Recommendations for addressing the translational gap between experimental and clinical research on amyloid diseases.

This paper is a report of recommendations for addressing translational challenges in amyloid disease research. They were developed during and following an international online workshop organized by the LINXS Institute of Advanced Neutron and X-Ray Science in March 2021. Key suggestions include improving cross-cultural communication between basic science and clinical research, increasing the influence of scientific societies and journals (vis-à-vis funding agencies and pharmaceutical companies), improving the dissemination of negative results, and strengthening the ethos of science.

The Problem of Aggregating Validators for Psychiatric Disorders.

Since the time of the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, evidence for the validity of psychiatric disorders has been expressed in the form of validators, which are instances of particular kinds of evidence. There has never been an explicit discussion of how the validators should be aggregated to come to an overall conclusion about the strength of the evidence for a psychiatric category. We include both the challenges of aggregating validators of the same type and the challenges of aggregating different types of validators. We consider five different alternatives: informal aggregation, weighted informal aggregation (simple evidence hierarchy), formal aggregation, underdetermination, and inclusion of values. Each of the alternatives has different implications. We suggest that, going forward, aggregation of validators should be more explicit, maximizing rigor and reproducibility.

Naming migraine and those who have it.

Medical language has implications for both public perception of and institutional responses to illness. A consensus panel of physicians, academics, advocates, and patients with diverse experiences and knowledge about migraine considered 3 questions: (1) What is migraine: an illness, disease, syndrome, condition, disorder, or susceptibility? (2) What ought we call someone with migraine? (3) What should we not call someone with migraine? Although consensus was not reached, the responses were summarized and analyzed quantitatively and qualitatively. Panelists participated in writing and editing the paper. The panelists agreed that "migraine," not "migraine headache," was generally preferable, that migraine met the dictionary definition for each candidate moniker, terms with psychiatric valence should be avoided, and "sufferer" should be avoided except in very limited circumstances. Overall, while there was no consensus, "disease" was the preferred term in the most situations, and illness the least preferred. Panelists disagreed strongly whether one ought to use the term "migraineur" at all or if "person with migraine" was preferable. Panelists drew upon a variety of principles when considering language choices, including the extent to which candidate monikers could be defended using biomedical evidence, the cultural meaning of the proposed term, and the context within which the term would be used. Panelists strove to balance the need for terms to describe the best science on migraine, with the desire to choose language that would emphasize the credibility of migraine. The wide range of symptoms of migraine and its diverse effects may require considerable elasticity of language.

Trust: The Need for Public Understanding of How Science Works.

General science literacy contributes to good public decision-making about technology and medicine. This essay explores the kinds of science literacy currently developed by public education in the United States of America. It argues that current curricula on "science as inquiry" (formerly the "nature of science") need to be brought up to date with the inclusion of discussion of social epistemological concepts such as trust and scientific authority, scientific disagreement versus science denialism, the role of ideology and bias in scientific research, and the importance of peer review and responsiveness to criticism.

Epistemological reflections on the art of medicine and narrative medicine.

This article challenges the widespread view that there is both a science and an art of medicine. Through examination of recent work in medical humanities --Jodi Halpern's From Detached Concern to Empathy (2001), Kathryn Montgomery's How Doctors Think (2006), and Rita Charon's Narrative Medicine (2006)--I argue that while a variety of epistemic techniques are important in medicine, it is not helpful to dichotomize them as "science" versus "art." I assess the epistemic strengths and weaknesses of narrative medicine, a recent exemplar of humanistic medicine.