Selection of Western Medicine Based on the Reticular DIKWP Model

Selection of Western Medicine Based on the Reticular DIKWP Model (Acetaminophen vs. Ibuprofen)

Yucong Duan

Benefactor: Zhendong Guo

International Standardization Committee of Networked DIKWP for Artificial Intelligence Evaluation(DIKWP-SC)

World Artificial Consciousness CIC(WAC)

World Conference on Artificial Consciousness(WCAC)

(Email: duanyucong@hotmail.com)

Overview of the DIKWP Model and Its Role in Drug Selection

The DIKWP model (Data, Information, Knowledge, Wisdom, Purpose) is a semantic mathematical model proposed by Professor Yucong Duan to describe artificial consciousness and cognitive processes (Analysis of the Application of DIKWP Information Field and Energy Field in Neuroscience and Consciousness Research). Unlike the traditional linear hierarchical DIKW pyramid, the DIKWP model presents a networked interactive structure with multidirectional connections between layers. This means the cognitive process from "Data" to "Purpose" is not a single path but encompasses 25 possible cognitive pathways, with each pair of elements (e.g., D→I, K→W, etc.) representing a cognitive module.

In clinical drug selection, the DIKWP model provides a systematic thinking framework (Application of the DIKWP Model in Drug Selection: Acetaminophen vs. Ibuprofen - Zhihu Column). First, multidimensional patient data (symptoms, signs, test results, etc.) are collected. At the Information layer, preliminary diagnoses or situational judgments are formed. At the Knowledge layer, pharmacological mechanisms and evidence-based guidelines are matched. At the Wisdom layer, the patient's overall condition and experiential factors are weighed. Finally, drug decisions are made with treatment goals in mind (Application of the DIKWP Model in Drug Selection: Acetaminophen vs. Ibuprofen - Zhihu Column). This cognitive pathway from D to P ensures comprehensive decision-making. For example, Professor Duan's analysis points out that doctors often use ibuprofen specifically when inflammation is confirmed or stronger analgesia is needed (corresponding to action after confirming information at the I/K layer), while acetaminophen is preferred for general fever or mild pain (Application of the DIKWP Model in Drug Selection: Acetaminophen vs. Ibuprofen - Zhihu Column). This reflects the core role of the DIKWP model in drug selection: integrating patient conditions, drug characteristics, clinical knowledge, and treatment goals to form an explainable cognitive pathway, thereby enhancing the scientific and individualized rationality of decisions (ScienceNet - AI Applications of DIKWP and Active Medicine in Degenerative Disease Management - Blog Post by Yucong Duan).

The following sections will analyze multiple commonly used drug combinations based on the original networked DIKWP model proposed by Professor Yucong Duan. Each case will include a comparison table of DIKWP 25-pathway scores and a brief explanation of the performance differences between the two drugs under each pathway. Additionally, differences in cognitive structure, pharmacological mechanisms, and clinical strategies among the combinations will be interpreted, along with drug recommendations for special populations such as pregnant women, chronic disease patients, and the elderly.

NSAID Drug Selection: Loxoprofen vs. Diclofenac (Rheumatoid Arthritis Pain)

Scenario and Drug Overview:
Loxoprofen and diclofenac are both NSAIDs (nonsteroidal anti-inflammatory drugs) commonly used to relieve inflammatory pain, such as in rheumatoid arthritis. Both work by inhibiting cyclooxygenase (COX) to reduce prostaglandin synthesis, thereby exerting anti-inflammatory and analgesic effects. However, they differ in pharmacokinetics and safety. Loxoprofen is a prodrug that is converted into an active metabolite in the body, generally acting mildly with a relatively fast onset and potentially lower gastrointestinal irritation (Comparative safety of NSAIDs for gastrointestinal events in Asia-Pacific populations: A multi-database, international cohort study - PubMed). Diclofenac has stronger anti-inflammatory and analgesic effects and is often used for moderate to severe inflammatory pain, showing significant efficacy in relieving arthritis symptoms. However, long-term use is associated with higher risks of gastrointestinal and cardiovascular adverse events (Coronary Risks Associated with Diclofenac and Other NSAIDs). Studies indicate that diclofenac provides slightly better pain control than loxoprofen in postoperative pain models (Loxoprofen Sodium Versus Diclofenac Potassium for Post-Dental Extraction Pain Relief: A Randomized, Triple-Blind, Clinical Trial - PMC). Therefore, in clinical practice, loxoprofen is often used for moderate pain or when relatively higher safety is desired, while diclofenac is typically chosen for targeted treatment when strong inflammation or severe pain is confirmed.

