|Posted by Ciacco on July 30, 2012 at 4:10 PM|
The new and contemporary views of health care encompass three principal ideas: (1) health care must be patient-centered - not aiming at pathology or a physio-anatomical system, but centered on the patient's needs and medical history; (2) health care must be evidence-based - not relying on this or that piece of evidence, but on the consensus of the best available evidence that emerges following a systematic hypothesis-process of research synthesis; and (3) health care must be focused on effectiveness - meaning to say, cost-effectiveness, benefit-effectiveness and risk reduction-effectiveness. Thus, cost-effective patient-centered evidence-based health care is the challenging new frontier of obtaining the best available evidence that specifically targets a patient's needs, and of applying it in specific clinical settings.
To identify the patient's needs, we rely on translational research, which, by definition, goes from the patient's biopsy to the laboratory for the identification of the underlining molecular pathology, and back to the patient for treatment. Once identified, the patient's needs dictate the search of the best available evidence, which, when utilized in specific clinical settings, signifies translational effectiveness.
In brief, translational research and translational effectiveness are two sides of the same coin, two complementary dimensions of the same scientific domain: translational science. Translational science, like any other science, is in pursuit of its own philosophy of science. As any other science, translational science rests on reason and logic. Logic, like science evolves - from the aristotelian classical logic, to hegelian dialectical logic, to Pierce's inductive-deductive-abductive logic (abduction referring to the transaction from the best possible information to the optimal interpretation and explanation), to the modern and postmodern trialectical logic.
Whereas trialectical logic invokes dynamic denominalization, a rather random process of "reframing", we submit here that philosophy in our XXI Century will evolve logic to an abductive trialectic process. We propose that, particularly in the context of translational science where the process of research is engaged with the specific intent of obtaining the best available evidence for the most effective patient-centered intervention, the directionality of the logic process cannot be left random: it is directed by the clear intent stated above.
Taken together, these lines of thought lead us to conclude that the new logic of the new translational science in this the beginning of our new millennium must be an "intentist trialectics", a trialectic with the fourth dimension of "intent", a tetralectic logic of intentism.