非传染性疾病中循证医学与替代医学范式的竞争
Competition between evidence-based and alternative medical paradigms in non-infectious diseases
浏览论文内容
中文总结 AI 辅助
该研究构建非传染性疾病的行为-疾病耦合模型，用复制者动态建模循证与替代医学范式的竞争，揭示社会反馈致系统非线性、存在路径依赖，瞬时干预可带来文化构成的持久变化。
中文摘要 AI 辅助
标准流行病学模型结合演化博弈论（如疫苗博弈）通常依赖于传染病固有的搭便车困境。本文提出一种行为-疾病耦合模型，其中潜在疾病为非传染性疾病，传播严格发生在文化层面。我们利用针对特定治疗的社会放大系数驱动的复制者动态，对两种医学范式——循证医学（$M$）与替代医学（$A$）之间的竞争进行建模。我们通过分析表明，耦合系统的非线性源于社会反馈，而非潜在的生物动态。关键在于，稳定性分析显示该系统不存在孤立不动点，而是收敛至一维连续的非双曲中性均衡流形，在文化构成中产生持续的路径依赖。此外，我们推导了一个显式运动常数，该常数将每条轨迹约束在不同的不变水平集上。将此不变性限制在均衡流形上会产生一个严格单调的选择函数，该函数唯一确定从任意给定初始状态选出的均衡。我们的研究结果表明，基于导数的文化反馈足以产生连续共存的健康范式，而不对称的社会放大会改变这种选择。由于直接改变范式采用情况的瞬时干预会打破这种不变性，它们会将系统转移到不同的水平集，在长期文化构成中产生持续变化。因此，该模型揭示了社会如何保留对先前健康和治疗状态的确定性记忆，证明了错误信息冲击和针对性公共卫生干预都能在扰动结束后很久留下持久的结构性变化。
英文摘要
Standard epidemiological models coupled with evolutionary game theory (e.g., vaccination games) typically rely on the free-rider dilemma inherent to infectious diseases. In this paper, we present a coupled behavior-disease model where the underlying disease is non-infectious, and transmission occurs strictly at the cultural level. We model the competition between two medical paradigms, namely evidence-based medicine ($M$) and alternative medicine ($A$), using replicator dynamics driven by treatment-specific social-amplification coefficients. We show analytically that the nonlinearity of the coupled system arises from social feedback rather than from the underlying biological dynamics. Crucially, the stability analysis reveals that the system lacks isolated fixed points; instead, it converges to a one-dimensional continuous manifold of non-hyperbolic neutral equilibria, generating persistent path dependence in the cultural composition. Furthermore, we derive an explicit constant of motion that constrains each trajectory to a distinct invariant level set. Restricting this invariant to the equilibrium manifold yields a strictly monotonic selection function, uniquely determining the equilibrium selected from any given initial state. Our findings show that derivative-based cultural feedback is sufficient to generate a continuum of coexisting health paradigms, while asymmetric social amplification modifies this selection. Because transient interventions that directly alter paradigm adoption break this invariant, they shift the system to a different level set, producing persistent changes in the long-run cultural composition. The model thus reveals how societies retain a deterministic memory of prior health and treatment states, demonstrating that both misinformation shocks and targeted public health interventions can leave lasting structural changes long after the perturbation has ended.
