Theory and practice in biomedical informatics: a framework for discovery.

Abstract

Clarify disciplinary foundations and internal structure of biomedical informatics. We analyze BMI's emergence at disciplinary intersections and map its internal structure across 4 domains: theory and practice of knowledge discovery, knowledge representation and reasoning, knowledge architecture, and knowledge-driven transformation. We compare BMI with mathematics, computer science, biostatistics, and biomedical engineering, and illustrate emergent characteristics through a precision medicine example. BMI's distinctive contribution-elucidating the structure of biomedical knowledge and developing methods to discover, preserve, and make knowledge actionable-requires strength across all 4 domains. BMI developed these domains pragmatically: building systems, extracting principles, and formalizing theories. The discipline must now complement empirical approaches with rigorous theoretical work: assessing adequacy of existing theories, identifying gaps, and orchestrating collaborative development. BMI creates emergent capabilities across disciplines. As biomedicine becomes increasingly complex, BMI must strengthen its theoretical foundations while demonstrating transformative potential of knowledge spanning biological scales and time.