Medical Reasoning


Book Description

Modern medicine is one of humankind's greatest achievements.Yet today, frequent medical errors and irreproducibility in biomedical research suggest that tremendous challenges beset it. Understanding these challenges and trying to remedy them have driven considerable and thoughtful critical analyses, but the apparent intransigence of these problems suggests a different perspective is needed. Now more than ever, when we see options and opportunities for healthcare expanding while resources are diminishing, it is extremely important that healthcare professionals practice medicine wisely. In Medical Reasoning, neurologist Erwin B. Montgomery, Jr. offers a new and vital perspective. He begins with the idea that the need for certainty in medical decision-making has been the primary driving force in medical reasoning. Doctors must routinely confront countless manifestations of symptoms, diseases, or behaviors in their patients. Therefore, either there are as many different "diseases" as there are patients or some economical set of principles and facts can be combined to explain each patient's disease. The response to this epistemic conundrum has driven medicine throughout history: the challenge is to discover principles and facts and then to develop means to apply them to each unique patient in a manner that provides certainty. This book studies the nature of medical decision making systematically and rigorously in both an analytic and historical context, addressing medicine's unique need for certainty in the face of the enormous variety of diseases and in the manifestations of the same disease in different patients. The book also examines how the social, legal, and economic circumstances in which medical decision-making occurs greatly influence the nature of medical reasoning. Medical Reasoning is essential for those at the intersection of healthcare and philosophy.




Medical Problem Solving


Book Description




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Teaching Clinical Reasoning


Book Description

Chapter topics include: Clinical Reasoning and Diagnostic Error Theoretical Concepts to Consider in Providing Clinical Reasoning Instruction Developing a Curriculum in Clinical Reasoning Educational Approaches to Common Cognitive Errors General Teaching Techniques Assessment of Clinical Reasoning Faculty Development and Dissemination Lifelong Learning in Clinical Reasoning Remediation of Clinical Reasoning Novel Approaches and Future Directions Teaching Clinical Reasoning: Where do we go from here?




Medical Decision Making


Book Description

Medical Decision Making provides clinicians with a powerful framework for helping patients make decisions that increase the likelihood that they will have the outcomes that are most consistent with their preferences. This new edition provides a thorough understanding of the key decision making infrastructure of clinical practice and explains the principles of medical decision making both for individual patients and the wider health care arena. It shows how to make the best clinical decisions based on the available evidence and how to use clinical guidelines and decision support systems in electronic medical records to shape practice guidelines and policies. Medical Decision Making is a valuable resource for all experienced and learning clinicians who wish to fully understand and apply decision modelling, enhance their practice and improve patient outcomes. “There is little doubt that in the future many clinical analyses will be based on the methods described in Medical Decision Making, and the book provides a basis for a critical appraisal of such policies.” - Jerome P. Kassirer M.D., Distinguished Professor, Tufts University School of Medicine, US and Visiting Professor, Stanford Medical School, US




Stochastic Medical Reasoning And Environmental Health Exposure


Book Description

The validity of certain critical reasoning steps carried out during or on the sidelines of the environmental science, public health survey, medical experiment, population risk assessment, or disease space-time mapping under conditions of in situ uncertainty and space-time heterogeneity, is often not given sufficient attention and may even be out of the investigator's line of thought. For example, the technical complexity of an environmental exposure experiment may overshadow the logical assumptions made when moving from one phase of the experiment to the next, or the study of population risk assessment may focus on analytical and computational matters, whereas methodological and cultural factors are neglected.This book helps health investigators structure their thinking so that they avoid logical mistakes and argument pitfalls, and also gain new insights about reality, improve their awareness of the environment and context within which one's thinking takes place.




Comparative Approaches to Medical Reasoning


Book Description

This book focuses on approaches to computer-assisted medical decision-making. A unique feature of the book is that a specific problem in medical decision-making has been selected from the literature, with each contributed chapter presenting a different approach to the solution of the same problem. Theoretical foundations for each approach are provided, followed by practical application. Techniques include knowledge-based reasoning, neural network models, hybrid systems, reasoning with uncertainty, and fuzzy logic, among others. The goal is to supply the reader with a variety of theoretical techniques whose practical implementation can be clearly understood through the example. Using a single, concrete example to illustrate different theoretical approaches allows various techniques to be easily contrasted and permits the reader to determine which aspects are pertinent to specific types of applications. Although the methods are illustrated in a medical problem, they have wide applicability in numerous areas of decision-making.




Ethics by Committee


Book Description

"Ethics boards have become obligatory passage points in today's medical science, and we forget how novel they really are. The use of humans in experiments is an age-old practice that records show goes back to at least the third century BC and, since the early modern period, as a practice it has become increasingly popular. Yet, in most countries around the world, hardly any formal checks and balances existed to govern the communal oversight of experiments involving human subjects until at least the 1960s. Ethics by Committee traces the rise of ethics boards for human experimentation in the second half of the twentieth century. Using the Netherlands as a case-study, Noortje Jacobs shows how the authority of physicians to make decisions about clinical research gave way in most developed nations to formal mechanisms of communal decision-making that served to regiment the behavior of individual researchers. This historically unprecedented change in scientific governance came out of a growing international wariness of medical research in the decades after World War II. Research ethics committees were originally intended not only to make human experimentation more ethical but also to raise its epistemic quality. By examining complex negotiations over the appropriate governance of human subjects research, Ethics by Committee advances our understanding not only of the history of research ethics and the randomized controlled trial but also, more broadly, of how liberal democracies in the late twentieth century have sought to resolve public concerns over charged issues in medicine and science"--




Handbook of Research on Critical Thinking and Teacher Education Pedagogy


Book Description

Critical thinking is an essential skill for learners and teachers alike. Therefore, it is essential that educators be given practical strategies for improving their critical thinking skills as well as methods to effectively provide critical thinking skills to their students. The Handbook of Research on Critical Thinking and Teacher Education Pedagogy examines and explains how new strategies, methods, and techniques in critical thinking can be applied to classroom practice and professional development to improve teaching and learning in teacher education and make critical thinking a tangible objective in instruction. This critical scholarly publication helps to shift and advance the debate on how critical thinking should be taught and offers insights into the significance of critical thinking and its effective integration as a cornerstone of the educational system. Highlighting topics such as early childhood education, curriculum, and STEM education, this book is designed for teachers/instructors, instructional designers, education professionals, administrators, policymakers, researchers, and academicians.




Clinical Reasoning in the Health Professions E-Book


Book Description

Clinical reasoning is the foundation of professional clinical practice. Totally revised and updated, this book continues to provide the essential text on the theoretical basis of clinical reasoning in the health professions and examines strategies for assisting learners, scholars and clinicians develop their reasoning expertise. key chapters revised and updated nature of clinical reasoning sections have been expanded increase in emphasis on collaborative reasoning core model of clinical reasoning has been revised and updated