Lecture 12 Sci Thinking Research

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Slide 1:

Contemporary Topics in Human Biology Statastics Probability, Risk/ Benefit Analysis in Biology & Medicine

Slide 2:

No Single “Yes/No” Answer to Making Medical/Biological Decisions or Therapy Every venture to interact & alter biological function(s) is inherently accompanied by varying degrees of uncertainty & risks vs benefit

Slide 3:

Scientific Medical Analysis Benefits Risks Confidence/Probability

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Why is there such uncertainty? What are t he various factors? Pathophysiology: accuracy of diagnosis time/stage of diagnosis unknown/variable factors affecting diagnosis physician expertise & experience natural course of disease is highly variable Therapy: multiple approaches (e.g, different drugs, surgery, wait/watch) safety, side effects, potential complications unknown/variable factors affecting therapy or course of disease uncertainty of expectations (do similar therapies always yield the same degree of effect uncertainty of short-term, intermediate, vs long-term outcome

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Case: Simple Headache Diagnosis: H igh confidence for short term Chronic headaches my require more investigation with more uncertainty. Therapy: Ibuprofen (Advil) Confidence = high Benefit = high Risk = low for short term therapy = medium to high for long term (bleeding/ulcers) = medium to high for bleeding in surgery = low to medium for high blood pressure & heart attack

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Case: Simple Headache Diagnosis: H igh confidence for short term Chronic headaches my require more investigation with more uncertainty. Therapy: Aspirin Confidence = high Benefit = high Risk = low for short term therapy = high for long term (bleeding/ulcers) = h igh for bleeding in surgery = low for high blood pressure & heart attack

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Case: Simple Arthritis Diagnosis: High confidence Therapy: Celebrex Confidence = high Benefit = high Risk = low for short term therapy = low for long term (bleeding/ulcers) = low for bleeding in surgery = high for blood pressure & heart attack

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Case: Depression Diagnosis: low to moderate confidence Therapy: Zoloft Confidence = low to moderate, can be highly variable Benefit = low to moderate, can be highly variable Risk = moderate to high for side effects

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Case: Post-Menopausal Symptoms Diagnosis: low to moderate confidence Therapy: Estrogen or estrogen + progesterone Confidence = low to moderate, can be highly variable Benefit = low to moderate to high, can be highly variable Risk = low to moderate to high for toxicity (cancer)

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Case: Glioblastoma Multiforme (brain cancer) Diagnosis: high confidence ( possible no symptoms until tumor is very large Therapy: Drugs, surgery, radiation Confidence = initial improvement , does not alter eventual outcome Benefit = low Risk = high incidence of side effects & toxicity

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