Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
Fam Pract. 2013 Oct;30(5):501-5. doi: 10.1093/fampra/cmt031. Epub 2013 Jul 1.
This is an overview of the principles that underpin philosophy of science and how they may provide a framework for the diagnostic process. Although philosophy dates back to antiquity, it is only more recently that philosophers have begun to enunciate the scientific method. Since Aristotle formulated deduction, other modes of reasoning including induction, inference to best explanation, falsificationism, theory-laden observations and Bayesian inference have emerged. Thus, rather than representing a single overriding dogma, the scientific method is a toolkit of ideas and principles of reasoning. Here we demonstrate that the diagnostic process is an example of science in action and is therefore subject to the principles encompassed by the scientific method. Although a number of the different forms of reasoning are used readily by clinicians in practice, without a clear understanding of their pitfalls and the assumptions on which they are based, it leaves doctors open to diagnostic error. We conclude by providing a case example from the medico-legal literature in which diagnostic errors were made, to illustrate how applying the scientific method may mitigate the chance for diagnostic error.
这是对科学哲学基本原则的概述，以及它们如何为诊断过程提供框架。尽管哲学可以追溯到古代，但直到最近哲学家才开始阐明科学方法。自从亚里士多德提出演绎法以来，其他推理模式，包括归纳法、最佳解释推理、证伪主义、理论负载观察和贝叶斯推理，已经出现。因此，科学方法并不是一个单一的主导教条，而是一个思想和推理原则的工具包。在这里，我们证明诊断过程是科学实践的一个例子，因此受科学方法所包含的原则的约束。尽管在实践中，许多不同形式的推理都被临床医生轻易地使用，但如果没有清楚地了解它们的陷阱和它们所基于的假设，就会使医生容易犯诊断错误。我们最后通过提供一个来自医学法律文献中的案例来举例说明，说明如何应用科学方法可以降低诊断错误的可能性。
