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: 10599075
• 负责人: Christopher Phillips
• 金额: $ 4.08万
• 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/10599075
• 关键词: Address; Agriculture; American; Authorization documentation; Biomedical Research; Biometry; Books; Characteristics; Clinic; Clinical; Clinical Medicine; Clinical Practice Guideline; Clinical Trials; Computer Simulation; Curiosities; 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; Play; Population; Population Genetics; Pregnant Women; Probability; Procedures; Production; Professional Organizations; Prospective Studies; Psychiatry; Public Health; Recording of previous events; Research; Research Personnel; Research Support; Resistance; Retrospective Studies; Risk; Role; Series; Shapes; 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; 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; randomized, clinical trials; 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.项目摘要/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于精算和统计计算 在20世纪30年代，正式的统计检验和测量在医学文献中很少找到。只是 然而，半个世纪后，统计计算对临床医生和患者来说已经变得必不可少。 寻求衡量新药的疗效，在治疗方案中进行选择，建立临床 实践指南，推荐筛查测试，或评估日常暴露的致癌性。 统计驱动的创新，如随机临床试验、荟萃分析、n-of-1和适应性 试验以及前瞻性和回溯性研究已经成为现代医学的中心工具。 然而，令人惊讶的是，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。大多数现存的医学史都注意到了统计解释试验的兴起 作为内科改革者的一种策略，希望减少偏见和主观性在医学中的作用，但 历史学家还没有认真地参与到技术变革中来，这些变革使得曾经的 可用于决策的平均值和聚集域(主要用于流行病学家) 在个人(临床)水平上做出的。这一转变是有争议的，并面临阻力。 来自许多方面，但特别是来自外科和其他程序繁重的专业。这笔赠款 将支持出版专著《医生数量：生物统计学的出现和 现代医学的改革，这将重新塑造我们对统计和统计学家如何 在现代医学中起到了革命性的作用。这本专著将部分集中在一个 1947年受聘于国家癌症研究所社会学家哈罗德·多恩手下的一组生物统计学家， 但这很快就在美国国立卫生研究院和其他联邦机构中奏效，包括 食品和药物管理局、环境保护局以及卫生、教育和福利部门。 其他章节将追溯统计指标的传播，从人口遗传学和农业到 大学的生物统计学和临床流行病学课程以及 专业期刊和专业组织。最后几章将追溯NOW的起源- Metanalysis和模拟建模等常用工具。利用档案材料以及 医疗改革者的记述，由此产生的专著将是历史上第一部延展的 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“精确”医学的含义。