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Research Article| Volume 4, ISSUE 1, P3-23, March 1984

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The Pathologist and the Diagnostic Process: With a Note on Edelman’s Group Selection Theory and the Darwinian Computer

  • William Beautyman
    Correspondence
    Corresponding author: Department of Pathology, University of Massachusetts Medical School at Berkshire Medical Center, 725 North Street, Pittsfield, Massachusetts 01201
    Affiliations
    Professor of Pathology, University of Massachusetts Medical School at Berkshire Medical Center, Pittsfield, Massachusetts
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DOI:https://doi.org/10.1016/S0272-2712(18)30939-9
The Pathologist and the Diagnostic Process: With a Note on Edelman’s Group Selection Theory and the Darwinian Computer
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Next ArticleCan Physicians Be Rational About Diagnostic Tests?
      This paper is only available as a PDF. To read, Please Download here.
      In this well-detailed article, the author considers the diagnostic process phenomenologically (as it might be seen by an outside observer) and goes on to consider the process from an aspect that is more interesting, more important, and much more difficult to understand: what goes on in a physician’s mind as he makes a diagnosis.
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      References

        • Bayes T.
        Quoted in McNeil, B. J., Keeler, E., and Edelstein, S. J.: Primer on certain elements of medical decision making.
        N. Engl. J. Med. 1975; 293: 211
        • Beautyman W.
        Newman’s “Grammer of Assent” and the diagnostic process.
        Perspect. Biol. Med. 1982; 25: 472
        • Beautyman W.
        • Rawnsley H.M.
        A proposal for a department of pathology improvement program.
        Pathologist. 1981; 35: 92
        • Beck J.R.
        • Meier F.A.
        • Rawnsley H.M.
        Mathematical approaches to the analysis of laboratory data.
        in: Stefanini M. Benson E.S. Progress in Clinical Pathology. Vol. 8. Grune & Stratton, New York1981: 67
        • Bruce R.A.
        • Yarnell S.R.
        Computer-aided diagnosis of cardiovascular disorders.
        J. Chron. Dis. 1966; 19: 473
        • Bryant G.D.
        • Norman G.R.
        The communication of uncertainty.
        In Annual Conference on Research in Medical Education. 1979; 18: 205
        • Buck R.W.
        Iatral, not iatrogenic.
        N. Engl. J. Med. 1976; 294: 1298
        • Campbell E.J.M.
        Clinical science.
        Clin. Sei. 1976; 51: 1
        • Campbell E.J.M.
        • Scadding J.G.
        • Roberts R.S.
        The concept of disease.
        Br. Med. J. 1979; 2: 757
        • Casscells W.
        • Schoenberger A.
        • Graboys T.B.
        Interpretation by physicians of clinical laboratory results.
        N. Engl. J. Med. 1978; 299: 999
        • Crosby W.H.
        Chess and combat: The algorithm in medicine.
        J.A.M.A. 1977; 238: 2721
        • Edelman G.M.
        Group selection as the basis for higher brain function.
        in: Schmitt F.O. The Organization of the Cerebral Cortex. MIT Press, Cambridge1981: 535
        • Edelman G.M.
        Through a computer darkly: Group selection and higher brain function.
        Bull. Am. Acad. Arts Sei. 1982; 36: 20
        • Edelman G.M.
        • Mountcastle V.B.
        The Mindful Brain.
        MIT Press, Cambridge1978
        • Edelman G.M.
        • Reeke Jr., G.N.
        Selective networks capable of representative transformations, limited generalizations, and associative memory.
        Proc. Natl. Acad. Sei. 1982; 79: 2091
        • Edwards D.A.W.
        Flow charts, diagnostic keys, and algorithms in the diagnosis of dysphagia.
        Scot. Med. J. 1970; 15: 378
        • Elstein A.S.
        • Schulman L.S.
        • Sprafka S.A.
        Medical Problem Solving: An Analysis of Clinical Reasoning.
        Harvard University Press, Cambridge1978
        • Engle R.L.
        • Davis B.J.
        Medical diagnosis: Present, past and future.
        Arch. Intern. Med. 1963; 112 (520, 530): 512
        • Feinstein A.R.
        Clinical biostatistics XXXIX, the haze of Bayes, the aerial palaces of decision analysis and the computerized Ouija board.
        Clin. Pharmacol. Ther. 1977; 21: 482
        • Feinstein A.R.
        An analysis of diagnostic reasonsing. II. The strategy of intermediate decisions.
        Yale J. Biol. Med. 1973; 46: 264
        • Feinstein A.R.
        An analysis of diagnostic reasoning. III. The construction of clinical algorithms.
        Yale J. Biol. Med. 1974; 47: 5
        • Feinstein A.R.
        Boolean algebra and clinical taxonomy.
        N. Engl. J. Med. 1963; 269: 929
        • Feinstein A.R.
        Clinical Judgment.
        Williams and Wilkins, Baltimore1967
        • Harris Jr., J.M.
        The hazards of bedside Bayes.
        J.A.M.A. 1981; 246: 2602
        • Hood I.
        • Campbell E.J.M.
        Is pK OK?.
        N. Engl. J. Med. 1982; 306: 864
        • Hubel D.H.
        • Wiesel T.N.
        Functional architecture of macaque monkey visual cortex.
        Proc. R. Soc. Lond. [Biol.]. 1977; 198: 1
        • Huxley A.
        Proper Studies.
        Chatto and Windus, London1927
        • Kassirer J.P.
        • Gorry J.A.
        Clinical problem solving: A behavioral analysis.
        Ann. Intern. Med. 1978; 89: 245
        • Kirschner M.A.
        The role of hormones in the etiology of human breast cancer.
        Cancer. 1977; 39: 2716
        • Knox R.A.
        Essays in Satire.
        Sheed and Ward, London1933
        • Koran L.M.
        The reliability of clinical methods, data and judgments.
        N. Engl. J. Med. 1975; 293: 642-695
        • Kuin J.M.J.W.
        Newman’s Grammer of Assent—een verwarloosd meesterwerk.
        Te Elfder Ure. 1957; 4: 289

