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Causal reasoning and the diagnostic process

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Abstract

Background: Causal reasoning as a way to make a diagnosis seems convincing. Modern medicine depends on the search for causes of disease and it seems fair to assert that such knowledge is employed in diagnosis. Causal reasoning as it has been presented neglects to some extent the conception of multifactorial disease causes.

Goal: The purpose of this paper is to analyze aspects of causation relevant for discussing causal reasoning in a diagnostic context.

Procedures: The analysis will discuss different conceptions of causal reasoning in medical diagnosis, discriminating primarily between narrow causal diagnosis and more thorough causal explanation. The theory of causes as non-redundant factors in effective causal complexes is used as an analytical background. Causal explanations are performed according to different causal models. Such models of diagnosis are assumptions concerning structure and mechanisms, which cannot be directly or immediately observed. Conceptions and results of causal search strategies differ, according to the focus of the searcher. Causal reasoning is also seen in diagnosis in a more extensive meaning: the pin-pointing of factors responsible for the condition of the patient at any time during the course of disease.

Conclusion: Causal reasoning and diagnosis go well in hand, especially if both concepts are widened. The theory of causes as non-redundant components in effective causal complexes, modulated by what is referred to as the stop problem and causal fields, is valuable for explaining the many aspects of causal reasoning in medical diagnosis.

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References

  1. “Causal reasoning” has not been rigidly defined. Causal reasoning is one of various kinds of diagnostic reasoning. Not only medical diagnosis, but also procedures in surveillance systems, industrial processing, aircraft, etc. where malfunctions are detected and corrected are “diagnostic.” Causal reasoning refers to searches for what caused a system to malfunction in an existing malfunction situation. The causal behavior of the system and the reasoning employed must be expressed verbally for the application of an adequate theory of causality.

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This study was made possible through funding by the EC ESPRIT II, Basic Research Action Program, Project no. 3105,MOHAWC.

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Rizzi, D.A. Causal reasoning and the diagnostic process. Theoretical Medicine 15, 315–333 (1994). https://doi.org/10.1007/BF01313345

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