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[医学新视野。内科医学中的复杂性与可预测性]

[New horizons in medicine. Complexity and predictability in internal medicine].

作者信息

Guarini G, Onofri E

出版信息

Recenti Prog Med. 1993 Oct;84(10):691-7.

PMID:8235036
Abstract

Being a highly sophisticated structure, the human body should be considered on a physical level as a whole of inter-correlated non-linear dynamic systems, which are by definition, complex systems because they are always conditioned in their operativity by numerous variables. We must draw attention to the opportunity that within the field of medical science the concept of complexity referring to diagnostic, therapeutic and prognostical problems, is distinct between structural and functional. The functional complexity of a system, a phenomena, an event, MY be recognized in its dynamics, only if analysed using modern methods recently brought to light, on the relationship which exist between classic determinism and deterministic chaos. Furthermore, also on practical level, the recent discoveries on the general principles, which are at the base of the functional complexity of non-linear dynamic systems, demonstrate exactly how fragile is the probabilistic predictability which guides a doctor in clinical reasoning in all its various stages; in the gathering of anamnestic and objective data; in the programming the researches aimed at confirming the validness of the diagnosis; in the therapy aimed at reaching the best possible results; in the prognosis which summarize the destiny of the binomial patient illness. The scientific enunciate of universal nature, which demonstrate how, from a tiny uncertainty in the initial functional data of a system, of a phenomena, of an event can unleash a condition of absolute unpredictability, find daily confirmation in both clinical and experimental medicine.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

人体作为一个高度复杂的结构,在物理层面上应被视为一个相互关联的非线性动态系统的整体。根据定义,这些系统是复杂系统,因为它们的运行总是受到众多变量的制约。我们必须注意到,在医学领域,涉及诊断、治疗和预后问题的复杂性概念在结构和功能方面是不同的。一个系统、一种现象、一个事件的功能复杂性,只有在使用最近揭示的现代方法分析经典决定论和确定性混沌之间存在的关系时,才能在其动态中得到认识。此外,在实践层面上,关于非线性动态系统功能复杂性基础的一般原理的最新发现,确切地表明了在临床推理的各个阶段指导医生的概率预测是多么脆弱;在收集病史和客观数据时;在规划旨在确认诊断有效性的研究时;在旨在取得最佳结果的治疗中;在总结患者疾病二元组命运的预后中。具有普遍性质的科学阐述表明,一个系统、一种现象、一个事件的初始功能数据中极小的不确定性如何能够引发绝对不可预测的状态,这在临床医学和实验医学中每天都能得到证实。(摘要截取自250字)

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