Resnik D B
Department of Philosophy, University of Wyoming, Laramie 82071-3392, USA.
Theor Med. 1995 Jun;16(2):141-52. doi: 10.1007/BF00998541.
This paper argues that clinicians are sometimes justified in not testing diagnoses or in not subjecting them to a full battery of tests. In deciding whether to conduct a test, a clinician may consider and weigh several different factors, including her confidence in her initial diagnosis, the specificity and sensitivity of the test, the consequences of making a false diagnosis, the pain, harm, and inconvenience caused by the test, and the costs of the test to the patient and society. This view suggests that diagnoses are fundamentally different from scientific hypotheses in that they are not always subjected to the same evidential standards.
本文认为,临床医生有时有理由不进行诊断测试或不进行全面的测试。在决定是否进行一项测试时,临床医生可能会考虑并权衡几个不同的因素,包括她对初步诊断的信心、测试的特异性和敏感性、做出错误诊断的后果、测试所带来的疼痛、伤害和不便,以及测试对患者和社会造成的成本。这种观点表明,诊断与科学假设在根本上是不同的,因为它们并不总是遵循相同的证据标准。