Number Doctors: The Emergence of Biostatistics and the Reformation of Modern Medicine

数字医生：生物统计学的出现与现代医学的改革

基本信息

批准号：
10360848
负责人：
Christopher Phillips
金额：
$ 4.8万
依托单位：
CARNEGIE-MELLON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10360848
关键词：
Address Agriculture American Archives Biomedical Research Biometry Books Characteristics Clinic Clinical Clinical Medicine Clinical Practice Guideline Clinical Trials Computer Simulation Data Data Aggregation Decision Making Development Discipline Education Epidemiologist Epidemiology Etiology Evidence Based Medicine Exclusion Government Grant Health Health Policy History of Medicine Individual Insurance Carriers Intervention Journals Knowledge Laboratories Length Literature Measures Medical Medical Research Medicine Meta-Analysis Modern 1601-history Modern Medicine Monograph National Cancer Institute Observational Study Operative Surgical Procedures Patient Care Patients Physicians Plant Roots Play Population Population Genetics Pregnant Women Probability Procedures Production Professional Organizations Prospective Studies Psychiatry Public Health Randomized Clinical Trials Recording of previous events Research Research Personnel Research Support Resistance Retrospective Studies Risk Role Series Social Sciences Statistical Computing Statistical Data Interpretation Techniques Testing Therapeutic Agents Training Programs United States Environmental Protection Agency United States Food and Drug Administration United States National Institutes of Health United States Public Health Service Universities Work authority base carcinogenicity clinical epidemiology design evidence base experience individual patient innovation interest medical specialties member models and simulation novel novel therapeutics people of color personalized medicine precision medicine pressure programs public health insurance response screening guidelines sociologist statistics tool welfare

项目摘要

7. Project Summary/Abstract Statistics fundamentally transformed the practice of and meaning of medicine in the twentieth century. Though insurers and public health reformers had relied on actuarial and statistical calculations for years, formal statistical tests and measures were rarely found in the medical literature in the 1930s. Just a half century later, however, statistical calculations had become essential for clinicians and patients seeking to measure the efficacy of new drugs, choose among treatment options, establish clinical practice guidelines, recommend screening tests, or assess the carcinogenicity of everyday exposures. Statistically-driven innovations such as randomized clinical trials, meta-analyses, n-of-1 and adaptive trials, as well as prospective and retrospective studies have become central tools of modern medicine. Yet we know surprisingly little about the emergence of biostatistics and the related field of clinical epidemiology. Most existing histories of medicine have noted the rise of statistically-interpreted trials as a strategy of physician-reformers looking to reduce the role of bias and subjectivity in medicine but historians have yet to seriously engage with the technical transformations that enabled what was once a field of averages and aggregation (and mainly of use to epidemiologists) to be applicable to decision making at an individual (clinical) level. This transformation was controversial, and faced resistance from many quarters, but particularly from surgical and other procedure-heavy specialties. This grant will support production of a monograph, Number Doctors: The Emergence of Biostatistics and the Reformation of Modern Medicine, that will reframe our understanding of how statistics and statisticians came to play a transformative role in modern medicine. The monograph will partially center on a group of biostatisticians hired in 1947 under sociologist Harold Dorn at the National Cancer Institute, but that soon worked across the National Institutes of Health and other federal agencies, including the Food and Drug Administration, Environmental Protection Agency, and Heath, Education, and Welfare. Other chapters will trace the spread of statistical measures from population genetics and agriculture to biostatistics and clinical epidemiology programs at universities as well as the development of specialized journals and professional organizations. The final chapters will trace the origins of now- common tools like metanalysis and simulation modeling. Drawing on archival materials as well as accounts of medical reformers, the resulting monograph will be the first extended history of biostatistics and clinical epidemiology, and will contribute to larger discussions about the role of data, risk calculations, and the meaning of “evidence-based” and “precision” medicine.

7。项目摘要/摘要统计学从根本上改变了20世纪医学的实践和意义。尽管保险和公共卫生改革者依靠实际和统计计算几年，在1930年代的医学文献中很少发现正式的统计检验和措施。只是但是，半个世纪后，统计计算对临床医生和患者来说已成为必不可少的寻求测量新药的效率，在治疗方案中选择，建立临床练习指南，建议筛查测试或评估每天暴露的致癌性。统计驱动的创新，例如随机临床试验，荟萃分析，N-1和自适应试验以及前瞻性和回顾性研究已成为现代医学的中心工具。然而，我们对生物统计学和临床相关领域的出现知之甚少流行病学。大多数现有的医学历史都注意到统计解剖试验的兴起作为希望减少偏见和主观性在医学中的作用的策略，但历史学家尚未认真参与实现曾经的技术转变一个平均值和聚合（主要是用于流行病学家）的领域，适用于决策在个人（临床）水平上制作。这种转变是有争议的，面临着抵抗力从许多方面，尤其是从手术和其他手术繁重的特色菜中。这笔赠款将支持专着的生产，编号医生：生物统计学的出现和现代医学的改革，这将重新构想我们对统计学家的理解开始在现代医学中发挥变革性作用。该专着将部分集中在 1947年聘用的生物统计学家在国家癌症研究所的社会学家哈罗德·多恩（Harold Dorn）但这很快在美国国立卫生研究院和其他联邦机构（包括食品和药物管理局，环境保护局以及希思，教育和福利。其他章节将追踪统计测量的传播，从人口遗传学和农业到农业大学的生物统计学和临床流行病学计划以及发展专业期刊和专业组织。最后一章将追踪现在的起源 - 常见工具等工具等工具和仿真建模。利用档案材料以及医学改革者的帐户，由此产生的专着将是第一篇扩展历史生物统计学和临床流行病学，并将为数据的作用提供更大的讨论，风险计算以及“基于证据”和“精度”医学的含义。