Notes
1 Thus, as recent scholarship has emphasised (Paavola 2006, McKaughan 2008, Campos 2011), abduction should not be identified with the so-called Inference to the Best Explanation.
2 The point has been raised by Frankfurt (1958) and Kapitan (1997). McKaughan (2008) defends the pursuit-worthiness interpretation against generative interpretations. Schaffner (1993) similarly criticizes Hanson (1958) for obscuring the distinction between the generation and preliminary evaluation of hypotheses.
3 Interpretations along these lines have been proposed by Fann (1970), Curd (1980) and Psillos (2011).
4 Similar objections were raised against Hanson (1958) and others who defended abduction as a “logic of discovery.” See Nickles (1980) for several contributions to this debate and Schaffner (1985) for ones focused on medical diagnosis.
5 Stanley and Campos (2013, 306) call the former of these “creative abduction” and the latter “habitual abduction.”
6 Sometimes ‘differential diagnosis’ is instead used to refer to the process or method of considering and distinguishing different diagnostic hypotheses (e.g. Sox, Higgins and Owens 2013, Ch. 2). We will here use the term only to refer to a set of competing hypotheses, rather than the process of generating or selecting between these.
7 A similar point also applies to treatment: even if a given treatment fails to alleviate a patient’s symptoms, it may still provide valuable clues for further investigations. The line between treatment and testing is not always a sharp one.
8 The following case is developed on the basis of the clinical experience of one of the authors. While we do not make any claims as to how statistically common scenarios of this type are, we regard it as sufficiently typical to illustrate the ability of our framework to explicate patterns of clinical reasoning.
9 ‘Decrescendo diastolic murmur’ means that a sound of decreasing intensity occurs during diastole, i.e. period of the cardiac cycle where the heart relaxes and refills with blood.
10 For a recent survey of currently available programs, see Bond et al (2012). Philosophers in the 1980s debated whether computer programs could in principle replace all aspects of diagnostic reasoning (e.g. Schaffner 1985, Wartofsky 1986). We here focus on how useful currently existing programs are for the task of generating hypotheses.
11 An aneurysm is an abnormal widening of a blood vessel. This can cause weakness in the wall of the vessel. A dissection is a rupture of the blood vessel where blood flows into the layers of the wall of the vessel, forcing them apart.
12 For instance, threshold models highlight the importance of weighing initial probability against the potential benefits and harms of testing or treating. Similarly, Bayes’ Theorem can highlight importance lessons about probabilistic reasoning. Thus, they may provide useful analytic frameworks for teaching clinical reasoning (Sox, Higgins and Owens 2013). We are less optimistic about proposals to reform clinical practice to conform more closely to probabilistic models, proposed e.g. by Richardson (2007); see Marewski and Gigenrenzer’s (2012) critique of information-greedy procedures for clinical decision-making.
13 Kassirer, Wong and Kopelman, (2013, 46) also mention aanalogies between expertise in chess and in medical diagnosis.