How risk is transforming aging, disease and medicine. Or, learning to practice desktop medicine.
In the Fall of 2010, while I was writing in my study, a phrase finally came to me: “desktop medicine.” It was one of those revelations. For years, I had been thinking about risk and medicine.
This term describes how a desk with a networked computer is transforming medical science and, in turn, medical practice. Unlike bedside medicine that organizes the physician-patient relationship around the chief complaint guided history and physical and diagnosis based on clinical-pathological correlation, desktop medicine describes the space where researchers discover risk-factor based diseases such as dyslipemia and where physicians diagnose and treat patients with these diseases. Medicine is now practiced not just at the bedside but the desktop as well. Diagnosis is based on clinical-actuarial correlation.
With this model, I am examining the how the concepts of risk and the biomarker are transforming medical epistemology -- that is, what we call a fact -- and nosology -- that is, what we call a disease. My case study for changing concepts of disease is Alzheimers disease. I am also looking at how risk calculators such as the Framingham cardiac risk score, the National Cholesterol Education Program 10-year risk calculator, and FRAX illustrate how medical knowledge, and thus power, are shifting from expert clinical judgment to an autonomous, quantitative medicine accessible to anyone with a networked computer. "Google" the term "health risk calculator" and see what you discover! I am thinking about how medical education and training need to change.
To read the essay “Desktop Medicine,” follow this link to the Journal of the American Medical Association.
I wrote about the concept in a blog essay on Science Progress.