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Scientific nature of diagnosis

  • 1.  Scientific nature of diagnosis

    Posted 02-15-2021 12:11
      |   view attached
    In the attached paper, 'The scientific nature of diagnosis', I point out that the high diagnostic accuracy of 85 to 90 percent seen in practice is due to the hypothesis generation and verification method, which is identical to the scientific method, that is employed for diagnosis in practice. Inferential errors due to System 1 reasoning, heuristics and biases occur in unscientific day to day reasoning, and not, in my view in scientific diagnostic reasoning in practice. Diagnostic errors that are seen in practice in 10 to 15 percent patients in practice are likely to be reduced by improved hypothesis generation and verification during diagnosis.
    Please review and comment on this paper.


    Bimal Jain MD
    Northshore Medical Center
    Salem MA 01970
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  • 2.  RE: Scientific nature of diagnosis

    Posted 02-15-2021 12:21
    Hi Dr. Jain,
    I'm wondering if the following review article might provide you with a better point of fixation than the seminal work stemming from Elstein, Shulman and Sprafka's "Medical Problem Solving: An Analysis of Clinical Reasoning" or Neorman's 2005 review (Norman, Geoffrey. "Research in clinical reasoning: past history and current trends." Medical education 39, no. 4 (2005): 418-427.).

    Koufidis, Charilaos, Katri Manninen, Juha Nieminen, Martin Wohlin, and Charlotte Silén. "Unravelling the polyphony in clinical reasoning research in medical education." Journal of Evaluation in Clinical Practice (2020).


    David Chartash, BESc (Western), MHSc ClinEng (Toronto), PhD (Indiana)
    Lecturer in Public Health, Department of Biostatistics, Division of Health Informatics
    Postdoctoral Fellow, Yale Center for Medical Informatics
    Yale University School of Medicine
    300 George Street, Suite 501 E-06, New Haven, Connecticut, United States of America, 06511
    phone: +1-203-737-5325

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  • 3.  RE: Scientific nature of diagnosis

    Posted 02-15-2021 12:27
    I read the Koufidis review article a while back and found it to be interesting. Thanks for the reference.