DIKWP 25-Pathway Score Comparison: Loxoprofen vs. Diclofenac

Cognitive Pathway	Loxoprofen	Diclofenac	Key Comparison Points
D→D	3	3	Both drugs are NSAIDs with different pharmacokinetic parameters, but both can reduce inflammatory markers.
D→I	4	3	Loxoprofen is considered for mild inflammation and pain relief, while diclofenac requires clearer signs of inflammation.
D→K	3	4	Patient inflammation signs directly align with pharmacological knowledge—diclofenac is more effective for severe inflammation.
D→W	3	2	Judging drug choice directly from patient data: diclofenac is inappropriate for mild cases, while loxoprofen is safer.
D→P	4	3	Achieving treatment goals directly from data: loxoprofen suffices for mild-moderate pain, while diclofenac may be overtreatment.
I→D	3	3	Similar ability to adjust dosage and regimen based on efficacy and adverse reaction feedback.
I→I	3	3	Internal consistency in the information layer: both drugs align well with clinical indications.
I→K	3	4	Matching diagnostic information with knowledge: guidelines favor diclofenac for arthritis, while loxoprofen is less mentioned (regional differences).
I→W	4	3	Clinical information to wisdom-based decisions: safer loxoprofen is preferred for elderly arthritis patients.
I→P	4	3	Goal achievement guided by information: loxoprofen adequately relieves general arthritis pain.
K→D	3	4	Knowledge applied to data collection: diclofenac may require more monitoring (liver/kidney function, cardiovascular assessment).
K→I	3	4	Knowledge-guided information interpretation: diclofenac is preferred for clear inflammation (stronger anti-inflammatory effect).
K→K	4	4	Internal consistency in the knowledge layer: both drugs have well-established mechanisms and indications.
K→W	3	4	Knowledge-to-wisdom conversion: diclofenac is more effective but requires risk assessment; loxoprofen has a better safety margin.
K→P	4	3	Goal achievement via knowledge: diclofenac better fits inflammation control, while loxoprofen aligns with safe pain relief.
W→D	3	2	Wisdom-driven data needs: diclofenac requires more pre-use checks (blood pressure, ulcer history), unlike loxoprofen.
W→I	4	3	Wisdom-guided information selection: experienced doctors prefer loxoprofen for mild pain, reserving diclofenac for severe cases.
W→K	3	4	Wisdom-mapped knowledge: doctors acknowledge diclofenac’s efficacy but recognize its risks.
W→W	4	3	Wisdom-layer coherence: "Prefer safer drugs when possible" aligns with clinical wisdom; diclofenac requires careful risk-benefit weighing.
W→P	3	4	Wisdom-driven goal achievement: experienced doctors choose diclofenac decisively for stubborn inflammation.
P→D	3	2	Goal-driven data needs: diclofenac may require more monitoring for full anti-inflammatory effects; loxoprofen needs less data for analgesia.
P→I	4	3	Goal-guided information processing: patient comfort favors low-side-effect options (loxoprofen).
P→K	4	4	Goal-influenced knowledge application: both drugs fit evidence-based pain/anti-inflammatory goals.
P→W	4	3	Goal-constrained wisdom: long-term safety favors loxoprofen; short-term efficacy may justify diclofenac’s risks.
P→P	4	4	Goal-layer consistency: both drugs ultimately serve pain and inflammation relief.

