complexity

Living with complexity and big data. Causal dispositionalim enters pharmacovigilance

Ralph Edwards on dispositionalism in pharmacovigilance

We have seen a lot of interest in the CauseHealth approach and issues during these last years, especially among clinicians who see a need for a more person centered healthcare. Can this be useful also outside the clinic? Yes, according to senior medical advisor at the WHO Uppsala Monitoring Center for Drug Safety, Ralph Edwards. In a recent perspectives article in the UMC report, he argues that dispositionalism can be useful for dealing with complexity, individual variation and the patient’s unique context. (more…)

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Capturing the Colour: Classification and its Consequences

Author Eivind Hasvik
(#5 in the Whole Person reflections series)

Gazing through my window, I’m enriched by a muted but beautiful December twilight-palette. The remains of autumn covered by a thin layer of snow. It’s said that every culture has its own sense of the different hues. I’m reading a beautiful passage in White by Kenya Hara about the traditional Japanese way of naming colours. Contrary to the modern way of categorizing a given spectrum of light, such as greens, magentas or yellows, it’s said that red, blue, white and black were the only basic colour adjectives in 8th century Japan. The tradition was not to classify, but to describe and texturize, capturing the seasons and surroundings. This narrative heritage is beautifully documented in the book The traditional colours of Japan.

I’m imagining a metaphorical link from all this to the difficulties of describing experience—sensations, emotions, pain or pleasure. (more…)

Thinking about guidelines

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National Geographic Wild, Trafalgar Square in London, January 28, 2016.

On October 24, 2016, the CauseHealth crowd met with a small group of other philosophers, healthcare practitioners, and members of the guidelines community. We had a rousing discussion that lasted the whole day, with few pauses and enthusiastic participation from all in attendance. We talked about several issues with how guidelines are developed and implemented and how we thought philosophy could be relevant in solving those issues.

It is difficult to summarize the discussion in a few words—the topics were wide-ranging and participants shared complex ideas from multiple perspectives. I’m going to highlight here some of the themes that came up more than once, and to give an idea of where the group thought the discussion should go next.

Read more of Samantha’s review of the workshop
Read Rani on Real v. Ideal Guidelines
Read Elena on How Decisions are Made
Read Karin on the Ethics of Reduction
Read Stephen on the Notion of Guideline
Read Roger on the Challenges to Come
Read Fiona on Guidelines in Situ
Read Sarah on Truth, Simplicity and Personalization
Read Anna Luise on Challenging Multi-Morbidity
Read Stephen on Standards for Regulation
Read Samantha on Analogies and High-Stakes Inferences
(more…)

Reductionism isn’t enough for public health

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Chinese medical poster, 1933 (ref US NLM; image source here)

By Håkon Boman Andresen

The overarching goal of the public health sciences is to increase the population’s health. Society spends a lot of money each year on health research, which again is used to develop public policies and guidelines. However, is this causing the population to have better health? (more…)

You’re History (Hasta la Vista, baby)

By Neil Maltby — author of the becomingmorehuman blog, a physiotherapist in the UK, and a CauseHealth collaborator

She seemed straight forward enough on assessment. 45yrs old. Sudden pain onset from a seemingly innocuous movement many years ago. Episodic but progressive back pain since. Almost full range of movement. No significant neurological, inflammatory, vascular or other suspicious signs. One thing did sit in my mind though. It was as I asked her to reach down to the floor. (more…)

Can medicine explain medically unexplained symptoms?

By Elisa Arnaudo

Medically unexplained symptoms (MUS) represent a major challenge for healthcare systems in industrialised countries. These symptoms are so prevalent that they are assessed in up to 50% of consultations in primary care. The repeated referral of these patients to secondary care represents a substantial cost, but not a resolution of the symptoms which often remain unexplained. (more…)