The Logic of Medical Diagnosis

Establishing diagnoses is a crucial aspect of medical practice. However, this process has received comparatively little logical and pedagogical attention when compared to statistical methods for evaluating evidence. This article investigates the logic of medical diagnosis in order to fill this void. It is organized in three parts: the first attempts to explain why more attention ought to be paid to diagnosis, at least as much as to evidence; the second calls attention to the method of diagnosis by abductive reasoning developed in the 19th century by Charles Sanders Peirce (1839-1914); and the third demonstrates the use and pervasiveness of abduction by any other name in clinical diagnosis. We examine six diagnostic strategies in common use that contain most, if not all, of Peirce's structure of inquiry in science.

[1]  C. Hartshorne,et al.  Collected Papers of Charles Sanders Peirce , 1935, Nature.

[2]  M. Wegman.  International classification of diseases. , 1959, Pediatrics.

[3]  A. Burks,et al.  Collected Papers of Charles Sanders Peirce Vols. VII and VIII. , 1960 .

[4]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[5]  Charles S. Peirce,et al.  Reasoning and the Logic of Things. The Cambridge Conferences Lectures of 1898 , 1994 .

[6]  A. Tversky,et al.  Judgment under Uncertainty: Heuristics and Biases , 1974, Science.

[7]  J. Krantz,et al.  The birth of the clinic. An archaeology of medical perception , 1975, Medical History.

[8]  M. Gee,et al.  Case records of the Massachusetts General Hospital. Case 25-2012. A 15-year-old boy with abdominal pain, hematochezia, and anemia. , 2012, The New England journal of medicine.

[9]  Daniel G. Campos,et al.  On the distinction between Peirce’s abduction and Lipton’s Inference to the best explanation , 2011, Synthese.

[10]  Katharina Sonderegger-lseli,et al.  Diagnostic errors in three medical eras: a necropsy study , 2000, The Lancet.

[11]  H. Putnam,et al.  Reasoning and the Logic of Things. The Cambridge Conferences Lectures of 1898. , 1993 .

[12]  A. Bernard Ackerman,et al.  Histologic Diagnosis Of Inflammatory Skin Diseases: An Algorithmic Method Based On Pattern Analysis , 2005 .

[13]  Robert M Wachter,et al.  Bringing diagnosis into the quality and safety equations. , 2012, JAMA.

[14]  D. Bates,et al.  What practices will most improve safety? Evidence-based medicine meets patient safety. , 2002, JAMA.

[15]  Mary F. Wisniewski,et al.  Diagnostic error in medicine: analysis of 583 physician-reported errors. , 2009, Archives of internal medicine.

[16]  C. Kloesel,et al.  The essential Peirce : selected philosophical writings , 1992 .

[17]  R. Anderson,et al.  A model for the autopsy-based quality assessment of medical diagnostics. , 1990, Human pathology.

[18]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[19]  Donald M. Berwick,et al.  Counting Deaths Due to Medical Errors—Reply , 2002 .