Evidence-Based Practice: Logic and Critical Thinking in Medicine / Edition 1

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Evidence-Based Practice: Logic and Critical Thinking in Medicine provides easy access to fundamental principles, quickly assimilated techniques, and proven, rigorous application that demonstrates how logic and critical thinking are applied to the medical thinking process. This marriage allows health professionals to understand the critical use of evidence logically and in a structured, methodological way to make medical decisions. Such uses of evidence are the essence of Evidence-Based Practice as reflected in the spirit of this book.

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Editorial Reviews

Doody's Review Service
Reviewer: Sally Ling, M.D.;FACP(University of Missouri-Kansas City School of Medicine)
Description: This book is intended to educate the reader in the rational uses of evidence in medicine. To that end, the book is written by a physician and by a classical philosopher who together first explore and define the principles and methods of logic and critical thinking and then apply these principles to various scopes including traditional patient care and daily practice, medical research and literature, and society and the law.
Purpose: The purpose ultimately is to benefit the patient by better educating those who impact care at multiple levels, to hone their skills to critically read, evaluate, and use medical evidence. The content of this book would do well as course curriculum in teaching logic and critical thinking in medical education.
Audience: Ideally the concepts so elegantly reviewed in this book can be incorporated early into the medical school curriculum so that one is sharpened by the concepts of logic and critical thinking to make the right decisions. The book, however, has relevance at any level of experience by bringing focus to the highly important processes of decision making.
Features: This book reviews basic concepts, principles and methods used in logic and critical thinking. It then applies the principles in various contexts encountered by physicians.
Assessment: This very detailed book guides the reader from relative unawareness of the field of logic and critical thinking in medicine to appreciation, interest, and empowerment.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9781579476267
  • Publisher: American Medical Association
  • Publication date: 10/1/2004
  • Series: Evidence-Based Practice Series
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 302
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.80 (d)

