Greenhalgh Trisha
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
J Eval Clin Pract. 2025 Feb;31(1):e14263. doi: 10.1111/jep.14263.
This commentary on Sturmberg and Mercuri's paper 'Every Problem is Embedded in a Greater Whole' [1] argues that those authors have approached complexity from a largely mathematical perspective, drawing on the work of Sumpter. Whilst such an approach allows us to challenge the simple linear causality assumed in randomised controlled trials, it is itself limited. Mathematical complexity can explain nonlinearity and network effects but it cannot explain human values. It overlooks, for example, how science itself is historically and culturally shaped and how values-driven misunderstandings and conflicts are inevitable when people with different world views come together to try to solve a problem. This paper argues that the mathematical version of complexity thinking is necessary but not sufficient in medical research, and that we need to enhance such thinking further with attention to human values.
这篇对斯特伦贝格和梅尔库里论文《每个问题都嵌入在一个更大的整体之中》[1]的评论认为,这些作者主要从数学角度探讨复杂性,借鉴了桑普特的研究成果。虽然这种方法使我们能够质疑随机对照试验中假设的简单线性因果关系,但其本身也存在局限性。数学复杂性能够解释非线性和网络效应,但无法解释人类价值观。例如,它忽视了科学本身是如何在历史和文化中形成的,以及当持有不同世界观的人聚在一起试图解决问题时,由价值观驱动的误解和冲突是不可避免的。本文认为,复杂性思维的数学版本在医学研究中是必要的,但并不充分,我们需要通过关注人类价值观来进一步深化这种思维。