require adaptation for patient care.
• Improved methodologies for data acquisition and unbiased comparison are essential for clinical decision-making.
• Integrating evidence from clinical practice is vital for advancing patient care science.