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Inferences of clinical diagnostic reasoning and diagnostic error

Published on Jun 1, 2011in Journal of Biomedical Informatics 2.95
· DOI :10.1016/j.jbi.2010.01.003
Anton E. Lawson41
Estimated H-index: 41
(ASU: Arizona State University),
Erno S. Daniel1
Estimated H-index: 1
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Abstract
This paper discusses clinical diagnostic reasoning in terms of a pattern of If/then/Therefore reasoning driven by data gathering and the inference of abduction, as defined in the present paper, and the inferences of retroduction, deduction, and induction as defined by philosopher Charles Sanders Peirce. The complex inferential reasoning driving clinical diagnosis often takes place subconsciously and so rapidly that its nature remains largely hidden from the diagnostician. Nevertheless, we propose that raising such reasoning to the conscious level reveals not its basic pattern and basic inferences, it also reveals where errors can and do occur and how such errors might be reduced or even eliminated.
  • References (37)
  • Citations (22)
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References37
Newest
Published on Nov 9, 2009in JAMA Internal Medicine 20.77
Gordon D. Schiff28
Estimated H-index: 28
(Harvard University),
Omar Hasan10
Estimated H-index: 10
(Harvard University)
+ 10 AuthorsNela Krosnjar3
Estimated H-index: 3
Background Missed or delayed diagnoses are a common but understudied area in patient safety research. To better understand the types, causes, and prevention of such errors, we surveyed clinicians to solicit perceived cases of missed and delayed diagnoses. Methods A 6-item written survey was administered at 20 grand rounds presentations across the United States and by mail at 2 collaborating institutions. Respondents were asked to report 3 cases of diagnostic errors and to describe their perceive...
Published on Feb 9, 2009
Jonah Lehrer1
Estimated H-index: 1
(University of Piura)
Este trabajo estaba en concordancia con la linea de investigacion que ambos psicologos habian iniciado tiempo atras. Su interes se enfocaba en la puesta en practica de reglas heuristicas, asi como el efecto de las distorsiones o sesgos cognitivos de los sujetos, en las diversas oportunidades de toma de decision. Entre los diversos postulados de los psicologos se hallaba la critica a la asuncion de la economia moderna del sujeto que decide de modo racional, en su animo de maximizar la utilidad en...
Published on Jan 1, 2009in Science Education 2.90
Anton E. Lawson41
Estimated H-index: 41
(ASU: Arizona State University)
Helping students better understand how scientists reason and argue to draw scientific conclusions has long been viewed as a critical component of scientific literacy, thus remains a central goal of science instruction. However, differences of opinion persist regarding the nature of scientific reasoning, argumentation, and discovery. Accordingly, the primary goal of this paper is to employ the inferences of abduction, retroduction, deduction, and induction to introduce a pattern of scientific rea...
Published on May 1, 2008in The American Journal of Medicine 4.76
Pat Croskerry33
Estimated H-index: 33
(Dal: Dalhousie University),
Geoff Norman36
Estimated H-index: 36
(McMaster University)
Published on May 1, 2008in The American Journal of Medicine 4.76
Eta S. Berner24
Estimated H-index: 24
(UAB: University of Alabama at Birmingham),
Mark L. Graber15
Estimated H-index: 15
(SBU: Stony Brook University)
The great majority of medical diagnoses are made using automatic, efficient cognitive processes, and these diagnoses are correct most of the time. This analytic review concerns the exceptions: the times when these cognitive processes fail and the final diagnosis is missed or wrong. We argue that physicians in general underappreciate the likelihood that their diagnoses are wrong and that this tendency to overconfidence is related to both intrinsic and systemically reinforced factors. We present a...
Published on Sep 5, 2007in JAMA 51.27
Paul B. Batalden38
Estimated H-index: 38
,
Frank Davidoff36
Estimated H-index: 36
Houle’s choice of words warrants serious atten-tion: a profession is defined by what it does, not just whatit knows, and by doing what it does better all the time, notjust doing it well.Medicine’s enormous and highly specialized body ofknowledgeinarguablymakesitalearnedprofession,butde-liveringcareisperformance,notscholarship.Initsmostba-sic form, the delivery of science-based care consists of ap-plying generalizable scientific knowledge to the problemsof particular patients who are ill, with th...
Published on Nov 23, 2006in The New England Journal of Medicine 70.67
Judith L. Bowen1
Estimated H-index: 1
This article considers how doctors learn to reason in the clinical environment and recommends practical approaches that clinical teachers can use to promote the development of strong diagnostic reasoning skills in their students.
