From Big Medical Encyclopedia

CYBERNETICS MEDICAL (grech, kybernetike management skill) — the section of cybernetics studying management processes and processings of information in live organisms and groups of people that it is used at problem solving of prevention and treatment of diseases, and also tasks of management of health care. In view of exclusive complexity of the mathematical description of patterns of functioning separate fiziol, systems and an organism in general, mechanisms of development patol, processes or the description of processes of medical service of the large contingents of the population, snowballing To. began m only after creation of high-speed computers with large volumes of memory (see. Electronic computer ).

In tasks To. the m enters development of the new principles of obtaining information on a state various fiziol. systems and organism in general; development of new methods of impact on an organism and its systems in to lay down. the purposes, including the methods providing short-term or long substitution of natural bodies artificial; development of methods of management of system of public health care. Close to a perspective To. m are problems of designing of robots and creation artificial intelligence (see).

The beginning of snowballing To. by m in the USSR it is connected with names of the scientists who made the significant contribution to development of the general ideas of cybernetics — A. I. Berg, A. A. Lyapunov, and also scientists-physicians — P. K. Anokhina, H. M. Amosova, H. N. Blochin, A. A. Vishnevsky, V. V. Larin, etc. From foreign specialists, there is a lot of made at an initial stage of development To. m, it is necessary to call first of all N. Wiener, N. Bailey, L. Bertalanffy, W. Ashby.

It is possible to allocate two main directions of development To. m. The first of them is connected with researches in the field of identification, modeling and management of the processes proceeding in an organism in the conditions of norm or pathology. The second direction covers works in the field of development of information systems and ACS (see. Automated control systems ), intended for management in a health system at various levels — from separate institutions (policlinic,-tsa, the station of ambulance, etc.) to the organizations responsible for the state of health of the population of the certain countries and carrying out the international scientific programs in the field of medicine.

The task of works of the first direction includes, in particular, development of diagnostic methods of diseases by means of special algorithms of recognition of images (see. Algorithm , Algorithm diagnostic ) and with use of the large volumes of medical information which are stored in computer memory at a grade level to diagnosis, and sometimes — and at a stage of the statement of the specific diagnosis (see. Diagnosis machine ). Distinguish problems of the choice of the most probable diagnosis from rather large number of a priori of estimated diagnoses and a problem of differential diagnosis — the choice of one diagnosis from in advance assumed couple of hard to distinguish diagnoses (owing to a similar developmental character of the corresponding diseases).

During the development of information retrieval and diagnostic systems on the basis of use of algorithms of recognition of images the following purposes can be allocated. 1. Rendering the consulting help to the doctor in difficult diagnostic situations. In this case the COMPUTER tells the doctor the most probable versions of the diagnosis (according to the formalized analysis of data on the specific patient) or recommends to conduct additional examination, if necessary. 2. Improvement of medical service of the population in conditions when immediate rendering the qualified medical aid on site is complicated (e.g., because of absence in this establishment of the specialist of the necessary profile). In this case the special communication systems connecting medical institutions on places to the central institutions which can hold the necessary consultation are used. At the same time along with use of purely formalized procedures also procedures of the mixed type where the active part is assigned to the experienced medical specialist who if necessary makes the decision on additional inspection of the patient on site are applied or itself makes the final diagnosis. 3. Identification at mass surveys of the big contingents of the population of belonging of individuals to group of the increased risk in relation to some disease. At the same time the questionnaires including biographic data inspected, data on working conditions and life, a way of life, the postponed diseases, etc. are used. Processing of results of these polls allows to make the decision on accessory (or not accessories) inspected to risk group. In view of the fact that data processing of questionnaires is rather simple, use of this method allows to save considerably resources on intensive inspection and medical examination in comparison, e.g., with intensive inspection or medical examination of all initial contingent. 4. Use of opportunities of storage of large volumes of information in the COMPUTER allows to choose, based on the analysis of diseases, close to this case, the best tactics of treatment. At the same time treatment is performed according to the closed scheme: the patient — the doctor — consultation with the COMPUTER — medical recommendations — the patient. 5. Questions of management of treatment during the use of strong, toxic and other means which action on an organism has system character (covers the majority of its systems). At the same time by means of methods of mathematical modeling (see) programs of treatment (terms of N of a dose), possible methods of compensation of undesirable effects, etc. are defined. Use of the COMPUTER is of great importance for calculation of dozny fields at radiation therapy, e.g., that allows the doctor to choose an optimal variant of an arrangement of a source of radiation.

Also works on machine interpretation of results of an electroencephalography, an electrocardiography and other types of inspections of the state of health of the patient concern to group of works of the first direction. Loop systems of management of an anesthesia, stimulations of cordial activity and breath etc. are developed. Here works on a research and development of loop systems of management of external auxiliary systems (e.g., cardiopulmonary bypasses), on creation of the managed prostheses of extremities etc.

Due to the developments of artificial organs enter (heart, kidneys, etc.) the attention is drawn by a problem of modeling of an organism in general or its large systems (blood circulation, breath, a metabolism). One of important problems is the problem homeostasis (see), as from the point of view of disclosure fiziol, mechanisms of maintenance of a state, favorable for an organism, of «the internal sphere» with the broad range of change of environmental conditions, and from the point of view of a possibility of sale of mechanisms of a homeostasis in various technical devices. It should be noted that the analysis of optional versions of implementation of a homeostasis in biol, systems leads to a conclusion about the nonlinear nature of bonds between separate elements of these systems that to a certain extent can be considered as distinctiveness biol, systems.

To the second direction of researches in To. m belong constructions of information systems and ACS, in particular the accounting of the state of health of the large contingents of the population, W. h population of the certain countries. Such account especially on condition of a possibility of bystry access to a case history of the certain patient allows to give quickly help in case of emergency, according to plan to carry out actions for prevention of diseases, detection and identification of the reasons of unfortunate trends in change of the state of health of the population. Thereby the multichannel loop system of mass medical service allowing to realize in the best way opportunities is formed to-rymi the health system has. It is also necessary to carry to number of information systems of medical appointment control systems of scientific research in medicine. During the development of these systems the aim of the maximum concentration of efforts of scientific many countries on problem solving on fight against the diseases bringing to society the most considerable losses is pursued (e.g., cardiovascular, malignant, tropical, etc.). The researches directed to fight against these diseases are coordinated by the international organizations, first of all WHO.

The significant role in management of activity of healthcare institutions belongs to information systems and ACS of various levels. Among these systems it is necessary to mention ACS «Health care», ACS the «Shots» aiming to provide the best distribution and use of medical shots in the country, ACS the «Clinic», «Policlinic», «Hospital» aiming to provide the best service of various contingents of the population, ACS «Drugstore», etc.

Development To. the m and implementation of its methods in practice of medicine and health care are closely connected with scientific and technical progress. The great value gets also planning difficult medical - biol, experiments, in particular on animals, and studying of a possibility of use of the received results in a wedge, practice.

See also Cybernetics , Systems analysis .

Bibliography: Antomonov Yu. G. Modeling of biological systems, Reference book, Kiev, 1977, bibliogr.; Bailey N. Mathematics in biology and medicine, the lane with English, M., 1970, bibliogr.; B y x about in-sky M. L. and Vishnevsky A. A. Cybernetic systems in medicine, M., 1971, bibliogr.; Vorobyov E. I. A.I's ikit. Introduction to medical cybernetics, M., 1977, bibliogr.; Sh at - poppies B. And., etc. Modeling of physiological systems of an organism, M., 1971, bibliogr.

A. M. Petrovsky.