Analysis and Interpretation

The comparison shows that in the Data (D) → Information (I) → Knowledge (K) pathway, diclofenac scores higher (4 vs. 3 for loxoprofen) due to its stronger anti-inflammatory and analgesic properties, making it the preferred choice for severe inflammation (Loxoprofen Sodium Versus Diclofenac Potassium for Post-Dental Extraction Pain Relief: A Randomized, Triple-Blind, Clinical Trial - PMC). However, in the Wisdom (W) → Purpose (P) pathway, loxoprofen scores higher, reflecting clinical preference for safety: experienced doctors often start with loxoprofen for mild pain and escalate to diclofenac only if needed (Application of the DIKWP Model in Drug Selection: Acetaminophen vs. Ibuprofen - Zhihu Column).

This highlights cognitive strategy differences:

·Loxoprofen follows a "broad and safe" approach, quickly addressing pain (high D→I score).

·Diclofenac follows a "precision strike" approach, used only after confirming significant inflammation (high I→K score).

Pharmacological Differences

·Diclofenac is a classic NSAID with stronger COX inhibition, offering superior anti-inflammatory and analgesic effects (Loxoprofen Sodium Versus Diclofenac Potassium... - PMC).

·Loxoprofen acts more mildly, with faster pain relief but weaker anti-inflammatory effects. Thus, diclofenac excels in acute rheumatoid arthritis or severe joint swelling, while loxoprofen is safer for long-term use (Comparative safety of NSAIDs for gastrointestinal events in Asia-Pacific populations... - PubMed). Cohort studies show loxoprofen has a lower risk of NSAID-related gastrointestinal hospitalization (Comparative safety of NSAIDs... - PubMed).

Clinical Strategies

·Loxoprofen: Used for early symptomatic relief, improving patient comfort.

·Diclofenac: Reserved for confirmed inflammation (e.g., joint swelling, elevated inflammatory markers) (Application of the DIKWP Model... - Zhihu Column).

oBest for short-term aggressive treatment (e.g., acute flare-ups).

oHigher cardiovascular and liver risks (Coronary Risks Associated with Diclofenac and Other NSAIDs) make it less suitable for elderly or comorbid patients.

Summary

The DIKWP analysis highlights:

·Loxoprofen: Excels in Data (D) and Wisdom (W), ideal for quick, safe symptom relief and long-term management.

·Diclofenac: Strong in Knowledge (K) and Purpose (P), optimal for targeted, potent anti-inflammatory action.

For rheumatoid arthritis, the choice depends on severity and patient risk:

·Mild-moderate pain: Loxoprofen (safer, symptom-focused).

·Severe inflammation: Diclofenac (stronger anti-inflammatory, with monitoring).

Antibiotic Selection: Cefuroxime vs. Levofloxacin (Respiratory/Urinary Tract Infections)

Scenario and Drug Overview

For community-acquired respiratory or urinary tract infections, two commonly used oral antibiotics are cephalosporins and fluoroquinolones.

·Cefuroxime is a second-generation cephalosporin, effective against common Gram-positive bacteria (e.g., Streptococcus pneumoniae) and some Gram-negative bacteria (e.g., E. coli). It is commonly used for respiratory infections (bronchitis, pneumonia) or UTIs. Cephalosporins are safe, even for pregnant women (Cefuroxime Axetil - an overview | ScienceDirect Topics).

·Levofloxacin is a broad-spectrum fluoroquinolone, effective against Gram-negative bacteria, some Gram-positive bacteria, and atypical pathogens (e.g., Mycoplasma, Chlamydia). It has strong efficacy, good tissue penetration, and once-daily dosing. However, fluoroquinolones carry serious risks, including tendon rupture, peripheral neuropathy, and CNS effects, prompting an FDA black box warning (FDA updates warnings for oral and injectable fluoroquinolone). They are also contraindicated in pregnancy and children due to potential cartilage damage (Levofloxacin - StatPearls - NCBI Bookshelf).

