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Difference between revisions of "Logic of medical language"
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Doctors' interpretations of vague medical terms often differ, reducing uniformity in clinical practices compared to guidelines.<ref>{{Cita libro | autore = Codish S | autore2 = Shiffman RN | titolo = A model of ambiguity and vagueness in clinical practice guideline recommendations | url = https://pubmed.ncbi.nlm.nih.gov/16779019/ | anno = 2005 }}</ref> | Doctors' interpretations of vague medical terms often differ, reducing uniformity in clinical practices compared to guidelines.<ref>{{Cita libro | autore = Codish S | autore2 = Shiffman RN | titolo = A model of ambiguity and vagueness in clinical practice guideline recommendations | url = https://pubmed.ncbi.nlm.nih.gov/16779019/ | anno = 2005 }}</ref> | ||
Ambiguity and vagueness are important concepts in understanding challenges in clinical communication and diagnosis. Despite being discussed in linguistic and philosophical contexts, they are underexplored in medical practice, with significant impact on clinical guidelines and diagnostic decisions. | |||
'''Ambiguity''' occurs when a word or phrase has multiple meanings. In medical language, it can appear in several forms:<blockquote>'''Syntactic ambiguity:''' When a sentence structure allows different interpretations. For example, "the pain is caused by inflammation" could mean that pain is directly caused by inflammation, or that inflammation is just one contributing factor<ref>Codish, S., & Shiffman, R. N. (2005). A model of ambiguity and vagueness in clinical practice guideline recommendations. AMIA Annual Symposium Proceedings, 2005, 146-150.</ref>. | |||
'''Semantic ambiguity:''' Terms like "neuropathic pain" can refer to either peripheral nerves or the central nervous system, leading to confusion without further specification<ref>Schick, F. (2003). Ambiguity and Logic. Cambridge University Press.</ref>. | |||
'''Pragmatic ambiguity:''' When the context does not provide enough information, such as when a doctor says "this is a suspicious diagnosis" without specifying which diagnosis is being considered<ref>Teigen, K. H. (1988). The language of uncertainty. Acta Psychologica, 67, 129-138.</ref>.</blockquote>'''Vagueness''' refers to cases where there is no clear distinction between categories:<blockquote>'''Clinical vagueness:''' The term "fever" is vague, as a temperature of 37.8°C might be considered febrile for an immunocompromised patient but not for a healthy individual<ref>Jääskeläinen, S. K. (2019). Differential Diagnosis of Chronic Neuropathic Orofacial Pain: Role of Clinical Neurophysiology. Journal of Clinical Neurophysiology, 36(6), 467-473.</ref>. | |||
'''Diagnostic vagueness:''' A concept like "syndrome" is often vague, such as with chronic fatigue syndrome, where symptoms are general and markers are unclear, leading to varied interpretations by different physicians<ref>Porporatti, A. L., et al. (2017). Pain from Dental Implant Placement, Inflammatory Pulpitis Pain, and Neuropathic Pain Present Different Somatosensory Profiles. Journal of Oral & Facial Pain and Headache, 31(3), 229-236.</ref>. | |||
'''Clinical Implications:''' Ambiguity and vagueness can negatively affect adherence to clinical guidelines, causing diagnostic errors and inconsistent treatments. For example, "conservative management" can be interpreted differently by doctors, leading to discrepancies in patient care<ref>Codish, S., & Shiffman, R. N. (2005). A model of ambiguity and vagueness in clinical practice guideline recommendations. AMIA Annual Symposium Proceedings, 2005, 146-150.</ref>.</blockquote>Examples: | |||
'''Ambiguity:''' "Orofacial pain" could mean a temporomandibular disorder (TMD) to a dentist, but neuropathic pain to a neurologist, leading to different diagnoses and treatments<ref>Sadegh-Zadeh, K. (2012). Handbook of Analytic Philosophy of Medicine. Springer.</ref>. | |||
'''Vagueness:''' The term "disease" varies depending on the context, such as hypertension being classified as a disease with organ damage, but seen as a manageable risk factor without complications<ref>Jääskeläinen, S. K. (2019). Differential Diagnosis of Chronic Neuropathic Orofacial Pain: Role of Clinical Neurophysiology. Journal of Clinical Neurophysiology, 36(6), 467-473.</ref>. | |||
This leads to inefficiencies in decoding the "machine message" transmitted by the system, as in the case of Mary Poppins' orofacial pain. Next, we delve into the concept of "encrypted machine language" in the subsequent chapters. | This leads to inefficiencies in decoding the "machine message" transmitted by the system, as in the case of Mary Poppins' orofacial pain. Next, we delve into the concept of "encrypted machine language" in the subsequent chapters. | ||