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因果推理与诊断过程。

Causal reasoning and the diagnostic process.

作者信息

Rizzi D A

机构信息

University of Copenhagen, Department of Medical Philosophy and Clinical Theory, Panum Institute, Denmark.

出版信息

Theor Med. 1994;15(3):315-33. doi: 10.1007/BF01313345.

Abstract

BACKGROUND

Causal reasoning as a way to make a diagnosis seems convincing. Modern medicine depends on the search for causes of disease and it seems fair to assert that such knowledge is employed in diagnosis. Causal reasoning as it has been presented neglects to some extent the conception of multifactorial disease causes.

GOAL

The purpose of this paper is to analyze aspects of causation relevant for discussing causal reasoning in a diagnostic context.

PROCEDURES

The analysis will discuss different conceptions of causal reasoning in medical diagnosis, discriminating primarily between narrow causal diagnosis and more thorough causal explanation. The theory of causes as non-redundant factors in effective causal complexes is used as an analytical background. Causal explanations are performed according to different causal models. Such models of diagnosis are assumptions concerning structure and mechanisms, which cannot be directly or immediately observed. Conceptions and results of causal search strategies differ, according to the focus of the searcher. Causal reasoning is also seen in diagnosis in a more extensive meaning: the pin-pointing of factors responsible for the condition of the patient at any time during the course of disease.

CONCLUSION

Causal reasoning and diagnosis go well in hand, especially if both concepts are widened. The theory of causes as non-redundant components in effective causal complexes, modulated by what is referred to as the stop problem and causal fields, is valuable for explaining the many aspects of causal reasoning in medical diagnosis.

摘要

背景

因果推理作为一种诊断方式似乎很有说服力。现代医学依赖于对疾病病因的探寻,可以说这种知识被应用于诊断之中。然而,目前所呈现的因果推理在一定程度上忽视了多因素疾病病因的概念。

目标

本文的目的是分析在诊断背景下与讨论因果推理相关的因果关系的各个方面。

过程

该分析将讨论医学诊断中因果推理的不同概念,主要区分狭义的因果诊断和更全面的因果解释。将有效因果复合体中的原因作为非冗余因素的理论用作分析背景。根据不同的因果模型进行因果解释。此类诊断模型是关于结构和机制的假设,无法直接或立即观察到。因果搜索策略的概念和结果因搜索者的关注点而异。因果推理在诊断中还具有更广泛的意义:在疾病过程中的任何时候确定导致患者病情的因素。

结论

因果推理与诊断相得益彰,尤其是当这两个概念都得到拓展时。将原因视为有效因果复合体中的非冗余成分,并受所谓的停止问题和因果场调节的理论,对于解释医学诊断中因果推理的诸多方面很有价值。

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