Clinical Experience:

·Cefuroxime is preferred for empirical treatment of typical bacterial infections due to its safety margin.

·Levofloxacin is reserved for complex or refractory infections where its broad-spectrum efficacy is justified (FDA Warning About Fluoroquinolones and Risk of Aortic Ruptures...).

DIKWP 25-Pathway Score Comparison: Cefuroxime vs. Levofloxacin

Cognitive Pathway	Cefuroxime	Levofloxacin	Key Comparison Points
D→D	3	4	Drug properties: Cefuroxime has a narrower spectrum, while levofloxacin is broad-spectrum, long-acting (once-daily dosing).
D→I	3	4	Initial symptom data: Cefuroxime is empirically safer; levofloxacin is reserved for severe symptoms.
D→K	3	4	Data-to-knowledge: If urine culture suggests common bacteria, cefuroxime is chosen; if atypical pathogens are suspected, levofloxacin is supported.
D→W	4	2	Data-to-wisdom: For mild infections, cefuroxime is the safer first choice; levofloxacin is unwise without clear need.
D→P	3	4	Data-to-purpose: Cefuroxime may control mild infections, but levofloxacin covers more pathogens for definitive cure.
I→D	4	3	Information feedback: Cefuroxime allows adjustment based on symptom response; levofloxacin’s broad coverage may leave no alternatives if ineffective.
I→I	4	3	Information consistency: Penicillin allergy affects cephalosporin use but not fluoroquinolones.
I→K	4	3	Diagnosis-to-knowledge: Guidelines favor narrow-spectrum antibiotics (cefuroxime) for common infections (FDA Warning About Fluoroquinolones...).
I→W	4	3	Information-to-wisdom: Cefuroxime suffices for mild cases; levofloxacin is used only for complex infections.
I→P	3	4	Information-to-purpose: Complex infections (e.g., recurrent/resistant) justify levofloxacin; mild infections are treatable with cefuroxime.
K→D	3	4	Knowledge-to-data: Cefuroxime may require culture sensitivity data; levofloxacin’s broad spectrum reduces data dependency.
K→I	3	4	Knowledge-guided information: Atypical pathogens prompt consideration of levofloxacin.
K→K	4	3	Knowledge consistency: Guidelines restrict fluoroquinolones to reduce resistance and side effects (FDA updates warnings...).
K→W	4	2	Knowledge-to-wisdom: "Narrow before broad"—avoid unnecessary fluoroquinolone use.
K→P	3	4	Knowledge-to-purpose: Levofloxacin covers all possible pathogens; cefuroxime balances efficacy and safety.
W→D	3	4	Wisdom-driven data collection: Levofloxacin use requires culture/sensitivity data; cefuroxime is empirically straightforward.
W→I	3	4	Wisdom-driven information: Levofloxacin is chosen only after assessing patient history (e.g., immune status, prior treatment failure).
W→K	3	4	Wisdom-calibrated knowledge: Experienced doctors prefer cefuroxime first, switching to levofloxacin only if necessary.
W→W	4	3	Wisdom coherence: Antibiotic stewardship favors cefuroxime; indiscriminate broad-spectrum use is unwise.
W→P	4	3	Wisdom-to-purpose: Minimizing patient risk favors cefuroxime; levofloxacin is a last-resort option.
P→D	3	4	Purpose-driven data needs: Levofloxacin reduces diagnostic data dependency (broad coverage); cefuroxime requires pathogen sensitivity confirmation.
P→I	3	4	Purpose-guided information: Public health goals favor cefuroxime; rapid cure goals may justify levofloxacin.
P→K	4	4	Purpose-influenced knowledge: Both drugs have evidence-based roles—cefuroxime for routine infections, levofloxacin for complex cases.
P→W	4	3	Purpose-constrained wisdom: Long-term antibiotic preservation discourages levofloxacin overuse.
P→P	4	4	Purpose consistency: Both drugs achieve infection cure when used appropriately.

