Fear of knowledge: Clinical hypotheses in diagnostic and prognostic reasoning

Journal of Evaluation in Clinical Practice - Tập 23 Số 5 - Trang 928-934 - 2017
Daniele Chiffi1,2, Renzo Zanotti1
1Molecular Medicine, University of Padova, Padova, Italy
2Ragnar Nurkse School of Innovation and Governance, Tallinn University of Technology, Tallinn, Estonia

Tóm tắt

AbstractPatients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes. We then distinguish between various forms of hypothetical reasoning applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur, whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are due to the different types of uncertainty involved in diagnostic and prognostic judgments.

Từ khóa


Tài liệu tham khảo

10.1136/bmj.e5595

10.1097/00001888-199911000-00010

10.1136/bmj.320.7233.469

Bieganski W, 1990, The Polish School of Philosophy of Medicine. From Tytus Chalubinski (1820–1889) to Ludwik Fleck (1896–1961), 112

Hempel CG, 1958, Minnesota Studies in the Philosophy of Science, 37

Salmon WC, 1970, The Nature and Function of Scientific Theories, 173

Carrier M, 2010, EPSA. Epistemology and Methodology of Science. Launch of the European Philosophy of Science Association, 23

10.1111/jep.12369

Hempel CG, 1965, Aspects of Scientific Explanation and Other Essays in the Philosophy of Science, 81

10.1111/jep.12146

10.1046/j.1365-2753.2003.00421.x

Federspil G, 2004, Logica clinica

Carnap R, 1950, Logical foundations of probability

10.5840/ipq200343335

10.1016/S0009-8981(98)00195-8

Duhem P, 1991, The Aim and Structure of Physical Theory

10.1002/cpt1977224485

Chiffi D, 2015, Perspectives on clinical possibility: elements of analysis, J Eval Clin Pract, 227, 509, 10.1111/jep.12447

10.1023/A:1011466711211

10.1007/BF02600190

Austoni M, 1975, Principi di metodologia clinica

Keynes JM, 2008, The General Theory of Employment, Interest, and Money

10.1007/BF00996342

10.1016/B978-0-444-51787-6.50011-8

10.1007/978-94-007-1171-6

Christakis NA, 1999, Prognostication and bioethics, Daedalus, 128, 197

10.1080/01947640290050247

Lewis D, 1975, Minnesota Studies in the Philosophy of Science, 3

10.1093/jmp/jhv033

10.1056/NEJMp1303295

GouldSJ.The median isn't the message.CancerGuide: Statistics;2002. Available at:http://cancerguide.org/median_not_msg.html. Accessed August 29 2016.

De Giovanni A, 1909, The Morphology of the Human Body

10.1023/A:1009913915839

Del Mar C, 2008, Clinical Thinking: Evidence, Communication and Decision Making

10.1007/BF00489469

10.1097/ANS.0000000000000011

10.1007/978-94-007-2260-6

Hempel CG, 1962, Frontiers of Science and Philosophy, 9

10.1046/j.1365-2753.1997.00004.x

Peirce CS, 1931, Collected Papers

Paavola S, 2005, Peircean abduction: instinct or inference?, Semiotica, 131

Festa R, 2009, Deduzione, induzione e abduzione nelle scienze mediche, Logic Philos Sci, 7, 41

10.1002/jclp.20516

Thagard P, 2006, Inductive Reasoning: Cognitive, Mathematical, and Neuroscientific Approaches, 226

10.1023/A:1009736414434

10.1007/978-1-4419-8562-0

10.1007/978-3-642-03631-6

10.1109/21.199462

Murri A, 1972, Quattro lezioni e una perizia. Il problema del metodo in medicina e biologia

10.1353/pbm.2013.0019

10.1111/jep.12417

Stanley D.E.andNyrup R.(2016)Strategies in abduction: generating and selecting diagnostic hypotheses. Manuscript in preparation.

Dummett M, 1976, Truth and Meaning: Essays in Semantics, 67

Risjord M, 2011, Nursing Knowledge: Science, Practice, and Philosophy

Thông tin
Thông tin xuất bản

Journal of Evaluation in Clinical Practice

Tập 23 Số 5

928-934

Thông tin tác giả