The ophthalmology in front of the scientific revolution of the Digital Age. A vision from the history and philosophy of science

Fernández-Vigo, José Ángel; Almorín Fernández-Vigo, Ignacio; Kudsieh, Bachar; Fernández-Vigo, José Ignacio

doi:10.1016/j.oftale.2022.11.004

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Una visión desde la historia y la filosofía de la ciencia" ] ] "textoCompleto" => "Thomas Kuhn was a physicist interested in the research, history and philosophy of science.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> In 1962, he proposed a new theory of scientific method analysed from a historical point of view that opposed Karl Popper's dominant ideas on falsification (disproving a hypothesis by experiment).<a class="elsevierStyleCrossRef" href="#bib0010">2</a> His ideas were highly controversial due to the changes they produced by arguing, for example, that science advances by replacing previous ideas instead of an aggregation thereof, or that scientific revolutions have a structure that they must fulfil in order to be considered as such, adding a far-reaching conclusion on which we want to base our hypothesis, i.e., that the world is not the same after a scientific revolution.The issue being debated is simple: science in general and ophthalmology in particular face a challenge in the Digital Age which is difficult to gauge in terms of magnitude. The fusion of biotechnology and info-technology (the application of computers and telecommunications in data processing) will radically transform our world. The incorporation of new technologies such as artificial intelligence, robotics and cyborgs will change our scientific and healthcare environment, supported by their respective neuroscientific and technological fields. And this forces us to rethink a question we posed in these same pages five years ago<a class="elsevierStyleCrossRef" href="#bib0015">3</a>: what will our role as ophthalmologists be and how will it affect us? Are we facing a scientific revolution as defined by Kuhn or are we facing an unprecedented revolution?Probably the best way to analyse this challenge is to turn to the philosophy and history of science by the hand of two of the authors who can best illustrate this process. Kuhn in the mid-20th century and Harari since the beginning of the 21st century.<a class="elsevierStyleCrossRefs" href="#bib0020">4–6</a>In 1962 Kuhn wrote his masterful and influential work: "The Structure of Scientific Revolutions".<a class="elsevierStyleCrossRef" href="#bib0005">1</a> At that time science was undergoing a major change. Physics was no longer at the centre of scientific attention (Einstein, Planck, …), which shifted to biotechnology. That year, the Nobel Prize in Physiology was awarded to Watson and Crick for the molecular biology of DNA and to Kendrew for the Nobel Prize in Chemistry for haemoglobin. These were signs that biotechnology was the science that would prevail for some time to come.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>Fifty years later Harari argued that the key revolution of the coming decades will be the fusion of biotechnology and info-technology<a class="elsevierStyleCrossRefs" href="#bib0020">4–6</a> and that the most outstanding idea of the 21st century will be that organisms are algorithms and that they can condition us. In practice it means that if we can accumulate enough biological data and computing power we will understand people better and be able to predict their desires and influence their decisions through AI and data processing. This is called "digital dictatorship and technological disruption".Going back to the initial idea, can this new situation be considered from the point of view of the philosophy of science as a scientific revolution, or is it something different? We have seen Harari's view, which is certainly groundbreaking, but does the fusion of biotechnology and infotechnology fit into Kuhn's scheme and will it replace the prevailing scientific order in which we operate?Let us apply the above-mentioned historical approach. For Immanuel Kant, the first scientific revolution arose with the transition from the mathematics of Babylon and Egypt to the proofs and postulates of Greece.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> The second one took place when researchers, such as Descartes, Galileo or Newton proclaimed the need to replace blind faith by methodical doubt and reason, establishing the scientific method.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>According to Kuhn, another scientific revolution took place in the early 19th century in which areas such as heat, light or magnetism received a mathematical treatment giving rise to the techno-scientific world we live in today.Then came radical revolutions in physics such as Einstein's theory of relativity, Max Planck's quantum revolution, Heisenberg's uncertainty principle<a class="elsevierStyleCrossRef" href="#bib0045">9</a> and finally the advent of biotechnology.Thus, throughout the history of science, more or less profound changes have taken place that affect all the concepts of scientific research. These are normally progressive changes, except when a very significant qualitative leap occurs, in which case we are faced with revolutions, which are rare and controversial, but which have come to change the course of the times.The scientific revolution occurs when the theories and laws assumed by the scientific community, which constitute Khun's paradigm, cease to be useful because they no longer provide an answer or because experimentation reveals results that do not agree with that which is accepted by the community. From this point on, a crisis arises and a different path opens up that will not normally be developed by those who have defended the community's own normal science.We end this dissertation by summarising the situation with the decisive and categorical description of one of today's most important and influential leaders, Klaus Schwab, director and founder of the World Economic Forum, better known as the Davos Forum: "We are on the brink of a technological revolution that will fundamentally change the way we live, work and relate to each other. In its scale, scope and complexity, the transformation will be unlike anything humankind has ever experienced before".<a class="elsevierStyleCrossRef" href="#bib0045">9</a>How will ophthalmology and ophthalmologists react to this paradigm shift, how will we adapt our scientific and care model to the Digital Age? The solutions involve, at the very least, a radical change in the service delivery model in the same way that its scientific-technical approach will have to change, as we described above.<a class="elsevierStyleCrossRef" href="#bib0050">10</a>Conflict of interestThe authors declare that they have no conflict of interest." 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Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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