The aesthetics of knowledge

Combined use of anticancerweb and global-ePHR platforms to build a knowledge escalating program generating clinical, molecular and social cancer signature


James Fleck, MD, PhD: Anticancerweb 30 (04), 2023

Anticancerweb (ACW) works with an andragogical strategy, that is, adult learning. All posts have clear objectives, focused on global cancer control. It promotes an inclusive and independent thinking, generating immediate value. The scope has practical implications, clarifying and improving constructive ideas. The result is translated as collective intelligence. There is already evidence that collective intelligence can be measured (factor c) and usually increases with the degree of diversity. Teamwork promotes growing synergy, generating individual satisfaction and improving the achievement of cooperative goals. This is the motivation that drives people on social media. Often this trend is used non-productively. ACW proposal is to use it in a focused and creative way, valuing what can be called the aesthetics of knowledge. Its dynamic encompasses all stakeholders and catalyzes their integration. Stakeholders have different motivations. They need to get to know each other and align specific interests. Stakeholder consensus will consolidate innovative ideas, improving cancer care guidelines. The result will be better aligned with all sectors of society. Figure 1 shows how ACW is modelling collective intelligence in global cancer care and next-generation clinical trial designs.

Let's explore three andragogical resources that working together are already generating collective intelligence in ACW:

• Fast Knowledge Tracking (FKT): Today, time is highly valued and FKT fulfills this essential requirement. The information is presented in a short and objective way. Each sentence conveys a clear thought. The language is fluid and very well connected. The post refers to a mental image fully representative of the proposed idea. Preferably, each text is published in editorial format, requiring a maximum of five to seven minutes of reading. A figure or table is usually included to summarize the thinking and make it easier to understand. Defining references are used to generate a supporting database, leading to the practice of evidence-based knowledge. As knowledge is unlimited, search is an individual decision, directly related to specific interests and motivations. Posts in FKT format are found in ACW header menu under Article. The current post is an example of FKT.

• Clinical Simulation System (CSS): These are fictional stories inspired by the real world, with the aim of developing attitudes and skills necessary for cancer patient care. Posts in CSS format are found in ACW header menu under Book. There, you will find ten clinical simulations. Table 1 relates each clinical simulation to the anatomical location of the primary tumor and the dominant behavioral trait expressed by the patient in coping with the disease. Patient is always the protagonist and doctor is the supporting actor. All posts are based on a multidimensional care model, where physical, emotional, cognitive and social components are worked on. Emphasis is placed on the turning point of the doctor-patient relationship.  This is the best time for patient-centered shared decision-making. Dividing the story into plot segments makes it possible to assess the emotional flow observed in human relationships. As CSS is powered by the real world, a connection can be made using anonymous personalized medical records (Global e-PHR) under the informed consent of the patient. This combined effort will create a big data system. Loaded data can improve clinical, laboratory, and image-guided cancer screening and diagnosis, as well as new personalized cancer treatments. More accurate algorithmic decision-making for cancer care could point to specific knowledge gaps, which would guide next-generation clinical trial designs. 

• Knowledge Translation Network (KTN): This andragogical resource is based on interdisciplinarity. Posts in KTN format are found in ACW header menu under Clinical Trial. Each post addresses technical advances in diagnosis and treatment of the world's most common and deadly malignant tumors. Navigation will guide you to innovative readings. Update includes editorials and original articles. Most articles were published in the top 10 medical journals. The textual structure follows the same criteria used in the FKT, but the focus here is landmark clinical trials. The text guide you in a technical reading. The method is simple and everyone can easily acquire the expected skills. Reading posts categorized as KTN makes it possible to understand how innovation is inserted in routine clinical practice. The methodology is recognized worldwide as translation knowledge and the process is always based on levels of evidence and recommendation. Typically, this goal is achieved through a multidisciplinary collective effort. Cancer knowledge translation can be accelerated through tumor board consensus meetings. Each committee is usually identified by anatomical location of the primary tumor. Each committee usually meets in a weekly bases. KTN publications also exercise creativity in basic science, new directions in clinical research, improvement in patient care, and better cost-effective public health interventions.

Currently, ACW reaches 396 posts, available in two natural languages and well distributed in the three andragogical formats described above (FNT, CSS and KTN). The posts generated 421,400 views and 1,451 comments. Despite the high satisfaction rate (98.5% among stakeholders), data is still immature to drive AI pattern recognition. The proposed model should be expanded. Future directions involve creating a comprehensive editorial board, seeking collaboration with international medical journals, and ensure cross-disciplinary cooperative work with a high-tech company aiming at the implementation of Global-ePHR.



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