Díaz Guzmán J
Servicio de Neurologia, Hospital Universitario Doce de Octubre, Madrid, Spain.
Neurologia. 2003 Dec;18 Suppl 2:3-10.
Diagnostic reasoning is a cognitive proccess that has various performance and results. There are several kinds of clinical reasoning, such as model or pattern recognizing, causal or physiopathologic reasoning, deterministic, exhaustive, and hypotetic-deductive ones. Each form of reasoning may be relevant in certain clinical context, and all of the forms are also complementary. The logical consequence of diagnostic reasoning, like every cognitive proccess, is a clinical error. It is necessary that the neurologist knows the principles of diagnostic reasoning and the more frequent errors and biases. These can be summarized as: errors associated with the proccess of taking history and clinical examination, mnesic and semantic components of clinical reasoning, failure of hipotetic- deductive reasoning, and inadequate use of probability theory in Medicine.
诊断推理是一个具有多种表现和结果的认知过程。临床推理有多种类型,如模式识别、因果或病理生理推理、确定性、穷举性以及假设演绎推理等。每种推理形式在特定临床情境中可能都具有相关性,并且所有这些形式也是互补的。与其他认知过程一样,诊断推理的逻辑结果是临床错误。神经科医生有必要了解诊断推理的原则以及更常见的错误和偏差。这些可总结为:与病史采集和临床检查过程相关的错误、临床推理的记忆和语义成分、假设演绎推理的失败以及医学中概率论的使用不足。