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面向具有成本效益的优质医疗保健的时间生物工程。

Chronobioengineering toward a cost-effective quality health care.

作者信息

Halberg F, Tamura K, Cornélissen G

机构信息

Chronobiology Laboratories, University of Minnesota, Minneapolis 55455.

出版信息

Front Med Biol Eng. 1994;6(2):83-102.

PMID:7993857
Abstract

The current disease-cure-oriented health care system does too little too late for too few. Engineering for concomitantly resolving the external conditions and the internal schedules, chronoengineering in the broad sense, could change this status quo into a system that recognizes environmental and organismic risk early, blows a whistle as a minimum and acts automatically, as an optimum. The chronobioengineering feature (of the broader chronoengineering for external as well as internal monitoring and decision helping) would gain new individualized information from the resolution of predictable variations that occur within the physiologic range, the chronomes, genetically anchored multifrequency rhythms and trends. Their resolution by chronobiometry provides a more precise and more accurate mean value (than the arithmetic mean) along with new dynamic endpoints for improved screening, diagnosis, prognosis, and timely and timed treatment. Trends are those with growth, development, maturation and aging, and also those with risk elevation or disease and treatment. Risk elevation may change amplitude or timing, but not necessarily the mean. The implementation of engineering for concomitantly resolving the external and internal schedules depends on telecommunications and telehygiene as well as telemedicine for (i) universal chronobiologic education (to assume self-responsibility and self-help in health care), (ii) physiologic monitoring (complemented as a sine qua non by chronobiologic data analysis and interpretation of the results) and (iii) the monitoring of pertinent environmental conditions. Thus, the number of cases of catastrophic diseases could be reduced and quality (since preventive) health care made available to all.

摘要

当前以疾病治疗为导向的医疗保健系统对太少的人做得太少且太晚。从广义上讲,同时解决外部条件和内部时间表的工程学,即时间工程学,可将这种现状转变为一个能够早期识别环境和机体风险、至少发出警报并在最佳情况下自动采取行动的系统。时间生物工程学特征(更广泛的时间工程学用于外部和内部监测以及决策辅助)将从解决生理范围内可预测的变化、时间组、基因锚定的多频节律和趋势中获取新的个性化信息。通过时间生物学测量对这些变化的解析提供了一个比算术平均值更精确、更准确的平均值,以及用于改进筛查、诊断、预后和及时治疗的新动态终点。趋势包括生长、发育、成熟和衰老方面的,以及风险升高、疾病和治疗方面的。风险升高可能会改变幅度或时间,但不一定改变平均值。同时解决外部和内部时间表的工程学的实施依赖于电信、远程卫生学以及远程医疗,用于(i)普及时间生物学教育(在医疗保健中承担自我责任和自助),(ii)生理监测(作为必不可少的补充,进行时间生物学数据分析和结果解读)以及(iii)监测相关环境条件。因此,灾难性疾病的病例数量可以减少,并且(由于具有预防性)所有人都能获得高质量的医疗保健。

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