Stolper C F, Van de Wiel Margje W J, Dinant G J, Van Royen Paul A M
Maastricht University, School for Public Health and Primary Care (CAPHRI), vakgroep Huisartsgeneeskunde.
Contact: C.F. Stolper (
Ned Tijdschr Geneeskd. 2019 Jan 9;163:D3181.
What role does uncertainty play in the doctor's diagnostic reasoning process? Would it not be better to avoid uncertainty as much as possible? In this article we answer this question from an epistemological perspective. Doctors build up relevant, situational knowledge during the diagnostic process through listening, observation and interpretation during their contact with the patient. Uncertainty can play a crucial role in this. We use a practical case to illustrate how allowing in some uncertainty - in the form of gut feelings - can improve the quality of the diagnostic thought process.
不确定性在医生的诊断推理过程中扮演着怎样的角色?尽可能避免不确定性不是更好吗?在本文中,我们从认识论的角度回答这个问题。医生在与患者接触的过程中,通过倾听、观察和解读,在诊断过程中积累相关的情境知识。不确定性在其中可能起着关键作用。我们用一个实际案例来说明,以直觉的形式允许一定程度的不确定性如何能够提高诊断思维过程的质量。