How Physicians Create New Information

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By Herb Wiggins, M.D.; Clinical Neurosciences; Discoverer/Creator of the Comparison Process/CP Theory/Model; 14 Mar. 2014
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This is an extension of the “Creating Information and Understanding” article:
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and shows specifically, the formal, testable, details of how this is done in medicine.
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We start with Duchenne, who first described some cases of what’s now known as Duchenne Muscular Dystrophy (DMD) in the 1850’s in Paris. Dr. Duchenne noted a first case of young boys who were getting weaker. Those were unlike any ever noted or described before. In each case, they were variations on a theme, (the myriads of ways of complex systems) consisting of a progressive weakness of muscles, occ. heart, hypertrophy of muscles, despite the  weakness of the enlarged muscle mass, and that they often died before age 5. It was not seen in girls, however, which he did not understand, but which our improving models showed was due to it being an X-;linked recessive, like some forms of hemophilia, also only affecting boys, of which the notable cases of the daughters of Queen Victoria spread to the royal houses of Europe. And which probably brought down the Romanov dynasty, or at least materially contributed to it, as the Czar’s son, and heir was so afflicted.
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Over the last several years the genetics of the disorder were found which was a single mutation in the membrane very large protein called dystrophin. This largely has shown how it came about, because being large gene, meant it was more likely to mutate. Treating the condition has been difficult, but therapies and other work are still extending the lifespans and some trophic factors, such as follastatin, altho with untoward effects, can effectively restore 80% of muscle strength. Work is ongoing to limit the untoward effects by trial and error modification of follastatin’s structure. Thus again, structure/function model is being used.
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DMD has many other characteristics. But the point is this in medicine. When we see an unusual syndrome, we remember it. If we see it again, we write it down and look for more cases of it. and if we see 3 or more, it’s then formally written up and submitted to medical journals. The important observations being if it’s seen again and again, this acts as confirmation of such a disease entity, being discrete, recurring and repeating. This as an extension of the behaviorist model is recalled by the naturally recurring reinforcements of events in existence, by which we  learn, lay down Long Term Memories, & then recall events. And in most each case, if rare enough there is the dopamine boost, which also naturally reinforces that perception and also promotes lay down of LTM via dendritic proliferation and synapses formation, to facilitate recall.
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That’s the basic neurophysiology of how we lay down LTM, and which the DA acts as an additional reinforcer to double down on recalling it, structurally. This structure/function observation can be seen again &  again, esp. from the Archimedes, historical example, of his stepping into his bath, seeing that his body displaced water, from which his revolutionary concept of the comparison of mass to density, now grams/cc., created the hugely efficient and widely applicable method of Density, using water as the general, fixed, stable measuring standard.
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In short, Duchenne had a “eureka” moment, when he saw the first case, which was reinforced by the 2nd and 3rd until the LTM began to get facilitated. He looked for more and found those. & so did many others, which they’d missed before. We cannot diagnose conditions which we do not know, recognize, and thus cannot see. And world of muscle diseases was changed, that being the first genetically caused and recognized form of the larger known class at present, of muscular dystrophies. Thus the finding of a the first of the class created a hierarchy of muscular dystrophy, which was then filled up with many other forms of the same. It created the means for more and more growth in understanding. Typically, a good finding will do this, esp. if it’s widely applicable. Also Typical hierarchy, taxonomic creation method of dealing with, organizing, and understanding disease states. The model is universally extended to most all medical conditions, often classified by the major organ affected, the next & Third in the hierarchy of our understanding.
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The point is this. This model of repeating comparison processes and methods without limit, its fertile daughter without limits, Least energy, derived from the Second law of Thermodynamics
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complex system modeling and thinking, and structure/function relationships works in our brain, more or less universally, to create new information. We create ideas/words both of which reinforce and stabilize each other, which act as comparison standards which we can apply efficiently to sensory events from the external world, or our internal phenomena and realities. And thus we describe most all events using those standards, be they verbal or numerical descriptions. Same method applies to both. Least energy identities, simplifying the system of understanding, where a single unifying concept.  comparison process, plus least energy creates knowledge/data, and understanding. Information is created from other information in this way, generally extending our knowledge, too.
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IN addition, the least energy, comparison processing method is highly realistic, tending to true, efficient means to describe events in existence, which are stable, useful and practical. Ockham’s Razor is least energy for this reason, as well. It’s a real existing solution finder!! How this applies to finding solutions to complicated systems is thus at once recognizable and usable. How it applies toe the solutions of QM equations, hitherto unsolvable is also at once apparent.
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Duchenne recognized the syndrome was something new. He then looked for more cases of it, thus creating scientific confirmation of what he’d found and therefore presented it in writing. And others began to see it, as well, formerly missed. This matches very much exactly with Kuhnian paradigm shift  “The Structure of Scientific Revolutions:, known for 60 years.  And Einstein’s dictum that “Every major advance in physics is preceded by an epistemological advance.” of which his was the epistemological discovery that measurement was relative to fixed, stable standards. And thus there was no real absolute space, nor time, as has shown, with unlimited repeating cases, confirming that fact, scientifically.
