Cynefin as Reference Framework to Facilitate Insight and Decision-Making in Complex Contexts of Biomedical Research

Abstract

The Cynefin scheme is a concept of knowledge management, originally devised to support decision making in management, but more generally applicable to situations, in which complexity challenges the quality of insight, prediction, and decision. Despite the fact that life itself, and especially the brain and its diseases, are complex to the extent that complexity could be considered their cardinal feature, complex problems in biomedicine are often treated as if they were actually not more than the complicated sum of solvable sub-problems. Because of the emergent properties of complex contexts this is not correct. With a set of clear criteria Cynefin helps to set apart complex problems from "simple/obvious," "complicated," "chaotic," and "disordered" contexts in order to avoid misinterpreting the relevant causality structures. The distinction comes with the insight, which specific kind of knowledge is possible in each of these categories and what are the consequences for resulting decisions and actions. From student's theses over the publication and grant writing process to research politics, misinterpretation of complexity can have problematic or even dangerous consequences, especially in clinical contexts. Conceptualization of problems within a straightforward reference language like Cynefin improves clarity and stringency within projects and facilitates communication and decision-making about them.

Keywords: complexity; decision making; management; neurodegeneration; systems biology; systems medicine.

Figure 1

The Cynefin scheme. This version is one of the many renderings of the Cynefin framework highlighting and explaining the five core contexts. Unlike some other replications, this version uses the arrangement from Snowden's original publication from 2007, in which the square stands on one corner, so that the “simple/obvious” category is found at the base and the “complex” category at the top. More commonly found is an arrangement with “chaotic” and “simple” next to each other at the bottom and “complex” and “complicated” as a top row. The version here has the advantage of highlighting the complex contents and assigning the simple contexts in their modularity a role at the basis. In some fields, quintessential concepts from biomedicine have been added.

Figure 2

The Cynefin scheme in complex genetics. Plotting effect size over allele frequency has been an important approach to visualize the complex situation underlying the noted “missing heritability,” the difference between overall heritability and the additive effect of identifiable gene loci (Manolio et al., 2009). Applying the Cynefin scheme to this pattern highlights the fact that contexts differ vastly across that scheme and that, thus, different consequences must arise. The statement that the situation is “complex” becomes enriched by details.