Difference between revisions of "The logic of the probabilistic language"

The logic of the probabilistic language (view source)

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 The uncertainties surrounding these factors render the theory-observation relationship probabilistic. In medical practice, two types of uncertainty predominantly impact diagnoses: subjective uncertainty and causality.<ref>{{Cite book | autore = Vázquez-Delgado E | autore2 = Cascos-Romero J | autore3 = Gay-Escoda C | titolo = Myofascial pain associated with trigger points: a literature review. Part 2: Differential diagnosis and treatment | url = http://www.medicinaoral.com/pubmed/medoralv15_i4_pe639.pdf | volume = | opera = Med Oral Patol Oral Cir Bucal | anno = 2007 | editore = | città = | ISBN = | PMID = 20173729 | PMCID = | DOI = 10.4317/medoral.15.e639 | oaf = <!-- any value --> | LCCN = | OCLC = }}</ref><ref>{{Cite book | autore = Thoppay J | autore2 = Desai B | titolo = Oral burning: local and systemic connection for a patient-centric approach | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459460/ | volume = | opera = EPMA J | anno = 2019 | editore = | città = | ISBN = | PMID = 30984309 | PMCID = PMC6459460 | DOI = 10.1007/s13167-018-0157-3 | oaf = <!-- any value --> | LCCN = | OCLC = }}</ref> Therefore, in this context, it becomes crucial to differentiate between these two uncertainties and to demonstrate that the concept of probability assumes different meanings in these contexts. We will endeavor to elucidate these concepts by connecting each critical step to the clinical approach that has been documented in previous chapters, particularly focusing on the dental and neurological domains in vying for diagnostic supremacy for our dear Mary Poppins.
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+==Subjective Uncertainty and Causality==
+Let's imagine asking Mary Poppins which of the two medical colleagues—the dentist or the neurologist—is correct.
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+The question would generate a kind of agitation based on internal uncertainty; therefore, the notions of certainty and uncertainty refer to the subjective epistemic states of human beings, and not to states of the external world, because there is no certainty or uncertainty in that world. In this sense, as we have mentioned, there are an inner world and an external world that both do not adhere to canons of uncertainty, but rather to probability.
+Mary Poppins may be subjectively certain or uncertain as to whether she is suffering from TMDs or a neuropathic or neuromuscular form of OP. This is because "uncertainty" is a subjective, epistemic state below the threshold of knowledge and belief; hence the term.
+====Subjective Uncertainty====
+Without a doubt, the term ‘subjective’ alarms many, especially those who aim to practice science by pursuing the noble ideal of ‘objectivity,’ as this term is perceived by common sense. Therefore, it is appropriate to make some clarifications on the use of this term in this context:
+‘Subjective’ indicates that the probability assessment depends on the information status of the individual who performs it.
+‘Objective’ does not mean arbitrary.
+The so-called ‘objectivity,’ as perceived by those outside scientific research, is achieved when a community of rational beings shares the same state of information. But even in this case, one should more properly speak of ‘intersubjectivity’ (i.e., the sharing of subjective opinions by a group).
+In clinical cases—precisely because patients rarely possess advanced notions of medicine—subjective uncertainty must be considered. Living with uncertainty requires us to adopt a probabilistic approach.
+======Causality ======
+Causality indicates the lack of a certain connection between cause and effect. The uncertainty of a close union between the source and the phenomenon is among the most challenging problems in determining a diagnosis.
+In a clinical case, a phenomenon <math>A(x)</math> (such as a malocclusion, a crossbite, an openbite, etc.) is randomly associated with another phenomenon <math>B(x)</math> (such as TMJ bone degeneration); when there are exceptions for which the logical proposition <math>A(x) \rightarrow B(x)</math> is not always true (but it is most of the time), we will say that the relation <math>A(x) \rightarrow B(x)</math> is not always true but it is probable.{{q2|<!--30-->We are moving from a deterministic condition to a stochastic one.|}}
+==Subjective and Objective Probability==
+In this chapter, we revisit some topics previously discussed in the insightful book by Kazem Sadegh-Zadeh<ref>{{cita libro
+|autore=Sadegh-Zadeh Kazem
+|titolo=Handbook of Analytic Philosophy of Medicine
+|url=https://link.springer.com/book/10.1007/978-94-007-2260-6
+|anno=2012
+|editore=Springer
+|città=Dordrecht
+|ISBN=978-94-007-2259-0
+|DOI=10.1007/978-94-007-2260-6
+}}</ref>, which tackles the problem of the logic of medical language. We adapt their content to our clinical case of Mary Poppins, aiming to keep our understanding more relevant to dental contexts.
+Events that are both random and subjectively uncertain are considered probable; therefore, causality and uncertainty are approached as qualitative, comparative, or quantitative probabilities.
+To clarify this concept, let's use the example of Mary Poppins. A doctor, after hearing her symptoms, could state that:
+# Mary Poppins is probably suffering from TMDs (qualitative term).
+#Mary Poppins is more likely to have TMDs than neuropathic OP (comparative term: the number of diagnosed cases of TMDs vs. neuropathic OP).
+#The probability that Mary Poppins has TMDs is 0.15 (quantitative term, relative to the population).
+=== Subjective Probability===
+In contexts of human subjective uncertainty, probabilistic, qualitative, comparative, and/or quantitative data can be interpreted by clinicians as measures of subjective uncertainty, to make 'states of conviction' numerically representable.
+For instance, stating "the probability that Mary Poppins is affected by TMDs is 0.15 of the cases" is akin to saying "with a 15% degree of belief, I think that Mary Poppins is affected by TMDs"; indicating that the degree of conviction corresponds to the degree of subjective probability.
+===Objective Probability===
+Conversely, events and random processes cannot be accurately described by deterministic processes in the form 'if A then B'. Statistics are utilized to quantify the frequency of the association between A and B, representing their relationship as a degree of probability, which introduces the concept of objective probability.
+Amid the increasing acknowledgment of the role of probabilization of uncertainty and randomness in medicine since the eighteenth century, the term "probability" has become an integral part of medical language, methodology, and epistemology. Unfortunately, the distinction between subjective and objective probability is not always clearly made in medicine, as is the case in other disciplines too. Nevertheless, the vital contribution of probability theory in medicine, especially in concepts of probability in etiology, epidemiology, diagnostics, and therapy, lies in its aid in understanding and representing biological causality.
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