Análisis del Razonamiento Clínico para el Diagnóstico Médico, Abordaje desde la Neurociencia, la Lógica, la Probabilidad y la Causalidad.

Abstract

The purpose of clinical reasoning is to make decisions under a level of uncertainty and responsibility, since it is expected from the medical act, as a theoretical and practical discipline: to establish a diagnosis, offer a treatment and outline a prognosis. Clinical reasoning was defined in terms of the analysis, collection and identification of key information about an explanatory knowledge of the hypotheses generated, then a contrast with questions on the gaps in knowledge or research needs of the case, this involves a series of processes and steps that have been of interest and object of study of various disciplines throughout history, thus, the philosophy of medicine, linguistics and mathematics have addressed aspects of the underlying cognitive process. For centuries, medical diagnosis has been taught in medical schools through the teacher-student dyad and has been based on the expert's expertise, his personal casuistry and the knowledge that the student acquires while observing him, learning from his virtues, contrasting his defects and forming his own criteria throughout his life, which he will transmit, if he wishes, to the new generations of physicians; however, this methodology ignores the increasingly rapid generational change. It becomes anachronistic and out of step with the current knowledge coming from different disciplines, making it necessary to resort to multidisciplinarity and to the analysis made by neuroscience of clinical reasoning. In the exercise of medical diagnosis, tools for clinical decision making are implemented and depend on the elements of judgment that justify them. Elements from several scientific areas will be used to integrate a theory of clinical reasoning for diagnosis, in a sequence or system of organized thought, through concepts such as abductive logic, probability and causality, to feed medical education and the reasoning process in medical students and trained physicians in order to guide them on how to solve complex clinical problems.