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Thus we take Einstein’s relativity shown by comparison process which can be extended massively, and created by this further application, of how the scientific discovery method, that is finding new knowledge, works coming out of and generated by the cortical brain/mind interface. And how such discoveries are converted into good, descriptive, efficient means into new words, reflecting a good usage of words, which stabilizes and passes into LTM so they can be used again and again. & because they are efficient, using them again and again creates growth, amplifying with each usage, their practical value.
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This is the article “The Relativity of the Cortex”, by which comparison processes are shown to be not only the source of relativity epistemology, but can also be shown to be the epistemological, paradigmatic extension of the Behaviorist model of reinforcement, as well.
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And can by becoming a more generally applicable model/paradigm is nearly universally applicable to our understanding. Comparison process can be used and applied to most all events within & outside of our brains. Least energy, it’s fertile and fruitful daughter, is just as widely applicable to nearly everything. This universality can create universe, unifying models, very likely. Both efficiently describe from a neurological level to mind and behaviors, what’s going on explicitly and in detail about how innovation, understanding and creativity come about. It formalizes and details what we are doing, in a way which has not been seen before. And why not seen? Because we habituate, ignore, and then facilitate those ignorings. This makes clearer how we are likely to be thinking, cortically and processing external sensory and internal information.
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The point which Einstein missed was that though he stated that there was NO privileged position in the universe, as all positions can used as the referent point for time and space were likely not privileged. However, he missed the characteristic thermodynamic of least energy being efficient, thus stable (fixed)  relative standard, which he implied but never specifically understood nor stated measuring standard. And that our words are largely such standards, thus uniting verbal description as being the parent form of measuring standards. Thus this model extends once again, Einstein’s revolutionary epistemology. That least energy creates a far more efficient, standard, such as the sun in the center of the solar system, and like wise universally, much larger bodies orbit much smaller bodies, is the case. Thus the sun, by least energy rules, is the center of our solar system, and by extension in most all other similar cases.
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And thus the MD’s were able to understand, apply and use Duchenne’s new finding of DMD and its characteristics. Which, it should be noted, the genetics model has vastly extended our understanding of it. The use of the EMG needle exam has shown characteristic and diagnostic changes of DMD. It, too, & creates a more complete model of the functional, diagnostic findings.  The pathology of muscle biopsy and posts mortem studies has also extended by using clear cut structure/function methods (the heretofore complicated, hard to apply and understand, “clinico-pathological correlation” which is a sesquipedalian form of S/F, and harder to apply because it’s not a simple enough term. Thus, not efficient as S/F!!).. Good, efficient creations create more creativity, building up the hierarchies of our organized understandings.
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Thus we have a much deeper understanding, a far more detailed, explicit & formal description of how our brains are working to create diagnoses from our observations. We have a new model of understanding understanding; of how we think by processing information, largely cortical.
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Understanding that EACH image the radiologist “reads” are a set of efficient descriptions about those images, be they CT scan, PA and Left Lateral chest x-rays, MRI of body parts, esp. brain and spinal images, are massive comparisons to a well established, efficient set of “Normal standards” which he intuitively learns & applies. This method formalizes those methods, explicitly for the first time. Those enable any radiologist to interpret, and read any image he’s so trained to see. This most all done by massive visual comparison methods, which have not been formally described, understood and whose structures and processing can now be seen.
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In the same ways, in our examinations, guided by experience and history, we compare as physicians, nurses, and other medical professionals, what we KNOW by constant confirmation and learn by same lay downs of LTM events, what’s normal, and what is not. And the implications of the latter patterns of findings used for diagnoses. This all organized by least energy efficiencies and methods. And these comparisons of the descriptions we daily make in diagnosing at first, then repeated exams to see and detect any characteristic changes over time, compared to our first exams, also written down, is how we create new knowledge. We compare to our verbal, efficient, descriptions by using a specialized language which uniquely and efficiently describes meaningful and useful observations which have significance. This is how we do it, in detail, within the massively interconnected cortical columns of Mountcastle, which are trained up & learned by unlimited repetitions,. Those are worked into efficient comparison methods by this creative method. This model explicitly shows how we work. And the protocols we use to make the diagnoses are also hierarchically arranged, esp. according to anatomy, physiology & in each specialty, their characteristic methods, forms and words.
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We use lab tests as well. Each are comparison standard structures, whose normal standards we compare to the blood counts, the chemistries, the blood gases, etc., to determine the nature and patterns of normals as well as those which are abnormal, viz. disease processes. Simply speaking, the comparison of patient data created by the lab studies, makes the diagnoses &/or confirms, it as well. using throughout all of this are the words/measures which act as the standards against which by comparison processing we find AND create the new data.  These are the methods by which we create new information, data, and knowledge, simply, efficiently and practical, most likely.
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This is how we create new knowledge about each new patient and how we organize specifically in each case, using the cameo of radiological reading of images, and Duchenne’s method as specifically how it’s done. & in addition, it’s complex systems thinking underlain by TD least energy efficiencies. Thus defining professional characteristics compared to the far less amateur & early student ways of doing the same tasks.  Biology is complex systems. Understanding biological complex systems by pattern recognition creates new knowledge, in other words.
