Abstract
In order to accommodate the forthcoming wealth of health and disease related information, from genome to body sensors to population and the environment, the approach to disease description and definition demands re-examination. Traditional classification methods remain trapped by history; to provide the descriptive features that are required for a comprehensive description of disease, systems science, which realizes dynamic processes, adaptive response, and asynchronous communication channels, must be applied (Wolkenhauer et al., 2013). When Disease is viewed beyond the thresholds of lines and threshold boundaries, disease definition is not only the result of reductionist, mechanistic categories which reluctantly face re-composition. Disease is process and synergy as the characteristics of Systems Biology and Systems Medicine are included. To capture the wealth of information and contribute meaningfully to medical practice and biology research, Disease classification goes beyond a single spatial biologic level or static time assignment to include the interface of Disease process and organism response (Bechtel, 2017a; Green et al., 2017).
Highlights
The nature of disease and disease states is the conceptual basis of medicine
There is a disconnect between what is accepted as explanation— how we model and describe—and how the world really works
This mirrors the conclusion of Moorman and Ivanov that Network Medicine alone is unable to create a model of sepsis from reduced components (Moorman et al, 2016)
Summary
The nature of disease and disease states is the conceptual basis of medicine. How patients perceive, how physicians communicate, how education is delivered, how research is forged, all rely on the definition of disease. There remains no facile ICD means to represent these measured changes in patient response to disease; when considering the forthcoming granular tests, including genome studies and molecular analytics (OMICS), such problems only increase. As a result medicalization and over diagnosis persist because medical linear boundaries and thresholds are moved or replaced; more alphanumeric codes and deeper testing have not brought science closer to meaningful disease definition that truly represents patient change or biologic depth. A New Taxonomy that recognizes contemporary science requires the incorporation of systems science: that complex systems, in biology and medicine, are made up of dynamic, adaptive subsystems. These subsystems are managed through competing communication channels and resultant emergent properties.
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