Table of Contents

List of Illustrations ix
Philosopher's Foreword xiii
Physician's Foreword xv
A Word From the Authors xix
Reader's Bookshelf xxiii
Part 1 Theory and Methodological Foundations
Chapter 1 From Philosophy to Logic, From Logic to Medicine: Fundamental Definitions and Objectives of this Book 3
1.1 Why Are Logic and Critical Thinking Needed in Our Practice, Research, and Communication? Why Read This Book? 5
1.2 Medicine as Art and Science 8
1.3 Philosophy in Medicine or Philosophy of Medicine? 9
1.4 Philosophy of Science, Scientific Method, Evidence, and Evidence-based Medicine 13
1.5 Thinking, Logic, Reasoning, and Critical Thinking 15
1.6 Where in Medicine May We Find Practical Applications and Practical Uses of Philosophy, Logic, and Critical Thinking and Their Expected Benefits? 17
References 19
Chapter 2 Logic in a Nutshell I: Reasoning and Underlying Concepts: What Is Required? Does It Make Sense? 23
2.1 A Brief Historical Note 25
2.2 Logic in General and Logic in Medicine 26
2.3 Reasoning and Arguments 28
2.4 Components and Architecture of Reasoning and Arguments: What Is Required? 29
2.4.1 Classical layout of arguments: premises and conclusions 29
2.4.2 Toulmin's modern scheme for layout of arguments 31
2.4.3 Reconstructing arguments from the natural language of daily life 36
2.5 Evaluation of Reasoning and Argument: Does It Make Sense? 41
2.5.1 Criteria for good reasoning 41
2.5.2 Sources of justified premises 46
2.5.3 Criteria for good arguments and good argumentation 49
2.6 Fallacies: Definition, Classification, and Examples 52
2.6.1 Definition of a fallacy 52
2.6.2 Classification of fallacies 53
2.6.3 Examples of fallacies 55
2.7 Conclusions 56
References 56
Chapter 3 Logic in a Nutshell II: Types of Reasoning and Arguments: How Can We Reason and Argue Better? 61
3.1 Deduction, Induction, and Abduction 63
3.2 Classical Aristotelian Logic 68
3.2.1 Testing categorical syllogisms by diagramming 70
3.2.2 Syllogisms in everyday communication 76
3.3 Contemporary Logic 78
3.4 Historical Note on Indian Logic 78
3.5 Uncertainty and Probability in Medicine 79
3.6 Chaos Theory in Medicine 82
3.7 Fuzzy Sets and Fuzzy Logic 83
3.7.1 Distinction between fuzzy logic and fuzzy set theory 83
3.7.2 Paradigm of fuzziness in medicine 84
3.7.3 Essentials of fuzzy reasoning in fuzzy logic 87
3.8 Conclusions: Implications of Logic for Medicine 89
References 93
Chapter 4 Critical Thinking in a Nutshell: What Is "Critical" and What Is Not? 99
4.1 Definition of Critical Thinking 101
4.2 A Checklist for Critical Thinking 109
4.2.1 Problem identification and analysis: What's in focus? 110
4.2.2 Clarification of meaning: What kind of study for what kind of question? What does this mean? 111
4.2.3 Gathering evidence: What basic relevant information can we obtain? 112
4.2.4 Assessing evidence: How good is our basic information? 112
4.2.5 Inferring conclusions: What follows? 114
4.2.6 Other considerations: What else is relevant to the problem? 114
4.2.7 Overall judgment: What is our stand on the problem? 114
4.3 Practical Example of Critical Thinking to Solve a Health Problem: The Challenge of Complementary and Alternative Medicine (CAM) 118
4.3.1 Identification of the problem 118
4.3.2 Analysis of the problem 120
4.3.3 Clarification of meaning: What is CAM? 121
4.3.4 Arguments for CAM interventions 125
4.3.5 Explanations of the popularity of CAM 128
4.3.6 Methods of investigating claims made by CAM proponents 129
4.3.7 Assessment of evidence in CAM studies 130
4.3.8 Cause-effect reasoning in CAM studies 131
4.3.9 Systematic reviews and meta-analyses of CAM research 132
4.3.10 Alternative methods of evaluating CAM claims 132
4.3.11 Summary remarks about CAM 133
4.3.12 Complementary and alternative medicine in medical education and practice 134
4.4 Conclusions 135
References 137
Part 2 Practical Applications
Chapter 5 Logic in Research: Critical Writing and Reading of Medical Articles: What Do These Results Really Prove? How to Write and Read Discussion and Conclusions Sections 147
5.1 Classification and Structure of Medical Articles 150
5.2 Causes and Their Effects 152
5.2.1 Historical milestones 153
5.2.2 Contributions of present generations 154
5.2.3 How a cause-effect relationship is demonstrated or refuted 157
5.3 Medical Articles as Arguments 161
5.3.1 Warrants for conclusions of a causal relationship 162
5.3.2 Arguments at the core of Discussion and Conclusions sections of medical articles 163
5.4 Fallacies in Causal Reasoning and Argument 167
5.5 Conclusions and Remedies to Consider 172
References 175
Chapter 6 Logic and Critical Thinking in a Clinician's Daily Practice: Talking and Listening to Colleagues and Patients: Am I Clear Enough? You've Got It Right! 179
6.1 Patient Logic 183
6.2 Physician Logic and Reasoning 185
6.2.1 Building up the history of the case and making a clinical examination 186
6.2.2 Making a diagnosis 187
6.2.3 Treatment 196
6.2.4 Prognosis and risk assessment 199
6.2.5 Making decisions about a particular patient in a particular setting: phronesis in medicine? 202
6.3 Logic in Communication with Patients 206
6.3.1 Understanding patients' statements and reasoning 207
6.3.2 Assessment and diagnosis of psychiatric patients 208
6.4 Logic in Communication with Peers 210
6.4.1 Verbal communication: rounds and consults 210
6.4.2 Written communication: Hospital and office charts and reports 215
6.5 Conclusions: Logic in Communication with the Outside World 219
References 219
Chapter 7 Communicating with the Outside World: Are We on the Same Wavelength? 225
7.1 Our Points of Contact in the Community 227
7.2 Physicians in Courts of Law: Their Contributions to Decision-making in Tort Litigation 229
7.2.1 What to expect when dealing with decision-making legal bodies 230
7.2.2 Cause-effect challenges: General and specific 231
7.2.3 Emergence of clinical guidelines and their role in courts of law 239
7.2.4 Reflective thinking in courts of law 241
7.3 Argumentation About Cases Before Worker Compensation Boards and Other Civic Bodies 241
7.4 Dealing with Health Problems in the Media and on the Political or Entertainment Stage 242
7.5 Conclusions 246
References 246
Concluding Remarks 251
Glossary 259
About the Authors 279
Index 281
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