title: Do clinicians decide relying primarily on Bayesians principles or on Gestalt perception? Some pearls and pitfalls of Gestalt perception in medicine.
abstract: Clinical judgment is a foundation of medical practice and lies at the heart of a physician's knowledge, expertise and skill. Although clinical judgment is an active part of all medical fields, thus including diagnosis and therapy, communication and decision making, it is still poorly defined. It can be considered a synthesis of intuition (mainly based on Gestalt principles) and an analytical approach. Gestalt perception finds its rationale in the evidence that perception of any given object or experience exhibits intrinsic qualities that cannot be completely reduced to visual, auditory, tactile, olfactory, or gustatory components. Thus, perceptions are not constructed in a "bottom-up" fashion from such elements, but are instead globally perceived, in a more "top-down" fashion. Gestalt perception, if cautiously and carefully combined with structured (techno)logical tools, would permit one to defoliate the often too-many-branches built diagnostic trees, and help physicians to better develop their competency. On the other hand, the practice of evidence-based medicine lies in the integration of individual clinical expertise and judgment with the best available external clinical evidence from systematic research. This article is aimed at providing some general concepts about Gestalt perception, and to discuss some aspects of clinical practice potentially influenced by this approach.
authors.affiliation: Emergency Department, Academic Hospital of Parma, Via Gramsci, 14, 43126, Parma, Italy, gcervellin@ao.pr.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cervellin
authors.forename: Loris
authors.initials: L
authors.lastname: Borghi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
mesh_terms: D001499:Bayes Theorem; D000066491:Clinical Decision-Making / Q000379:methods; D003952:Diagnostic Imaging; D004562:Electrocardiography; D005863:Gestalt Theory; D006801:Humans; D010808:Physical Examination