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In this light, the upper and central portion of the concept map covers
a good part of cause-effect relationships. Peripheral areas reflect more
sites, mechanisms, interventions, and outcomes.
Visually, concept maps might be confused with webs of causes or
consequences maps by uninitiated persons. However, as we can see,
concept maps go well beyond a simple cause-effect path or web. Concept
maps are now finding development and uses in teaching clinical medi-
cine 56,57 in various clinical specialties, in community medicine (disease
prevention), 58,59 and elsewhere in health sciences and other domains. 60-62
6. Additive effect and potentiation of effect.
A particular challenge in the study of multiple etiological factors in their
webs or sets is their possible additive effect or an effect of potentiation in
a synergy of their action. An additive effect occurs when the combined
effect of multiple factors is a sum of their isolated effects. Potentiation of
effect occurs when the combined effect of multiple causal factors is more
than the sum of the effects of each. Clinical pharmacologists know perhaps
more than other specialists about the study and the effect of this phenom-
enon in the domain of disease treatment by multiple drugs and their effects.
Our views of causality are important well beyond the scientific search
for causality. In daily practice, they affect our anamnestic inquiry, review of
systems, methods and extent of treatment, outcomes assessment and follow
up, and extension of care. Ways of Searching for Causes
In epidemiology, the search for causes may now be carried out in two ways. 15,39
Inductive research means using existing information and data (what-
ever the purpose of their collection might be) to generate and/or confirm a
hypothesis. In another words, a hypothesis is generated by preestablished
facts, data, and information. Sometimes, the derogatory expression “milking
and dredging” of the data is used as qualification of this, often only avail-
able approach.
Inductive research can often lead to what philosophers call inductive
reasoning: premises bring only some degree of support to conclusions (find-
ings from the study).
Deductive research works in an opposite direction: A general principle
or hypothesis is used as a starting point for data collection, analysis, and
interpretation in order to confirm or refute this principle. The hypothesis is
formulated first on the basis of past experience, independent of the planned
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