JMIR出版股份有限公司% v17 %N 3 %P e64 %T系统医卡塔尔世界杯8强波胆分析学2.0;电子医疗记录与系统科学模型相结合的潜在好处%A Tillmann,Taavi %A Gibson,Alexander R %A Scott,Gregory %A Harrison,Oliver %A Dominiczak,Anna %A Hanlon,Phil %+伦敦大学学院流行病学与公共卫生学系，伦敦托灵顿广场1-19号，WC1E 7HB，英国，44 20 7679 8252，taavi.tillmann@gmail.com %K基因-环境相互作用%K系统理论%K电子健康记录%K流行病学%K在线社交网络%K众包%K Web 2.0 %D 2015 %7 23.03.2015 %9观点% jj医学互联网研究%G英语%X背景:全球疾病负担越来越多地以非传染性疾病为主。与传染病相比，这些疾病更不容易得到治疗和预防干预。这对医疗实践和医学研究提出了挑战，两者都面临着投资增加带来的回报递减的问题。目的:我们的目的是(1)审查医学知识的产生方式及其局限性，(2)评估新兴技术和思想改善医学研究的潜力，以及(3)提出解决方案和建议，以提高非传染性疾病的医学研究效率。方法:我们对同行评议的文献和技术网站进行了非系统的综述。结果:我们的审查产生了以下结论和建议。(1)医学知识继续以还原论范式产生。这过度简化了我们的疾病模型，使它们无法充分理解非传染性疾病的复杂性。(2)通过采用“系统医学”范式，将人体建模为一个复杂的适应系统，可以克服其中的一些缺陷。 That is, a system with multiple components and levels interacting in complex ways, wherein disease emerges from slow changes to the system set-up. Pursuing systems medicine research will require larger datasets. (3) Increased data sharing between researchers, patients, and clinicians could provide this unmet need for data. The recent emergence of electronic health care records (EHR) could potentially facilitate this in real-time and at a global level. (4) Efforts should continue to aggregate anonymous EHR data into large interoperable data silos and release this to researchers. However, international collaboration, data linkage, and obtaining additional information from patients will remain challenging. (5) Efforts should also continue towards “Medicine 2.0”. Patients should be given access to their personal EHR data. Subsequently, online communities can give researchers the opportunity to ask patients for direct access to the patient’s EHR data and request additional study-specific information. However, selection bias towards patients who use Web 2.0 technology may be difficult to overcome. Conclusions: Systems medicine, when combined with large-scale data sharing, has the potential to raise our understanding of non-communicable diseases, foster personalized medicine, and make substantial progress towards halting, curing, and preventing non-communicable diseases. Large-scale data amalgamation remains a core challenge and needs to be supported. A synthesis of “Medicine 2.0” and “Systems Science” concepts into “Systems Medicine 2.0” could take decades to materialize but holds much promise. %M 25831125 %R 10.2196/jmir.3082 %U //www.mybigtv.com/2015/3/e64/ %U https://doi.org/10.2196/jmir.3082 %U http://www.ncbi.nlm.nih.gov/pubmed/25831125