Chapter 25 scientific planning

It is generally acknowledged that the biological sciences are brilliant.In the past decade alone, the biological sciences have revealed a vast amount of entirely new information, and much more is yet to be discovered.A revolution in biology is clearly in the ascendant.On the contrary, the public's attitude towards the progress of medicine in the same period has reservations, discounts, and mixed feelings.Notwithstanding some new knowledge, we still have terrible diseases with unsolved puzzles, no satisfactory explanations, and no satisfactory cures.One cannot help but ask: if the biological sciences continue to flourish, yielding new and powerful technologies capable of explaining the processes of life itself in great detail, why has it been so slow to create new panaceas?

It is useless to label our science with such a big word as "biomedical medicine", although we are willing to tell people that we all belong to the same research field, and there is no way to divide the results and share them equally.For example, there is still a significant imbalance between molecular biology and cancer treatment.Let us put it bluntly: there is a fairly clear distinction between advances in basic science and the application of new knowledge to solve human problems.This requires explanation. Because the issue is directly related to national science policy, it is a much-discussed issue today.It is fashionable in Washington to attribute the slow development of practical science in medicine to a lack of systematic planning.According to the cloud, if there is a new management system, and everyone pays more serious attention to the practical application of the invention, we can reach our goal more quickly, which is said to be more affordable and cheaper.So a new term appeared, called "finding" (targeting).We need more targeted research, more pragmatic science.Basic research could be less -- much less.It is said that this is the new trend nowadays.

There is a problem with this view: it assumes that biology and medicine already have a substantial body of information available that is consistent and interconnected.actually not.In real life, biomedicine is far from reaching the level where it can be generally used to explain the mechanism of disease.In some respects, we have flourished into new fields like physics did in the early 20th century, but there has been no corresponding advance in engineering.It is quite possible that we are about to produce a considerable applied science, but it has to be said that, after all, it has not yet been produced.An important question for policy makers is whether the science should be allowed to emerge naturally, or can be accelerated by using managerial and monetary influence.

There are some dangers here.We've had some familiar troubles, and now we may have more troubles of the same kind.Medicine has been in a trap for thousands of years, ever since it came into existence.Our beans have had this habit since ancient times. This is to give it a try if there is a little opportunity and hope.Sometimes this idea is based on experience, sometimes it is whimsical.And we've proven time and time again that it doesn't work.Phlebotomy, cupping, and diarrhea therapy are notable examples, and there are plenty of more recent examples that embarrass us.Until now, we have been fooled by some similar technological substitutes.There is no doubt that our motives are good in such matters: we all collectively aspire to become applied scientists as quickly as possible, if possible, by waking up tomorrow morning.

However this is to do something.Everyone forgets that it takes long hours and hard work to make really important practical technologies practical.The great achievement of modern medicine is the technology of controlling and preventing bacterial infection, but it did not fall in front of us all at once with the advent of penicillin and sulfonamides.That technology originated at the end of the last century, and decades of the most painstaking and laborious research were carried out to understand the etiology of pneumonia, scarlet fever, meningitis, and other diseases.Generations of energetic and imaginative explorers spent their lives trying to solve these problems.To say that modern medicine began with the era of antibiotics ignores a jaw-dropping amount of basic research.

However unpleasant, we have to face the realistic possibility that we understand as much about some unsolved diseases today as schizophrenia, cancer or stroke as we did about infectious diseases in 1875. similar critical knowledge has not yet been acquired.We are so far away from solving the problem: it will take so much, if not so many years, then so much work.If this, or nearly so, is the prospect, any suggestion of a better way of speeding things up must be scrutinized humbly and scrupulously. Long-term planning and organization at a national scale is clearly important.This matter is not unfamiliar at all.In fact, for more than 20 years, we have been organizing national-scale joint research through the National Institute of Health.The question today is: whether its planning is focused, and whether the organization is very strict; whether we need a new scientific research management system, so that all goals can be clearly displayed, and arrangements can be made, and we can follow suit in the future ?

The methodical and reassuring appearance of doing so, and the fact that some important problems have been overcome in this way, suggest that direct, frontal attacks do work.Polio is the most striking example.Once people know from basic research that there are three types of antigenic viruses, and they can grow in large quantities through tissue culture, everyone is sure that a vaccine can be made.That's not to say that things are easy, or that it doesn't require the same level of hard work and technical virtuosity as in previous studies.Just saying, it can be done.As long as it is tested with superb technology, it will not be a problem to make a vaccine.This example eloquently illustrates how applied science should be organized.Because of this, it would be surprising if things didn't work out.

This is where applied science differs from basic science.Just because of this surprise, things are different.When you organize, apply what you already know, and set the goal of making a useful product, you demand absolute certainty from the start.All the facts on which you base your plan must be solid and unambiguous.Success, then, depends on whether you can plan your work effectively and organize your staff so that the results can be expected and accurately presented.To do this, you need to have a lot of power, order and prohibition, a carefully planned timetable, and some kind of reward system based on progress and quality.But, most importantly, you have clear, basic facts to start with.And these facts must come from basic research, no other source.

In basic science, everything is just the opposite, a high degree of uncertainty is needed in the first place, or it wouldn't be an important problem.There are only partial facts at first, characterized by ambiguity of meaning.Often it is necessary to first discover the connections between disparate bits of information.The plans you base your experiments on are not entirely certain; the results are only probabilities, even remote ones.It's good that the results come out exactly as expected, but it's only a major discovery if it surprises you at the same time.The quality of your work can be measured by how surprised you are.You may be surprised that things turned out as expected (in some research fields, a 1% success rate is considered high efficiency); or that the predictions were all wrong, and you did not expect The results appear; or the problem is changed, requiring the development of a new research plan.Either way, you've succeeded.

I venture to think that if we take an inventory of the great problems of disease on the basis of this taxonomy, we will find a limited number of important questions to which the answers can be predicted with some degree of certainty.It would be a good idea to sit down with some committees and start planning for the long term, to map out some disease-specific research, to identify and separate these problems from all other problems, and in this regard the methods of operations research would be extremely useful.There must be a lot of debate among experts about which issues are sure and which are not; perhaps the intensity and duration of the debate can be used as a measure of confidence.In any case, once a consensus has been reached on some research-worthy problems, they can be solved using the extremely methodical methods of applied science.

However, I think more rashly that most of the important research to be done in biomedicine belongs to the category of basic science.Plenty of interesting facts are linked to our major diseases, and more information keeps coming from all sides of biology.The mass of newly arrived knowledge is still shapeless, incomplete, lacking key threads of interconnection, like a crooked alley, with misleading signs at every corner and dead ends.The whole field is full of fascinating ideas, countless experiments with irresistible temptations, various new paths, and a maze leading to problems, but every step is unpredictable, and the results are unpredictable.This is a fascinating season, and it is also a golden time for fruitfulness. Not sure how you're going to come up with an uncluttered plan for such an event.But I think you can find something by looking at the messy records of the past century.Either way, an atmosphere has to be created so that the unsettling feeling of making a mistake becomes the normal attitude of the explorer.It should be taken for granted that the only way to succeed is to let go of your baggage and let your imagination run wild.In particular, it is bold to admit that some things may be unimaginable, even almost impossible, but at the same time they are real. There is a good way here, you might as well go to the corridor to listen to the speeches of scientific researchers to understand the progress of basic research.You know someone's well-organized research project is well on its way when you hear someone finish talking and then say, "Ah, no way!" followed by a burst of laughter.