Evolutionary Medicine

Introduction and Rationale

Clinical trials are needed to make new medications, devices, and diagnostic tools available and approved for safe human use. Historically, participants in clinical trials often have come from a homogeneous group, white males, and there is a recognized need for increased diversity and representation in these clinical research studies. The shift of clinical trials towards more inclusive and diverse participant pools is critical. The absence of diverse participants in clinical trials makes it difficult for clinicians and researchers to know whether medications and devices are safe and effective for the broader population. This shift in clinical trial design and practice aims to enhance the generalizability and applicability of research findings to a broader range of individuals¹. Because differences among individuals in their genetics or physiology, such as allergies, can affect whether a drug is safe and effective, this is an example of evolutionary medicine: using knowledge of evolution to better understand diseases and their treatments.

The findings from clinical research studies fill knowledge gaps by providing new information about ways to treat, prevent, and diagnose diseases. Studies are needed to advance medicine and health care and optimize outcomes. Volunteers join these studies and contribute to the collected data on drug safety and efficacy. In many of these studies, the diversity of the participants is not representative of the general population, such as across the USA. Some subgroups of the population, including African Americans and Hispanics, were disproportionately under-represented in medical research studies.

Evidence has indicated that poor outcomes following drug administration, such as adverse reactions and reduced efficacy, can differ by patient characteristics, such as gender and ethnicity. Clinical research studies need to consider diversity when the goal is to improve care and outcomes for all patients².

I aim to develop a curriculum unit to teach the meaning of proportional relationships, specifically how the effects of medication errors can affect pediatric patients. Students will examine studies that discuss the importance of correct dosing, how dosages are determined, and why recommended doses may differ between adults and infants/children.  My students are often the caretakers of themselves and their younger siblings. They are often responsible for determining how much over the counter (OTC) and prescription medications to give themselves and their younger siblings. By the end of the unit, I hope students see the importance of following dosing guidelines for themselves and their younger siblings.

My goal is to help students understand the concept of a proportional relationship, and how that relationship connects to drug dosages. Students will build on the concept of equivalent ratios learned in 6th grade. In 6^th grade, students learned two ways of looking at equivalent ratios. First, if you multiply both values in a ratio a:b by the same positive number s (called the scale factor) you get an equivalent ratio sa:sb. Second, two ratios are equivalent if they have the same unit rate. A unit rate is the “amount per 1” in a ratio; the ratio a:b is equivalent to a/b:1, and a/b is a unit rate giving the amount of the first quantity per unit of the second quantity. One can also discuss the amount of the second quantity per unit of the first quantity, which is the unit rate b/a, coming from the equivalent ratio 1:b/a.

Students will describe proportional relationships and constants of proportionality, explain how to determine whether a relationship is proportional and how to compare and represent situations with different constants of proportionality.