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Is Evidence-Based Medicine Relevant to the Developing World?

  • Paul Chinnock mail,

    To whom correspondence should be addressed: E-mail: Paul.Chinnock@lshtm.ac.uk

    X
  • Nandi Siegfried,
  • Mike Clarke
  • Published: May 31, 2005
  • DOI: 10.1371/journal.pmed.0020107

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Single Patient Based Medicine: its paramount role in Future Medicine.

Posted by plosmedicine on 30 Mar 2009 at 23:46 GMT

Author: Sergio Stagnaro
Position: Researcher in Biophysical Semeiotics
Institution: Biophysical Semeiotcs LaLaboratory Research. Riva Trigoso (Genoa) Italy
E-mail: dottsergio@semeioticabiofisica.it
Submitted Date: September 16, 2005
Published Date: September 26, 2005
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

I have already introduced the concept of single patient-based medicine (SPBM) elsewhere [1, 2], emphasizing its usefulness when combined with evidence-based medicine (EBM). I have argued the case for SPBM from both an epistemological and a practical viewpoint [3].

The origin of SPBM is a logical consequence of the definition of a large number of biophysical-semeiotic constitutions, pre-metabolic syndrome, and all clinical refined methods of investigation, based on this original physical semeiotics

When a patient presents to doctor in order to be investigated and treated, first of all, the doctor must define precisely the biological situations of such an individual. In other words, the healing physician must answer the question: "What kind of patient is this? [1,2,3,4,5,6]. From a biophysical-semeiotic viewpoint, the doctor must, firstly, recognize at the bedside all the numerous inherited predispositions to well-defined diseases possibly present in that subject and, secondly, the "real risks" of the most common and severe human diseases, in relation to a precise biological system and the severity of the same real risk.

For example, if a subject does not have oncological terrain (i.e. an inherited predisposition to cancer), it would be purely academic to consider malignancy as a possible diagnosis and to waste money and time on useless diagnostic tests. In addition, even in the presence of oncological terrain, a biological system is not necessarily involved in a "real risk" of cancer. Cancer is possible only in the presence of both oncological terrain and the characteristic microcirculatory modifications that parallel the related parenchymal modifications, involving a well limited, defined, smallest part of a biological system. For instance, the breasts of woman with oncological terrain can be perfectly normal. In other words, a woman with oncological terrain is not necessarily at risk of breast cancer, if her mammary glands are free from oncological "real risk". It follows that, with the aid of biophysical semeiotics [3,4] and the use of the SPBM approach, diagnosis is faster, more reliable, and more precise; treatment is rationally personalized; and therapeutic monitoring is really objective, making prognosis more correct.

References
[1] Sergio Stagnaro. "Single Patient Based Medicine" versus EBM: http://bmj.com/cgi/elette...
[2] Sergio Stagnaro Planning for the EU public Health Portal: http://www.google.it/sear... Pg 36
[3] http://www.semeioticabiof... AND Stagnaro S., Stagnaro-Neri M., Oncological Terrain, conditio sine qua non of Oncogenesis: http://www.gutjnl.com/cgi...
[4] Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico. Travel Factory SRL., Roma, 2004. http://www.travelfactory.... and:
http://digilander.libero.... http://digilander.libero....)
[5] Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory SRL., Roma, 2005. http://www.travelfactory....
[6] Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory....

Competing interests declared: Not declared