Published on Aug 1, 2005in Journal of Research in Science Teaching 3.13
Anton E. Lawson41
Estimated H-index: 41
(ASU: Arizona State University)
A long-standing and continuing controversy exists regarding the role of induction and deduction in reasoning and in scientific inquiry. Given the inherent difficulty in reconstructing reasoning patterns based on personal and historical accounts, evidence about the nature of human reasoning in scientific inquiry has been sought from a controlled experiment designed to identify the role played by enumerative induction and deduction in cognition as well as from the relatively new field of neural mo...
Published on Jun 21, 2005in Annals of Internal Medicine 19.32
Donald A. Redelmeier62
Estimated H-index: 62
(U of T: University of Toronto)
Cognitive psychology is the science that examines how people reason, formulate judgments, and make decisions. This case involves a patient given a diagnosis of pharyngitis, whose ultimate diagnosis of osteomyelitis was missed through a series of cognitive shortcuts. These errors include the availability heuristic (in which people judge likelihood by how easily examples spring to mind), the anchoring heuristic (in which people stick with initial impressions), framing effects (in which people make...
Cited By22
Newest
Published on May 1, 2019in Advances in Health Sciences Education 2.76
Martin Klein2
Estimated H-index: 2
(Saarland University),
B. Otto31
Estimated H-index: 31
(LMU: Ludwig Maximilian University of Munich)
+ 1 AuthorsRobin Stark15
Estimated H-index: 15
(Saarland University)
The present study aims at fostering undergraduate medical students’ clinical reasoning by learning from errors. By fostering the acquisition of “negative knowledge” about typical cognitive errors in the medical reasoning process, we support learners in avoiding future erroneous decisions and actions in similar situations. Since learning from errors is based on self-explanation activities, we provided additional prompting procedures to foster the effectiveness of the error-based instructional app...
Published on Jun 20, 2018
Matteo Cristani10
Estimated H-index: 10
(University of Verona),
Francesco Olivieri1
Estimated H-index: 1
(CSIRO: Commonwealth Scientific and Industrial Research Organisation)
+ 1 AuthorsMargherita Zorzi8
Estimated H-index: 8
(University of Verona)
Diagnosis is widely used in many different disciplines to identify the nature and cause of a certain phenomenon. We present \(t\mathsf {L}\), a new logical framework able to formalise diagnostic reasoning, i.e., an hybrid learning technique based both on deduction and experiments. In this paper we introduce tL, a Labeled Modal Logic, garnishing with temporal and statistical information and a basic propositional language.
Published on Sep 1, 2017in Clinical Psychology & Psychotherapy 2.33
Jan Christopher Cwik5
Estimated H-index: 5
(RUB: Ruhr University Bochum),
Jürgen Margraf39
Estimated H-index: 39
(RUB: Ruhr University Bochum)
Published on Mar 1, 2017
Asma Khan (BU: Bahria University), Azeema Sadia (BU: Bahria University)+ 2 AuthorsM. Shahid Khan (BU: Bahria University)
The use of the ontologies has been prevalent in many domains especially in medical diagnostic systems. Ontologies exhibit features including knowledge representation, reusability, sharing, and logical reasoning support. Thus ontology-driven medical diagnostic systems can assist physicians in order to determine the most probable diagnosis of the patients. Traditionally, these systems have used deductive or inductive way of reasoning for assisting physicians. Nevertheless, the abductive reasoning ...
Published on Jan 1, 2017
Per Dahl1
Estimated H-index: 1
Published on Dec 1, 2016in BMC Family Practice 2.43
Olav Thorsen4
Estimated H-index: 4
(University of Bergen),
Miriam Hartveit4
Estimated H-index: 4
(University of Bergen)
+ 4 AuthorsAnders Baerheim21
Estimated H-index: 21
(University of Bergen)
Background GPs’ individual decisions to refer and the various ways of working when they refer are important determinants of secondary care use. The objective of this study was to explore and describe potential characteristics of GPs’ referral practice by investigating their opinions about referring and their self-reported experiences of what they do when they refer.
Mohamed Abderraouf Ferradji1
Estimated H-index: 1
(University of Batna),
Abdelmadjid Zidani2
Estimated H-index: 2
(University of Batna)
Despite the significant advances achieved these recent last years in terms of technologies widespread use in medical education, clinical reasoning learning (CRL) remains an extremely hard task in which there are still many gray areas that should be enlightened to better understand it. Furthermore, while CRL is basically a collaborative task implying the participation of many students and tutors working simultaneously on a same case, it should be considered from a social perspective. The authors ...