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医学推理的逻辑:迈向临床实践中归纳、演绎和溯因相结合的方法。

The logic of medical reasoning: toward an integrated inductive, deductive, and abductive approach to clinical practices.

作者信息

Pietarinen Ahti-Veikko, Stanley Donald E

机构信息

Hong Kong Baptist University, Hong Kong, China.

Maine Medical Center, Portland, Maine, United States.

出版信息

Philos Ethics Humanit Med. 2025 Sep 17;20(1):16. doi: 10.1186/s13010-025-00178-y.

DOI:10.1186/s13010-025-00178-y
PMID:40958095
Abstract

INTRODUCTION

This study explored the logical underpinnings of medical reasoning, focusing on the integration of abduction, deduction, and induction within clinical decision-making. It aimed to highlight the role of abduction in generating hypotheses, particularly in complex cases that defy standard protocols, and to examine the synergy between human expertise and AI-assisted tools in enhancing diagnostic accuracy.

METHODS

The research employed a qualitative approach, analyzing philosophical theories and integrating them with clinical case studies. The study examined the interplay of logical processes in medical diagnostics and the application of abduction in rare and novel cases. Additionally, the potential of AI-assisted tools to support clinical reasoning and reduce diagnostic noise was explored.

RESULTS

Abduction was identified as a critical yet often underappreciated element in medical reasoning essential for hypothesis generation. Deduction refines hypotheses against established medical knowledge, while induction validates decisions through empirical data. AI-assisted tools were found to enhance diagnostic accuracy by reducing noise, although they did not engage in the musement or genuine abductions that characterize human clinical reasoning.

DISCUSSION

The study concluded that a triadic approach to clinical reasoning, incorporating abduction, deduction, and induction, is essential for effective medical diagnostics. In particular, abduction plays a pivotal role in navigating the complexities of clinical decision-making. The integration of AI tools can reduce noise and improve diagnostic processes, but the essential human elements of insight and judgment remain irreplaceable in patient care.

摘要

引言

本研究探讨了医学推理的逻辑基础,重点关注临床决策中溯因推理、演绎推理和归纳推理的整合。其目的是突出溯因推理在生成假设方面的作用,特别是在那些不符合标准规程的复杂病例中,并研究人类专业知识与人工智能辅助工具在提高诊断准确性方面的协同作用。

方法

该研究采用定性方法,分析哲学理论并将其与临床案例研究相结合。研究考察了医学诊断中逻辑过程的相互作用以及溯因推理在罕见和新出现病例中的应用。此外,还探讨了人工智能辅助工具支持临床推理和减少诊断干扰的潜力。

结果

溯因推理被确定为医学推理中生成假设所必需的关键但往往未得到充分重视的要素。演绎推理根据既定医学知识完善假设,而归纳推理则通过实证数据验证决策。尽管人工智能辅助工具没有参与构成人类临床推理特征的沉思或真正的溯因推理,但发现它们通过减少干扰提高了诊断准确性。

讨论

该研究得出结论,临床推理采用包含溯因推理、演绎推理和归纳推理的三元方法对于有效的医学诊断至关重要。特别是,溯因推理在应对临床决策的复杂性方面发挥着关键作用。人工智能工具的整合可以减少干扰并改善诊断过程,但洞察力和判断力等关键的人类要素在患者护理中仍然不可替代。

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