Standing in the Shadows of Theory

As the field of biomedical informatics matures, investigators and systems implementers increasingly rely on theories, models, and frameworks to guide their work. Of these three, theory provides the greatest value to any discipline, because theory provides well-validated pathways to link observed phenomena with foundational knowledge, thus enhancing efficiency and generalizability. Theories are sets of propositional statements that explain, predict, or prescribe the relationship between concepts capable of being tested, verified, or refuted through empirical work. Theories serve to illuminate concepts deemed essential to understanding complex situations, such as why people with AIDS accept an electronic coaching system,1 or predict future states, such as how quickly physicians will adopt electronic health records.2 Reliance on theory demonstrates a level of sophistication in any discipline, and, as such, this increase in attention to theory-driven research and practice is much welcomed in biomedical informatics.So long as an applicable theory or theories exist, the necessary first step in any investigation or implementation should be to select the theory that will guide the endeavor. This is a significant right and responsibility. Each time a researcher or systems implementer selects a theory to guide his or her work, he or … Correspondence: School of Nursing and College of Engineering, University of Wisconsin-Madison, 1513 University Avenue, Room 3270, Madison, WI 53706 (e-mail: )