Generalized Resemblance Theory of Evidence: a Proposal for Precision/Personalized Evidence-Based Medicine

TL;DR

This paper introduces a novel theoretical framework for personalized evidence-based medicine, combining generalized uncertainty management and disease resemblance to improve clinical decision-making and evidence formation.

Contribution

It proposes the Generalized Resemblance Theory of Evidence, integrating uncertainty theory and prototype resemblance to enhance precision in medical evidence and decision-making.

Findings

Provides a new methodological framework for pEBM

Demonstrates application through meta-analysis example

Balances evidence generalizability with population homogeneity

Abstract

Precision medicine emerges as the most important contemporary paradigm shift of medical practice but has several challenges in evidence formation and implementation for clinical practice. Precision/Personalized evidence-based medicine (pEBM) requires theoretical support for decision making and information management. This study aims to provide the required methodological framework. Generalized Resemblance Theory of Evidence mainly rests upon Generalized Theory of Uncertainty which manages information as generalized constraints rather than limited statistical data, and also Prototype Resemblance Theory of Disease which defines diseases/conditions when there is a similarity relationship with prototypes (best examples of the disease). The proposed theory explains that precisely-personalized structure of evidence is formed as a generalized constraint on particular research questions, where the constraining relation deals with averaged effect sizes of studies and its comparison to null hypothesis; which might be of either probabilistic or possibilistic nature. Similarity measures were employed to deal with comparisons of high-dimensional characteristics. Real examples of a meta-analysis and its clinical application are provided. This is one of the first attempts for introducing a framework in medicine, which provides optimal balance between generalizability of formed evidence and homogeneity of studied populations.