临床医学中的人群悖论
Ralph I Horwitz1, Allison Hayes Conroy1, Mark R Cullen2
1Temple University, Philadelphia, USA.
The American journal of medicine
|February 10, 2026
概括
现代医学经常将生物学和传记分开,阻碍了个性化医学. 通过密集的个人资料来整合两者,可以改善治疗预测和设计.
科学领域:
- 综合医学是一个整体的医学.
- 医学认识论医学认识论
- 个性化医疗是个性化的医疗.
背景情况:
- 现代医学理论上拒绝心身二元论,但实际上将生物数据与传记叙述分开.
- 这种分离导致治疗有效性的显著变化,以及个性化医学的未满足期望.
- 当前的方法往往将传记信息视为无关的噪音,忽视其在健康结果中的关键作用.
研究的目的:
- 提出医学认识论的反转,以解决人群悖论.
- 倡导从人口平均概括转向密集的个体机械学概要.
- 建立一个框架,使生物-传记模式为医学预测,治疗和临床试验设计提供信息.
主要方法:
- 概念分析和理论框架开发.
- 批评当前的医学认识论和个性化医学范式.
- 建议采用自下而上的知识生成方法,重点关注个体患者数据.
主要成果:
- 展示了如何将生物变量优先于传记创造了治疗异质性.
- 识别"人群悖论",源于个人经验和基于人口的医学之间的脱节.
- 医学认识论的拟议转变,以整合生物和传记数据.
结论:
- 调和生物学和传记对于推进个性化医学至关重要.
- 密集的个体机理学概况为理解反复出现的生物-传记模式提供了一条途径.
- 通过优先考虑自下而上的医学认识论,个体数据可以提高预测,治疗和临床试验设计.
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