Tipping points, critical transitions, and bifurcations: Are "generic early-warning signals" applicable to medicine?

Recent work from Marten Scheffer and colleagues has made bold claims.

"Complex dynamical systems, ranging from ecosystems to financial markets and the climate, can have tipping points at which a sudden shift to a contrasting dynamical regime may occur [1]. Although predicting such critical points before they are reached is extremely difficult, work in different scientific fields is now suggesting the existence of generic early-warning signals that may indicate for a wide class of systems if a critical threshold is approaching." In a paper, now in Press in Critical Care Medicine, Scheffer and colleagues (including me) argue that these results may be applicable in medicine [2].  I will discuss this work from the context of my own interest in bifurcations, problems associated with alternans rhythms [3], and transition to and risk stratification for sudden cardiac death.

 [1] "Early-warning signals for critical transitions" Nature 461, 53 (2009) by Marten Scheffer et al.

 [2] "Slowing down of recovery as generic risk marker for acute transitions in chronic diseases" by Olde-Rikkert et al. Critical Care Medicine (2016)

 [3] "Predicting the onset of period-doubling bifurcations in noisy cardiac systems" T. Quail, A. Shrier, L. Glass, PNAS 112, 9358-9363 (2015)