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Difference between revisions of "Logic of medical language"
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Similarly, a neurologist will interpret "pain in the right half of the face" based solely on his professional context, involving concepts like synapses, axons, ion channels, and action potentials. Conversely, a dentist will frame the meaning through a lens focused on teeth, the temporomandibular joint, masticatory muscles, and occlusion, demonstrating how meaning is intrinsically linked to the reference context. | Similarly, a neurologist will interpret "pain in the right half of the face" based solely on his professional context, involving concepts like synapses, axons, ion channels, and action potentials. Conversely, a dentist will frame the meaning through a lens focused on teeth, the temporomandibular joint, masticatory muscles, and occlusion, demonstrating how meaning is intrinsically linked to the reference context. | ||
Considering concepts is crucial in formulating a "differential diagnosis," as their misunderstanding can lead to clinical errors. It is therefore essential to explore the modern philosophy of "Meaning," introduced by Gottlob Frege,<ref>[[:wikipedia:Gottlob_Frege|Wikipedia entry]]</ref> which articulates the meaning of a term through the notions of "extension" and "intension." | |||
The "extension" of a concept includes all entities that share a certain characteristic, while "intension" refers to a set of attributes that outline that idea. Taking "pain" as an example, this term is generically applied to a wide range of human experiences, showing high extension but low intension. However, analyzing specific pain in contexts such as dental implants, inflammatory dental pulpitis, and neuropathic pain (atypical odontalgia),<ref>{{cita libro | The "extension" of a concept includes all entities that share a certain characteristic, while "intension" refers to a set of attributes that outline that idea. Taking "pain" as an example, this term is generically applied to a wide range of human experiences, showing high extension but low intension. However, analyzing specific pain in contexts such as dental implants, inflammatory dental pulpitis, and neuropathic pain (atypical odontalgia),<ref>{{cita libro | ||
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| PMID = 31688325 | | PMID = 31688325 | ||
}}</ref> | }}</ref> | ||
==Ambiguity and Vagueness== | ==Ambiguity and Vagueness== | ||
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The term "orofacial pain" does not gain its meaning so much from its purest lexical expression as from the context in which it manifests, evoking a wide range of clinical domains, related symptoms, and interactions with other neuromotor systems, the trigeminal nerve, dental districts, etc. This machine language does not translate directly into verbal language but into an encrypted code based on its own alphabet, which must be deciphered to be converted into natural language. The focus then shifts to the linguistic logic employed to decode this message. To better illustrate this concept, let's consider some practical examples. | The term "orofacial pain" does not gain its meaning so much from its purest lexical expression as from the context in which it manifests, evoking a wide range of clinical domains, related symptoms, and interactions with other neuromotor systems, the trigeminal nerve, dental districts, etc. This machine language does not translate directly into verbal language but into an encrypted code based on its own alphabet, which must be deciphered to be converted into natural language. The focus then shifts to the linguistic logic employed to decode this message. To better illustrate this concept, let's consider some practical examples. | ||
Imagine that Mary Poppins complains of "orofacial pain," thus communicating her condition to the referring healthcare providers: | Imagine that Mary Poppins complains of "orofacial pain," thus communicating her condition to the referring healthcare providers:{{q2|<!--93-->Doc, 10 years ago I started with a widespread discomfort in the jaw, including episodes of bruxism; these worsened so much that I was accusing ‘diffuse facial pain’, in particular in the area of the right ‘TMJ’ with noises in the movements mandibular.<br><!--94-->During this period, ‘vesicular lesions’ formed on my skin, which were more evident in the right half of my face.<br>In this period, however, the pain became more intense and intermittent|}} | ||