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How this applies universally is very, very clear. We can take each & every field and ask the very same, Big Question. How do we compare the outputs of a professional to an amateur? How do we compare the skills of the med student to his training, experienced, learned teachers? Because the professionals have universally built up a series of definable, clear cut methods by which they create information by comparison to known standards from visual mostly, but also other sensory data of touch, hardness, smoothness, sounds, and the other unlimited numbers of sensory descriptions also often seen and reinforced by visual means. & those methods are highly efficient in most all respects compared to amateurs and young students.
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And taking a set of 12  fine professionals, for instance, to create confirmability and good sampling, cabinet making carpenters. We study each one for his definable comparison process methods, and show from each of those and how they select the wood, cutting the wood, making the shelves, and then the frames into which those shelves are parts. The surface painting and preparation. The affixing of the hardware. And in each case, how the job is done by the professional cabinet maker (& indeed ANY known professional) that gives a faster job, a job better done, with less waste of materials, and better outcomes, all methods of which are underlain by the creative use of least energy methods, trial and error discoveries and rules. THAT is what creates and defines a professional,largely. But we have much yet to learn and can by this means, as we journey & epxlore into the Undiscovered Country.
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And when we do the work which delimits the very many, detailed specific methods/skills that each professional does in ANY field, we find an overlapping and commonality of similar methods. And each of those are not final, nor absolute, but pretty good. We find we can improve Each of them without limit using the applications of the above, now formally described and enumerated, to advance and progress in work outputs of better and faster, and more efficiencies, without limit. Thus setting in motion, where this method is widely adopted and properly developed, growth without limit. And an efflorescence of progress and vastly improved techniques, without limit across most all of the professions. Not to ignore that the teaching of these known methods from study of professionals, will significantly improve and speed up the production of more professionals, also without limit. It creates a science of technologies and the professionalism derived from those. And this probably universal general method can be likely extended to most all of the arts, sciences, and heretofore not scientific professions known.  Without limit.
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And further it is enough work to occupy the times of millions of researchers, who can also teach such methods in their own fields, as well. Thus more fully uniting practice and education.
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The consequences of these methods are therefore clear. Comparison processing and methods (trial and error developed) using the least energy guiding method, plus complex systems understanding and thinking. and structure/function methods make all of this substantial paradigm change possible, indeed inevitable, along least energy and thus growing methods, driven by the epistemological changes first shown by Einstein. Plus Least energy as the major driver of growth and development.
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How this can be applied to general AI is clear. IF there is a clear cut, detailned working model of how the brain/mind create knowledge, use it and extend it, viz. the wellsprings of creativity, then a model of this can be built using current and developing methods, which the above model can ALSO create using AI. If we know where to go, we can get there much faster and more efficiently, rather than brute force Trial and Error working within a huge, very time consuming to work through, combinatorial complexity, which is the case.
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These methods and insights can create very efficiently general AI along the lines of Gazzaniga, that the brain is a modular, complex system. This is at once likely and apparent from the above model. Creating the creativity, the tools to create the tools is also implicit within the comparison process and methods system.
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Taking the AI of imaging recognition, this can be used to create automated image interpretation, at first of PA and Left lateral chest images. Once the several radiologists are “debriefed” about all the known and often subconscious methods they use, which are efficient, then those are collected, studied for overlapping similarities by the same comparison system using the Bayesian, more efficient methods by which machine recognize, to some extent, and simulate our cortical comparison processing methods. Guided, by explicit use of Least energy efficient methods.
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Then each and every imaging kind be it ultrasound of heart, carotids, abdominal or uterine imaging methods can be so studied from those who are best qualified to use them. And in each case, this knowledge then built into the AI image interpreter.  It will also create a database for teaching more radiologists more easily and faster and efficiently, because what’s been subconsciously learned and not specified become formal, explicit and thus far, far more useful heuristic than known before. Combining talents & knowledge of fine radiologists can be very good.
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It will also speed up interps of basic bone imaging studies, and free radiologists from this kind of repetitive work, where they can at once reviews such films, add or subtract from them as per supervising of the interps by AI. And then create better, and more efficient methods over time via AI plus supervised guidance by expert, highly trained and experienced radiologists in each sub field.
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Thus the field of medicine will greatly advance in this area, and then these methods can be ,more widely applied using radiological imaging interps to the rest of medical fields. And in fact, most all other fields, without limit, too.
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No doubt we have much to learn. But these methods will, over time, because they are more efficient, effective will grow without limit into a finer practice of medicine, using our AI assistants.
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But recall to keep the “genie of AI”  in the bottle. That we take their suggestions and do the work with them, and not to surrender decision making to AI, wherein it can take over and create problems for us, as genies are quite well known to do!!!  We never surrender our supervision. Or final decision making actions which affect patient outcomes.
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Knowledge is good because from knowledge can come wisdom. And from wisdom can come many good things. But, use the knowledge WISELY.  –Proverbial saying
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