Can Medical Research Do Its Job?
Can Medical Research Do Its Job?
Jay Pravda 0
0 Therashock LLC , Wilmington, DE , USA
-
Essay
We’ve heard it often enough. A medical disease researcher
will announce some important breakthrough; never to be
heard from again. So, what’s the problem? Why can’t medical
science figure out the cause of diseases such as inflammatory
bowel disease (ulcerative colitis and Crohn’s disease) sepsis
and neurodegenerative disease (Alzheimer’s, Parkinson’s, and
multiple sclerosis) to name a few?
Heaven knows we’ve been working on them long enough
and billions of dollars have been poured into research over the
past 50 years to no avail. Despite having the most advanced
technology and the smartest and dedicated researchers
working on the problem, we are no closer to finding the cause or a
cure for these diseases that afflict more and more people every
year. In fact, it’s hard to find someone whose life hasn’t been
touched in some horrendous way by these incurable afflictions
that also include autism, cancer, and systemic lupus
erythematosus among others.
Despite the lack of progress, we soldier on; going back to
the laboratory and doing more experiments in the hope that
one fortunate happenstance will provide the breakthrough that
will lead to a cure. Although serendipity may work well with a
pot-luck party, it’s not the way to approach medical research if
we want to find cures before the burden of disease becomes so
overwhelming; financially, emotionally, politically, and
socially overwhelming that we simply give up hope in our
ability to conquer these diseases.
Although we have made great strides in building up our
medical research infrastructure with investments in
technology and medical scientist training programs, without a theory
of disease to guide future experiments we are simply groping
in the dark when it comes to medical research. To illustrate
how important a theory of disease can be; the germ theory of
disease paved the way for advances in immunization,
pasteurization, antibiotics, public health, and surgery. Most of us
(including me) would not be here today if not for this simple
theory.
But who comes up with these theories? With over 26
million research publications in the National Library of
Medicine’s database (PubMed) [
1
], laboratory based
researchers don’t have enough hours in the day to do the
timeconsuming relational data mining needed to understand how
and where their results fit in and propose falsifiable theories of
disease that arise from insight gained by studying little known
areas of medicine such as redox biochemistry, bioenergetics
and redox biology in addition to emerging sources of
information such as Bbig data^ [
2
].
Theoretical biology and medicine is the missing piece of
the puzzle. Laboratory-based researchers are trained to design
and carry out experiments not to develop new theories of
disease that can lead to a cure. Medical theorists are needed
to propose new theories of disease and help guide laboratory
research along a focused path of discovery that leads to the
cause of diseases and their cures. Medicine needs to realize
that Bdifferent minds are suited to different aspects of research
and society as-a-whole benefits from the interplay of theorists
and experimentalists^ [
3
]. Theorists provide the creativity
without which medical research cannot flourish and advance.
Without guiding theories of disease, medical research into
causation is haphazard and wasteful; eventually settling into
decades of stagnation that we see today, forcing clinicians to
treat sick patients using algorithms or consensus guidelines in
an effort to plug the gap in our knowledge of pathogenesis that
research is meant to supply.
Physicists realized the value of theory in the early 20th
century and today we have the separate branches of theoretical
and experimental physics that continue to advance the science
into unimaginable realms. However, medicine lags far behind.
We have the finest experimental research laboratories focused
on producing data, which provide a small piece of the puzzle
to the cause of disease but without a wider integration into all
previously published results guided by a plausible theory of
disease the data just sits on PubMed’s website, waiting for a
medical theorist to put the pieces all together and predict what
the cause actually is.
Unfortunately, no graduate programs in theoretical biology
and medicine exist in the United States. Educational grants for
pilot programs must be provided and policy changes enacted
to address this shortcoming starting with graduate biomedical
training programs in theoretical biology and medicine that
emphasize a patho-mechanistic model of medical education
as an alternative to the current patient care approach. Creative
divergent thinking and not rote memorization should be the
basis of this new curriculum. Faculty positions should be
made available for these theoretical medical specialists whose
needed expertise should be brought (...truncated)