David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jonathan Jenkins Ichikawa
Jack Alan Reynolds
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Theoretical Medicine and Bioethics 19 (1):59-72 (1998)
Diagnostic errors are more frequently a result of the clinician's failure to combine medical knowledge adequately than of data inaccuracy. Diagnostic reasoning studies are valuable to understand and improve diagnostic reasoning. However, most diagnostic reasoning studies are characterized by some limitations which make these studies seem more simple than diagnostic reasoning in real life situations actually is. These limitations are connected both to the failure to acknowledge components of knowledge used in clinical practice as well as to acknowledge the physician-patient relationship's influence on clinical knowledge and on the reasoning process itself. In addition the modes of reasoning described in these studies frequently is oversimplified. In this paper three simplistic and competing models of diagnostic reasoning are analyzed and criticized, followed by an evaluation of two alternative models proposing a combined view.
|Keywords||diagnostic reasoning emotions non-verbal communication uncertainty physician-patient relationship|
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Citations of this work BETA
Andrew Miles, Michael Loughlin & Andreas Polychronis (2008). Evidence‐Based Healthcare, Clinical Knowledge and the Rise of Personalised Medicine. Journal of Evaluation in Clinical Practice 14 (5):621-649.
James A. Marcum (2012). An Integrated Model of Clinical Reasoning: Dual‐Process Theory of Cognition and Metacognition. Journal of Evaluation in Clinical Practice 18 (5):954-961.
William E. Stempsey (2009). Clinical Reasoning: New Challenges. Theoretical Medicine and Bioethics 30 (3):173-179.
Sandro Tsang (2013). Quantifying Judicious Use of Health Information Technology. Journal of Evaluation in Clinical Practice 19 (2):393-399.
Monica Ortendahl (2008). Models Based on Value and Probability in Health Improve Shared Decision Making. Journal of Evaluation in Clinical Practice 14 (5):714-717.
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