{
  "abstract": "The term physicianeer was coined to describe the merging of medicine and engineering training in order to produce a new specialty that includes a systems approach as applied to medicine. Examples of academic programs include the Physicianeer Programme at the University of Galway and the Engineering Medicine Program at Texas A & M (Houston) in the United States. While most applications of the merged discipline have pertained to biomedical developments such as vaccines, the combined approach might also lend itself to an innovative view of clinical research and practice. Reconsideration of established treatments in medicine may be a challenge for reasons such as 1) first-do-no-harm assumptions, e.g., reluctance to remove a factor which is thought to possibly be of benefit; 2) inertia, including disinclination to change longstanding practice; 3) expert opinion filling gaps to form established practice in areas that lack an evidence base for treatment and that may become de facto standard of care; 4) fears such as legal or ethical concerns about possibly missing information. In engineering, machine learning ablation studies remove a variable to measure an effect such as system efficiency. The concept of ablation may have a novel potential: to encourage routine reflection about overdiagnosis/overtreatment and to help to actively visualize placebo arms for research. For example, the concept might encourage study of active surveillance as compared to treatment for low-risk prostate cancer. An example of the ablation concept visualized for practice might be to encourage consideration of measures to reduce the number of medications for people experiencing polypharmacy. Of course, any placebo-controlled trials or reassessment of established treatments must be subject to rigorous pre-evaluation for ethical concerns and patient values/preferences, as well as careful clinical follow-up to ensure lack of harms. However, routinely thinking about overuse of tests and treatments may also produce benefits such as avoidance of unnecessary therapies or attendant harms; better-directed resources; or reduction of discomfort and anxiety. Assessing diagnostic or therapeutic processes that fit this paradigm with a physicianeer approach has potential to prompt reevaluation of a more-is-better mindset for selected areas of medical training, practice, or research.",
  "authors": [
    {
      "affiliations": [
        "Physician, Syosset, USA"
      ],
      "name": "Sheila Feit"
    }
  ],
  "title": "023 Could an engineering approach inform medical research, training, or practice? A hypothesis",
  "uid": "09f11bce-e6ac-5201-a88c-90b1f8b4cefb"
}