Atomic data: James Mackenzie Lecture 2015.
BRITISH JOURNAL OF GENERAL PRACTICE(2016)
摘要
When Sir James Mackenzie was moving back to Scotland from London in 1918 to set up the Institute for Clinical Research in St Andrews he said that he wanted ‘To do for medicine what the Atomic Theory had done for chemistry’ .1 He was referring to the fact that Sir Ernest Rutherford had ‘split the atom’ the year before and ushered in a new scientific age through nuclear fission. Mackenzie saw an analogy with what he hoped to achieve in medicine through fusion of data across time and from various sources. He believed that the information recorded in GP consultations about the early stages of disease would lead to new ways to understand health and disease, leading to earlier and better diagnosis and treatment.2 He was frustrated then, as we often still are, by not knowing what the symptoms and signs our patients consult us about really mean. Mackenzie hoped that a group of family physicians who kept continuous records of all cases they saw, including details of the patients’ living conditions, dietary and smoking habits, and employment, would enable research to be carried out into the relationship between environmental factors and disease.3 In this idea, he was ahead of his time, but developments in using electronic medical records and practice-based research networks are now enabling his vision to be realised. This lecture will describe the extent to which the data recorded by GPs are already contributing to improved care for patients and discuss emergent opportunities in research internationally by describing how family physicians can now make significant contributions to medical science every day in their work.4In a GP consultation such as that shown in Box 1 there are many data points that are already present in the patient’s record and many others that will …
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