Rizzi D A
Københavns Universitet, Laegevidenskabelige Fakultet, medicinsk videnskabsteoretisk enhed.
Ugeskr Laeger. 1991 Mar 4;153(10):694-7.
The diagnostic process holds a firm position in medical practice, but is often claimed to be part of the "art of medicine", partially beyond reach of rational and logical analysis. Research in clinical cognition, decision analysis and artificial intelligence have, however, elucidated essential parts of medical diagnosis. A characteristic feature of diagnosis is the manner in which uncertainties are handled. Early generation of hypotheses about the nature of the condition present seems to be useful method. Similarly, probabilistic, causal and deterministic reasoning can be illustrated by diagnostic models which have found favor during recent years. A certain type of cognitive process (heuristic) is employed when assessing information of probabilistic nature. The diagnostic models are partial and concern the parts of the process, which may be represented verbally and consciously. This raises the question of how the clinician actually draws upon experience (background knowledge), which preconditions shape the generation of applicable diagnostic hypotheses and how the diagnostic capability of the individual physician can be facilitated.
诊断过程在医疗实践中占据着稳固的地位，但人们常称其为“医学艺术”的一部分，部分超出了理性和逻辑分析的范畴。然而，临床认知、决策分析和人工智能方面的研究已经阐明了医学诊断的关键部分。诊断的一个显著特征是处理不确定性的方式。尽早对所患病症的性质提出假设似乎是一种有用的方法。同样，概率性、因果性和确定性推理可以通过近年来颇受青睐的诊断模型来说明。在评估概率性信息时会采用某种类型的认知过程（启发式）。诊断模型是局部的，关注过程的各个部分，这些部分可以用语言表述并被有意识地认知。这就引发了一个问题：临床医生实际上是如何借鉴经验（背景知识）的，哪些前提条件塑造了适用诊断假设的产生，以及如何提升个体医生的诊断能力。
