I am fairly certain that in my posts over these last 3.5 years, I have mentioned the individual differences I have seen in human physiology. This has led me to a conclusion, that could be important.
Conclusion: People are so different that every health intervention works for somebody, NO health intervention works for everybody.
So, what?
What is that the way we practice medicine and health, in general, is simplistic and pretty often WRONG.
What?
As a scientist, I am compelled by scientific convention to report my results in terms of "group means" or "treatment means". Which is to say we talk about average responses. In about 2001, it struck me that "average" applies to very few people, and NO athletes. Consequently, in our research reports on athletes since 2003, we have reported individual results. This is in addition to treatment averages, because those, as I said, are mandatory. In fact, to do this, I had to invent a statistical approach that uses the group standard deviation (variability) to determine who is far enough from the average to be considered a "responder" or a "non-responder".
I am quite aware that the "mean" characteristic is most common in the population, but the mean may end up describing only a small sample when it comes to the complexity of human physiology.
So, two people with the same symptoms of an illness go to the doctor. The M.D. scarcely knows them, but she/he knows the symptoms, and on average, this looks like the flu. The M.D. quickly writes a prescription, which the pharmacist fills. One patient responds quickly and very well to the medication. The other doesn't improve at all.
Why?
Because it may be:
For centuries now we have assumed that all of us are pretty similar and that most of us are pretty close to average. The normal distribution on any particular measure of humans suggests that we are more like the "average" than like anything else. But, a lot of very small differences can really add up to something big.
Maybe always focusing on the "mean" response or characteristic isn't such a good idea. Maybe individuality is more the rule. Maybe G^d is Big enough and Creative enough, that we all are indeed, individuals.
Conclusion: People are so different that every health intervention works for somebody, NO health intervention works for everybody.
So, what?
What is that the way we practice medicine and health, in general, is simplistic and pretty often WRONG.
What?
As a scientist, I am compelled by scientific convention to report my results in terms of "group means" or "treatment means". Which is to say we talk about average responses. In about 2001, it struck me that "average" applies to very few people, and NO athletes. Consequently, in our research reports on athletes since 2003, we have reported individual results. This is in addition to treatment averages, because those, as I said, are mandatory. In fact, to do this, I had to invent a statistical approach that uses the group standard deviation (variability) to determine who is far enough from the average to be considered a "responder" or a "non-responder".
I am quite aware that the "mean" characteristic is most common in the population, but the mean may end up describing only a small sample when it comes to the complexity of human physiology.
So, two people with the same symptoms of an illness go to the doctor. The M.D. scarcely knows them, but she/he knows the symptoms, and on average, this looks like the flu. The M.D. quickly writes a prescription, which the pharmacist fills. One patient responds quickly and very well to the medication. The other doesn't improve at all.
Why?
Because it may be:
- Two totally different causes precipitate almost the same symptoms in two different patients. OR
- The drug does nothing, or worse, does damage in this patient or disease. OR
- This patient's physiological nuances are such that the drug does nothing, or does damage. OR
- The combination of #1, #2 and #3 explain the differences.
For centuries now we have assumed that all of us are pretty similar and that most of us are pretty close to average. The normal distribution on any particular measure of humans suggests that we are more like the "average" than like anything else. But, a lot of very small differences can really add up to something big.
Maybe always focusing on the "mean" response or characteristic isn't such a good idea. Maybe individuality is more the rule. Maybe G^d is Big enough and Creative enough, that we all are indeed, individuals.
No comments:
Post a Comment