[Diagnostic process in internal medicine: decision analysis or intuition?].
The diagnostic process is a hypothesis-testing approach under conditions of uncertainty. Experience-based intuition plays an important role in complex clinical situations. Serious cognitive errors may be avoidable if possible heuristic problems are considered. Probabilistic reasoning according to Bayes' theorem, especially for determination of pretest probability, is crucial for coping with uncertainty and the myriad available diagnostic tests and procedures. Their proper interpretation depends on fundamental test variables such as sensitivity, specificity and likelihood ratio. Computers and neural networks cannot replace cognitive reasoning and probabilistic strategies in daily clinical practice. Decision analysis is pivotal, particularly when the aim is to maintain high-quality medical care at a time of limited resources.
Speich
R
R
Departement Innere Medizin, Universitätsspital Zürich.
D003658:Decision Making, Computer-Assisted; D003661:Decision Support Techniques; D003933:Diagnosis; D006801:Humans; D007388:Internal Medicine; D019545:Intuition; D011237:Predictive Value of Tests; D011336:Probability