CauseHealth Oct 2015 Network Meeting

The first official network meeting of CauseHealth was held at NMBU in October 2015. Below is the program for the meeting.

Details about presenters can be found on the CauseHealth collaborators page.

The sessions

Session 1: The problem

Introduced by Vegard Bruun Wyller, Elisa Arnaudo and Karin Mohn Engebretsen

Medically unexplained (MUS), complex diseases, multi-morbidity, heterogeneity, medical uniqueness

Medically unexplained symptoms (MUS) are characterised by sets of conditions that seem unique to the patient and, because of their heterogenic and complex nature, represent a challenge to the medical profession. It has been suggested that the inefficiency of MUS treatment show a limitation of current medical thinking. CauseHealth considers the problem of MUS as a symptom of a deeper philosophical problem for health sciences related to causation, complexity and individual variation. As consequence, the challenging features of MUS should be considered as exemplary of all complex medical conditions rather than to be dismissed as marginal. In this perspective, CauseHealth is investigating causation in cases of complexity and heterogeneity, in order to gain better understanding of health and disease in general.

Session 2: The methods

Introduced by Roger Kerry, Elena Rocca and Samantha Copeland

Evidence-based methods, models, idealisations, context, external validity, reproducibility

The majority of existing medical research methods are designed for a large scale population data and homogenous groups, excluding individual variation from the picture. In evidence-based practice, increasing authority is given to statistical results of randomised controlled studies with respect to the observation of patient’s unique state of health. This is poorly contributing to the understanding of complex medical conditions such as MUS, setting a methodological challenge for health sciences.

Similarly, pre-clinical investigation is based on idealisation and isolation since it uses genetically identical animal models in closed and controlled systems. While this methodology provides useful insights, it completely excludes heterogeneity and complexity, limiting the translatability of the findings from the lab to diverse real life situations.

Session 3: The model

Introduced by Linn Getz and Michael Loughlin

Ontology, reductionism, dualism, medicalisation, bio-medical model, patient stories

Researchers and practitioners dealing with MUS, multi-morbidity and individual variations are increasingly concerned about the limitation in current medical thinking. Some are moving toward a change in the ontological foundation:

1. from the biomedical model towards the bio-psychosocial model,
2. from monocausality towards multifactorial causes,
3. from population studies towards increasing focus on patient stories and socio-cultural context.

Taken together, these concerns seems to call for a broad and systematic philosophical renewal of the orthodox scientific framework.

Session 4: The practice

Introduced by Matthew Low and Stephen Tyreman

Person-centred, evidence-based, policy-making, clinical situation, multi-disciplinarily, specialisations

The inadequacy of treatment of MUS patients seems to generate from the extreme specialisation of medical practise and from isolation of the symptoms. Indeed, these conditions more than any need to be understood as a complex whole. Similarly, the treatment of multi-morbidity seems inefficient when symptoms are isolated and separately cured. This suggests the need of a more holist, person-centred approach in clinical practice.