      33. Newman, J. H.: An Essay in Aid of a Grammar of Assent (1870). Reprinted in Harrold, C. F. (ed): New York, Longmans Green and Co., 1947.

      34. Norman, G. R., Jacoby, L. L., et al.: Clinical experience and the structure of memory. In Annual Conference on Research in Medical Education, 18:214, 1979.

        • Norusis M.J.
        • Jacquez J.A.
        Diagnosis. I. Symptom nonindependence in mathematical models for diagnosis.
        Comput. Biomed. Res. 1975; 8: 156
        • Rakic P.
        Local circuit neurons.
        Neurosci. Res. Prog. Bull. 1975; 13: 295

      37. Reeke, G. N., and Edelman, G. M.: Selective networks and recognition automata. Ann. N.Y. Acad. Sei., in press.

        • Reggia J.A.
        Computer-assisted medical decision making: A critical review.
        Ann. Biomed. Eng. 1981; 9: 605
        • Scadding J.G.
        Diagnosis: The clinician and the computer.
        Lancet. 1967; 2: 877
        • Scadding J.G.
        Principles of definition in medicine with special reference to chronic bronchitis and emphysema.
        Lancet. 1959; 1: 323
        • Schmitt F.O.
        • Dev P.
        • Smith B.H.
        Electrotonic processing of information by brain cells.
        Science. 1976; 193: 114
        • Schwartz W.B.
        • Wolfe H.J.
        • Pauker S.G.
        Pathology and probabilities: A new approach to interpreting and reporting biopsies.
        N. Engl. J. Med. 1981; 305: 917
        • Shepherd G.M.
        The neuron doctrine: A revision of functional concepts.
        Yale J. Biol. Med. 1972; 45: 584
        • Sher P.P.
        Mathematical and computer assisted procedures in clinical decision making.
        Hum. Pathol. 1980; 11: 420
        • Smith E.E.
        • Medin D.L.
        Categories and Concepts.
        Harvard University Press, Cambridge1981
        • Sokal R.R.
        Numerical taxonomy and disease classification.
        in: Jacquez J.A. The Diagnostic Process. University of Michigan Press, Ann Arbor1964: 51
        • Szentagothai J.
        The “module-concept” in cerebral cortex architecture.
        Brain Res. 1975; 95: 475
        • Warner H.A.
        A mathematical approach to medical diagnosis. Application to congenital heart disease.
        J.A.M.A. 1961; 177: 177

      49. Webster’s New International Dictionary of the English Language. Edition 2. Unabridged. Springfield, Massachusetts, G. and C. Merriam Co., 1944.

        • Whewell W.
        History of Scientific Ideas.
        J. W. Parker and Son, London1858

      51. Wile, M. Z., Wingenfeld, J. R., et ah: Physician-patient communication: Interpretations of non-technical phrases. In Annual Conference on Research in Medical Education, 18:208, 1979.

        • Woodbury M.A.
        • Clive J.
        • Garson Jr., A.
        Mathematical typology: A grade of membership technique for obtaining disease definition.
        Comput. Biomed. Res. 1978; 11: 277
        • Young D.W.
        A survey of decision aids for clinicians.
        Br. Med. J. 1982; 285: 1332
        • Zajicek G.
        On the inadequacy of the concept of disease.
        Med. Hypotheses. 1982; 9: 169

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      DOI: https://doi.org/10.1016/S0272-2712(18)30939-9

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      © 1984 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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