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

• 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
• 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

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. 项目总结/摘要 统计学从根本上改变了二十世纪医学的实践和意义。 尽管保险公司和公共卫生改革者依赖精算和统计计算 多年来，在 20 世纪 30 年代的医学文献中很少发现正式的统计测试和测量。只是 然而，半个世纪后，统计计算对于临床医生和患者来说变得至关重要 寻求衡量新药的疗效、选择治疗方案、建立临床 实践指南、推荐筛查测试或评估日常接触的致癌性。 统计驱动的创新，例如随机临床试验、荟萃分析、n-of-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核心工具。 然而，令人惊讶的是，我们对生物统计学的出现和临床相关领域知之甚少。 流行病学。大多数现有的医学史都注意到统计解释试验的兴起 作为医生改革者寻求减少医学中的偏见和主观性作用的策略，但 历史学家尚未认真研究使曾经的事物成为可能的技术变革 适用于决策的平均值和聚合字段（主要用于流行病学家） 在个人（临床）水平上进行。这种转变是有争议的，并面临阻力 来自许多方面，特别是来自外科和其他手术繁重的专业。这笔补助金 将支持专着《数字医生：生物统计学的出现和 现代医学的改革，将重新构建我们对统计学和统计学家如何进行统计的理解 在现代医学中发挥了变革性的作用。该专着将部分集中于 1947 年，国家癌症研究所社会学家哈罗德·多恩 (Harold Dorn) 聘用了一群生物统计学家， 但这很快就在美国国立卫生研究院和其他联邦机构中发挥了作用，其中包括 食品和药物管理局、环境保护局以及健康、教育和福利局。 其他章节将追溯统计措施从人口遗传学和农业到农业的传播。 大学的生物统计学和临床​​流行病学课程以及开发 专业期刊和专业组织。最后几章将追溯现在的起源—— 元分析和模拟建模等常用工具。借鉴档案材料以及 医疗改革者的叙述，由此产生的专着将是第一部扩展的历史 生物统计学和临床​​流行病学，并将有助于更广泛地讨论数据的作用， 风险计算，以及“循证”和“精准”医学的含义。