Intended for healthcare professionals

Rapid response to:

Education And Debate

The complexities of predictive genetic testing

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7293.1052 (Published 28 April 2001) Cite this as: BMJ 2001;322:1052

Rapid Response:

Understanding "complexity" in medicine, health and disease.

Evans and co-authors do define and describe "predictive genetic
testing" and its complicated related issues, but do not define or describe
"complexity," in their article "The complexities of predictive genetic
testing" (1). They conclude with further mention of complexity "the
complexity of these factors calls for discussions about testing ..."

The complexity of factors involved in medicine, health and disease
should also require a discussion of the nature and meaning of
"complexity." This Professor Michael Baum and I have attempted to do in a
paper "A new mathematical (chaos and complexity) theory of medicine,
health and disease(2), which is descriptive and non-mathematical, and uses
concepts derived from the new field of chaos and complexity theory.

I invite readers to search these terms on the internet (chaos,
complexity, fractals, sensitive dependence, nonlinear dynamics,chaos in
medicine, etc.), and to explore the fascinating world of complexity which
offers one explanation of how the complex dynamic (everchanging) small and
large interactions come together, and provides a reasonable explanation
of the outcomes we observe, of how and why things happen in real life, and
of how we can use these to create change (2,3,4).

With this we can more easily understand the complexities of the
interactions of genes and the environment, of predictive genetic testing,
and of medicine, health and disease (3), and use this understanding to
create desired change (2,3,4).

References:

1) Evans JP, Skrzynia C, Burke, W. The complexities of predictive
genetic testing. BMJ 2001;322:1052-1056.

2)Rambihar VS, Baum M. A new mathematical (chaos and complexity)
theory of medicine, health and disease. Update in "A new chaos based
medicine beyond 2000: a response to evidence." Rambihar VS, Toronto:
Vashna Publications 1999.

3)Rambihar VS. Genes, variety, variability and chaos. Book chapter in
"Chaos 2000: Making a new medicine for a new millennium." Toronto: Vashna
Publications 2000.

4) Sardar Z, Abrams I. Chaos for Beginners. Cambridge: Icon Books
1998.

Competing interests: No competing interests

27 April 2001
Vivian S Rambihar
cardiologist
The Scarborough Hospital, Toronto, Canada.