The healthcare provider, whether a dermatologist, dentist, or neurologist, picks up certain verbal messages in Mary Poppins' dialogue, such as "widespread facial pain" or "TMJ" or "vesicular lesion," and establishes a series of hypothetical diagnostic conclusions that have nothing to do with encrypted language. | The healthcare provider, whether a dermatologist, dentist, or neurologist, picks up certain verbal messages in Mary Poppins' dialogue, such as "widespread facial pain" or "TMJ" or "vesicular lesion," and establishes a series of hypothetical diagnostic conclusions that have nothing to do with encrypted language. | ||
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The key can be defined as "Real Context." | The key can be defined as "Real Context." | ||
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| oaf = <!-- qualsiasi valore --> | | oaf = <!-- qualsiasi valore --> | ||
}}</ref> | }}</ref> | ||
==Decryption == | ==Decryption == | ||
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{{q2|<!--145-->A System Logic that integrates the sequence of the machine language code|<!--146-->true! we'll get there with a little patience}} | {{q2|<!--145-->A System Logic that integrates the sequence of the machine language code|<!--146-->true! we'll get there with a little patience}} | ||
== | ==Final Considerations== | ||
The logic of language is not a theme of exclusive interest to philosophers and educators; it concerns a crucial aspect of medicine, namely diagnosis. It's noteworthy that the International Classification of Diseases, in its ninth revision (ICD-9), includes 6,969 disease codes, a number that increases to 12,420 in the tenth revision, ICD-10, as reported by the WHO in 2013.<ref name=":0">{{cite book | |||
| autore = Stanley DE | | autore = Stanley DE | ||
| autore2 = Campos DG | | autore2 = Campos DG | ||
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| DOI = 10.1353/pbm.2013.0019 | | DOI = 10.1353/pbm.2013.0019 | ||
| oaf = <!-- qualsiasi valore --> | | oaf = <!-- qualsiasi valore --> | ||
}}</ref | }}</ref> Based on data collected from a wide series of autopsies, Leape, Berwick, and Bates (2002a) estimated that diagnostic errors contribute to causing between 40,000 and 80,000 deaths per year.<ref>{{cite book | ||
| autore = Leape LL | | autore = Leape LL | ||
| autore2 = Berwick DM | | autore2 = Berwick DM | ||
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| DOI = 10.1001/jama.288.4.501 | | DOI = 10.1001/jama.288.4.501 | ||
| oaf = <!-- qualsiasi valore --> | | oaf = <!-- qualsiasi valore --> | ||
}}</ref> | }}</ref> Moreover, a recent survey conducted on over 6,000 physicians revealed that 96% of respondents believe diagnostic errors are preventable.<ref>{{cite book | ||
| autore = Graber ML | | autore = Graber ML | ||
| autore2 = Wachter RM | | autore2 = Wachter RM | ||
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| DOI = 10.1001/2012.jama.11913 | | DOI = 10.1001/2012.jama.11913 | ||
| oaf = <!-- qualsiasi valore --> | | oaf = <!-- qualsiasi valore --> | ||
}}</ref>. | }}</ref> Charles Sanders Peirce (1839–1914) was a logician and scientist who progressively developed a triadic approach to the logic of inquiry.<ref>[[wpit:Charles_Sanders_Peircehttps://it.wikipedia.org/wiki/Charles_Sanders_Peirce|Charles Sanders Peirce]]</ref> He also distinguished between three forms of argumentation, types of inference, and methods of investigation used in scientific inquiry, namely: | ||
* Abduction, or hypothesis generation; | |||
* Deduction, or drawing conclusions from hypotheses; | |||
* Induction, or testing of hypotheses. | |||
In the concluding part of the study by Donald E. Stanley and Daniel G. Campos, Peirce's logic is considered fundamental to ensuring the effectiveness of the diagnostic transition from populations to individuals. A diagnosis is based on the analysis of individual signs and symptoms of a disease. These manifestations cannot be extrapolated directly from the general population without a broad base of experience; it is precisely this extensive experiential context that provides significant clinical insights, strengthens the instinct in interpreting perceptions, and lays the foundation for the competence necessary to act. We acquire fundamental knowledge and validate experience in order to transform our observations into diagnoses. | |||
