Healthcare and Medicine Reference
In-Depth Information
In lathology (the study and management of error and harm in medicine
and other health sciences), 12 knowing, understanding, and avoiding fallacies,
biases, and cognitive errors eliminate some potential sources of harm as a
result of our reasoning and decision making. An exhaustive list of biases as
laws in research is well beyond the scope of this text and it must be sought
in the above quoted literature and paired with more general lists of cogni-
tive biases found elsewhere. 12
2.2 Challenges of Causal Reasoning within the General
Context of Medical Thinking and Reasoning
Usually, we have several questions about the health problems we encounter:
What have we seen? Diagnosis and counting cases help.
How often do they occur? Case series are the first source of information.
What is their overall burden? Prevalence rates reflect this.
How fast and how much do they spread? Incidence rates must be
established.
How serious are they? Disease spectrum and gradient, mortality, and
case fatality measure the gravity of the situation.
What do they explain? What are their causes? Causal reasoning based
on comparisons of various sets of observations are essential to answer
such questions.
What are the causes of improvement or deterioration in health and
disease if we do something about it? Treatment in clinical trials or health
programs in community medicine are analyzed as possible causes of
improvement in patient and community health.
To establish and demonstrate the relationship of cause and effect
between two or more variables in medicine remains a Rosetta Stone chal-
lenge and a subject for further interpretations, methodological developments,
and improvements by both philosophers 35 and health professionals. 36-38
Philosophers like John Stuart Mill or biostatisticians like Sir Austin Bradford
Hill and many others contributed to our view of causality in medicine today.
Their contribution is reviewed elsewhere. 15,36 -39
Within the general framework of reasoning, as explained in Section 2.1,
perhaps the most important problem-related reasoning focuses on the rela-
tionship between causes and consequences. What causes coronary heart
disease? What are the consequences of cocaine abuse? Do daily low doses
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