Analysis and Interpretation

The DIKWP comparison shows:

·Levofloxacin scores higher in direct data-to-purpose pathways (D→P, P→D = 4), reflecting its "one-drug-fits-all" broad-spectrum efficacy, which increases the likelihood of cure even with limited diagnostic data.

·However, its wisdom-layer scores (W-related pathways) are lower—clinical experience strongly cautions against unnecessary fluoroquinolone use (FDA updates warnings...).

·Cefuroxime performs better in wisdom (W) and information (I) layers (e.g., W→W = 4, I→K = 4), aligning with antibiotic stewardship principles: "Use narrow-spectrum first, escalate only when necessary."

Pharmacological and Clinical Knowledge (K) Differences

·Levofloxacin inhibits DNA gyrase, killing bacteria intra- and extracellularly, including atypical pathogens (Mycoplasma, Legionella). It is effective for complex UTIs, prostatitis, and resistant infections (Levofloxacin vs. cefuroxime axetil in acute...).

·Cefuroxime disrupts cell wall synthesis, covering common streptococci, staphylococci, and E. coli, but not atypicals. Thus, if atypical pneumonia is suspected, levofloxacin is preferred.

Wisdom (W) and Purpose (P) Considerations

·Cefuroxime aligns with long-term public health goals: Minimizing resistance and side effects makes it the wiser first-line choice.

·Levofloxacin’s risks (tendon rupture, neurotoxicity, aortic aneurysm concerns (FDA Warning...)) limit its use to severe/complex infections where benefits outweigh risks.

Clinical Strategies

·Cefuroxime: First-line for mild/moderate infections, adjusted based on response and culture data.

·Levofloxacin: Reserved for severe/complex cases (e.g., treatment failure, suspected resistant/atypical pathogens).

Summary

The DIKWP analysis highlights:

·Cefuroxime excels in data (D), information (I), and wisdom (W), supporting safe, stepwise treatment.

·Levofloxacin scores higher in knowledge (K) and purpose (P), serving as a potent but high-risk option for complex infections.

Key Takeaway:

·Start with cefuroxime for routine infections.

·Escalate to levofloxacin only when necessary, ensuring optimal patient outcomes while minimizing resistance and adverse effects (FDA Warning About Fluoroquinolones...).

Antihypertensive Drug Selection: Amlodipine vs. Valsartan (Elderly Hypertension)

Scenario and Drug Overview

Elderly patients with primary hypertension often require long-term medication to control blood pressure (BP) and prevent cardiovascular complications. Two first-line antihypertensive classes are calcium channel blockers (CCBs) and renin-angiotensin system inhibitors (e.g., ARBs).

·Amlodipine (a dihydropyridine CCB) works by relaxing vascular smooth muscle, effectively lowering BP—particularly systolic hypertension common in the elderly. It has a long half-life, enabling once-daily dosing for 24-hour BP control (Comparison of valsartan and amlodipine on ambulatory and...). Common side effects include peripheral edema and flushing due to vasodilation.

·Valsartan (an ARB) inhibits the RAAS system, reducing vascular resistance and sodium retention. ARBs offer organ protection, reducing proteinuria in diabetic nephropathy and improving heart failure outcomes. They are well-tolerated, with minimal side effects (unlike ACEIs, they do not cause cough), but require monitoring for hyperkalemia and renal function changes. ARBs are contraindicated in pregnancy (risk of fetal harm) (Diovan (valsartan) tablets label - accessdata.fda.gov).

Clinical Summary:

·Amlodipine: Direct, potent BP reduction, ideal for