Lookup NU author(s): Dr Tiago Moreira,
Professor John Bond
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In this paper, we investigate recent changes in the definition and approach to Alzheimer's disease brought about by growing clinical, therapeutic and regulatory interest in the prodromal or preclinical aspects of this conditione In the last decade, there has been an increased interest in the biomolecular and epidemiological characterization of pred clinical dementiae It is argued that early diagnosis of dementia, and particularly of Alzheimer's disease. will facilitate the prevention of dementing processes and lower the prevalence of the condition in the general population, The search for a diagnostic category or biomarker that would serve this purpose is an ongoing but problematic endeavour for research and clinical communities in this area. In this paper, we explore how clinical and research actors, in collaboration with regulatory institutions and pharmaceutical companies, come to frame these domains as uncertainties and how they red deploy uncertainty in the 'collective production' of new diagnostic conventions and bioclinical standards. While drawing as background on ethnographic, documentary and interview data, the paper proposes an in-depth, contextual analysis of the proceedings of an international meeting organized by the Peripheral and Central Nervous System Drug Advisory Committee of the US Food and Drug Administration to discuss whether or not a particular diagnostic convention - mild cognitive impairment - exists and how best it ought to be studied. Based on this analysis we argue that the deployment of uncertainty is reflexively implicated in bioclinical collectives' search for rules and conventions, and furthermore that the collective production of uncertainty is central to the 'knowledge machinery' of regulatory objectivity.
Author(s): Moreira T, May C, Bond J
Publication type: Article
Publication status: Published
Journal: Social Studies of Science
ISSN (print): 0306-3127
ISSN (electronic): 1460-3659
Publisher: Sage Publications Ltd.
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