BMJ 2001;323:685-688 ( 22 September )

Education and debate

Complexity science

Complexity and clinical care

This is the second in a series of four articles

Tim Wilson, director, St Paul RCGP Quality Unit ^a, Tim Holt, general practitioner ^b,  Trisha Greenhalgh, professor of primary health care ^c. 

^a Royal College of General Practitioners, London SW7 1PU, ^b Danby Practice, Dale End Surgery, Danby, Whitby YO21 2JE, ^c University College London, London N19 3UA

Correspondence to: T Wilson twilson@rcgp.org.uk

The first 150 words of the full text of this article appear below.

Biological and social systems are inherently complex, so it is hardly surprising that few if any human illnesses can be said to have a single "cause" or "cure."¹ This article applies the principles introduced in the introductory article in this series² to three specific clinical areas: the control of blood glucose levels in diabetes, the management of diagnostic uncertainty, and health promotion.

A complex adaptive system is a collection of individual agents with freedom to act in ways that are not always totally predictable, and whose actions are interconnected so that the action of one part changes the context for other agents.² In relation to human health and illness there are several levels of such systems.

• The human body is composed of multiple interacting and self regulating physiological systems including biochemical and neuroendocrine feedback loops

• The behaviour of any individual is determined partly by an internal set of rules based . . . [Full text of this article]

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