Low Matthew
The Royal Bournemouth and Christchurch NHS Trust, Bournemouth, UK.
J Eval Clin Pract. 2017 Oct;23(5):1062-1070. doi: 10.1111/jep.12713. Epub 2017 Feb 21.
This paper explores a novel clinical framework that is underpinned by a specific philosophical perspective of causation and its utility in clinical practice. A dispositional theory of causation may overcome challenges that clinicians face in complex clinical presentations including those that are medically unexplained. Dispositionalism identifies causes not as regular events necessitating an effect but rather phenomena, which are highly complex, context-sensitive, and which tend toward an effect. Diagnostic uncertainty and causal explanation are significant challenges in terms of clinical reasoning, communication, and the overall therapeutic outcome. This novel framework aims to facilitate improved collaborative clinical reasoning, enhanced patient-practitioner interaction, and supported treatment planning. The paper uses a real case study of a patient with nonspecific spinal pain to demonstrate the clinical framework as used in clinical practice.
本文探讨了一种新颖的临床框架,该框架以特定的因果关系哲学视角为基础,并阐述了其在临床实践中的效用。一种因果关系的倾向性理论可能会克服临床医生在复杂临床症状(包括那些医学上无法解释的症状)中所面临的挑战。倾向性理论将原因识别为并非必然导致某种结果的常规事件,而是高度复杂、依赖情境且倾向于引发某种结果的现象。在临床推理、沟通及整体治疗效果方面,诊断不确定性和因果解释是重大挑战。这个新颖的框架旨在促进改进协作式临床推理、加强医患互动并支持治疗计划制定。本文通过一个非特异性脊柱疼痛患者的真实案例研究,来展示该临床框架在临床实践中的应用。