In a further recent study, author Pat Croskerry presents the concept of "adaptive expertise in the medical decision-making process." According to Croskerry, more effective clinical decision-making can be achieved through adaptive reasoning, leading to advanced levels of competence and mastery.<ref name=":1">{{cite book | |||
| autore = Croskerry P | | autore = Croskerry P | ||
| titolo = Adaptive Expertise in Medical Decision Making | | titolo = Adaptive Expertise in Medical Decision Making | ||
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| DOI = 10.1080/0142159X.2018.1484898 | | DOI = 10.1080/0142159X.2018.1484898 | ||
| oaf = <!-- qualsiasi valore --> | | oaf = <!-- qualsiasi valore --> | ||
}}</ref>. | }}</ref> | ||
Adaptive competencies can be developed by emphasizing additional aspects of the reasoning process: | |||
* Being aware of the inhibitors and facilitators of rationality. Specialists, often unconsciously, tend to be anchored to their own scientific and clinical context. | |||
* Pursuing the standards of critical thinking. Specialists tend to exhibit self-referentiality and show difficulty in accepting criticism from other scientific disciplines or fellow specialists. | |||
* Developing a comprehensive awareness of cognitive and emotional biases and learning how to mitigate them. It's crucial to use arguments that reinforce the awareness of aspects that facilitate rationality. | |||
Furthermore, it is essential to develop a deep understanding of logic and its potential errors through the use of metacognitive processes such as reflection and awareness. This topic is introduced already in the first chapter, titled "Introduction | |||
In this context, factors of exceptional interest emerge that lead to a comprehensive synthesis of what has been discussed in this chapter. It is undeniable that the arguments of abduction, deduction, and induction optimize the diagnostic process, but they fundamentally rely on clinical semiotics, that is, on the interpretation of symptoms and/or clinical signs.<ref name=":0" /> Similarly, the adaptive experience discussed by Pat Croskerry is refined and applied in diagnosis and in errors arising from clinical semiotics.<ref name=":1" /> | |||
It is, therefore, necessary to clarify that semiotics and/or the specific value of clinical analysis are not the subject of criticism, as these procedures have represented extraordinary innovations in diagnostics over time. In the current era, both due to the change in human life expectancy and the social acceleration we are experiencing, 'time' has transformed into a conditioning factor, understood not so much as a mere temporal succession but rather as a vehicle of information. | |||
In this perspective, the medical language described so far, focused on symptoms and clinical signs, fails to prevent disease. This does not occur due to a lack of knowledge, technology, or innovation, but because the diagnostic contribution does not exploit the information conveyed by time. The 'Ephaptic' element was already known ten years ago but was not interpreted correctly. | |||
This lack cannot be attributed to healthcare workers, nor to the Health Service or the political-industrial class, as each acts within the limits of the resources and knowledge available in the socio-epochal context in which they operate. | |||
The problem lies, rather, in humanity's mentality, which prefers a deterministic reality to a stochastic one. These topics will be detailed in subsequent chapters. | |||
In the following chapters, all focused on logic, we aim to shift the attention from symptom and clinical sign to encrypted machine language. The arguments of Donald E. Stanley, Daniel G. Campos, and Pat Croskerry are well received but need to be reinterpreted in light of the concept of 'time' (in terms of symptom anticipation) and of the message (as assembler and non-verbal machine language). This, of course, does not undermine the validity of the clinical history (semiotics), which is essentially based on a verbal language anchored in medical reality. | |||
We are aware that our "Sapiens Linux" is perplexed and wonders: | |||
{{q2|... <!--180-->could the logic of Classical language help us to solve the poor Mary Poppins' dilemma?|<!--181-->You will see that much of medical thinking is based on [[The logic of classical language|the logic of Classical language]] but there are limits}} | {{q2|... <!--180-->could the logic of Classical language help us to solve the poor Mary Poppins' dilemma?|<!--181-->You will see that much of medical thinking is based on [[The logic of classical language|the logic of Classical language]] but there are limits}} | ||