Commentary on Discussion Paper by Miles, A and Mezzich J.E. (2011). Person-centred medicine as an emergent model of clinical practice: The devil is in the details
Bibliographic record
Abstract
Miles and Mezzich have written a comprehensive review of the origins, development and current status of two influential international movements aimed at shaping the practice of medicine - evidence-based medicine (EBM) and patient-centred care. As the authors point out, these two movements have been largely independent of each other with little crossover of ideas as each pursues its own goals of trying to broaden its influence. Miles and Mezzich propose to take the strengths of both movements and to create a new integrated model of person-centred care (PCC) which is evidence-informed (rather than evidence-based) and incorporates a role for patient values in clinical decision-making. While laudable and logical to try to move forward with this approach which integrates two seemingly contradictory principles underlying each movement (clinical practice based on the findings of clinical research evidence and clinical practice that is responsive to patients’ values, preferences and beliefs), this task is not easy and, as the authors themselves note, the model that results from this process is still in elementary form. By proposing this new integrated model, the authors hope to stimulate further debate on the meaning of a person centred-care approach to medical practice.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".