Prognosis in healthcare

2019 ◽  
pp. 11-21
Author(s):  
Peter Croft ◽  
Richard D Riley ◽  
Karel GM Moons
Keyword(s):  
Medical Education ◽  
Medical Practice ◽  
Treatment Decisions ◽  
Evidence Base ◽  
Central Place ◽  
History Of ◽  
Prognosis Research ◽  
Access To Data ◽  
Available Information ◽  
Effective Treatments

Predicting what might happen in the future to individuals, based on experience and available information, has always been a prominent part of medical practice and healthcare. This chapter describes the history of prognosis in healthcare. Prognosis had a central place in medical practice in times before scientific diagnosis and effective treatments, and predicting the likely course of an individual’s illness from experience and observation was a valued quality. As the science of diagnosis developed, prognosis lost its importance in medical education and practice. With the advent of effective treatments and with rapid acceleration of access to data—from genetics to physiology, psychology to social status—to inform outcome prediction in sick people and guide treatment decisions, prognosis is again at the centre of healthcare. Modern prognosis research provides an evidence base for prediction in practice.

Empiricism in Sixteenth-Century Medical Practice

2013 ◽  
Vol 18 (6) ◽  
pp. 487-516 ◽  
Author(s):  
Michael Stolberg
Keyword(s):  
Sixteenth Century ◽  
Medical Practice ◽  
Central Place ◽  
Sensory Experience ◽  
General Knowledge ◽  
Personal Observation ◽  
Lay Persons ◽  
History Of ◽  
The Creation ◽  
Key Terms

Based on an analysis of some 4.000 pages of manuscript notes on ordinary medical practice which the little-known Bohemian physician Georg Handsch (1529–1578?) wrote from the late 1540s, this article traces the central place which empiricist attitudes and approaches held in mid-sixteenth-century learned medical practice. While explicit epistemological statements are rare, the very effort which Handsch put into recording thousands of observations he and other physicians around him had made, and the value they attributed to the experiences of ordinary lay persons and even “empirics” reflects a profound belief in the value of sensory experience and personal observation. The paper traces the uses of empiricist key terms like “experientia,” “historia” and “observatio,” it highlights the epistemic effects of personal observation, from confirming and challenging established notions to the creation of new general knowledge from particulars, and it suggests, in conclusion, that such brief notes on ordinary medical practice played an important role in the history of “facts.” 


Part II: Reformers in Medical Education and Practice

2001 ◽  
Vol 9 (2) ◽  
pp. 59-68 ◽  
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Professional Practice ◽  
Medical Practice ◽  
Care Society ◽  
Analytical Quality ◽  
Financial Gain ◽  
John Hunter ◽  
History Of ◽  
Definition Of ◽  
Historical Article

Background Part I was published in Can J Plast Surg 2000;8(1):25–29. It established that standards of professional practice shift constantly. When a standard falls short of professional expectation or when a physician becomes more concerned with financial gain rather than patient care, society needs the action of a reformer. Part II continues the study and begins with the contribution of reformer John Hunter (1728–1793), and follows with the contributions of seven other reformers, concluding with Wilder Penfield (1891–1976). Study Design The reformers were physicians and scientists who were selected throughout the history of medicine: they conformed to our definition of reformers, namely, a person whose action changed the structure or ideology of medical practice. Results The present historical article shows that reforms are produced by people possessing critical judgement and analytical quality who influenced the direction of medical practice. Conclusion Reforms have been achieved through intuitive leaps, alterations of conventional practice, painstaking research or administrative restructuring.

Policy Making in Medical Schools

1987 ◽  
Author(s):  
William G. Rothstein
Keyword(s):  
Medical Education ◽  
Medical Practice ◽  
Medical Science ◽  
Medical Schools ◽  
Third Party ◽  
Educational Policies ◽  
Human Organism ◽  
American Health Care System ◽  
American Health Care ◽  
History Of

Medical schools today are being closely scrutinized. Questions have been raised about their educational policies, the activities of their faculty members, and the quality of care provided in their clinical facilities. The concern is due in part to the activities of the medical schools themselves, in part to their accountability for use of government funds, and in part to changes in the American health care system. It is thus appropriate to examine the history of American medical schools to understand how the central issues in medical education have changed and how medical schools have responded to the changes. In this study, medical schools in each period have been placed in the context of that period. Their educational policies have been analyzed in terms of the state of medical practice of the time. Their educational standards have been compared to those of other institutions of higher education. This chapter will develop a framework for the analysis by examining the major issues and groups involved in medical education. The casual reader may wish to know that this framework is not essential for understanding the historical narrative, and that each part of the narrative can be read independently. Because medical education is designed to prepare students for employment as physicians after graduation, a fundamental pedagogical issue concerns how to balance the need to teach students the basic concepts of medical science with the need to train them in the practical skills needed to practice medicine. This becomes particularly difficult when the two bodies of knowledge are as intellectually demanding and as different as they are in medicine. The science and practice of medicine, in their broadest sense, are concerned with the structure and functions of the human organism in health and disease, the causes of change from one to the other, the prevention of disease, and the means of restoring health when disease occurs. Medical science is concerned primarily with the first two of these, medical practice with the last three. Medical practice also involves a social and economic relationship between a patient and a physician. The patient agrees to compensate the physician, either directly or through a third party.

Reformers in Medical Education and Practice

2000 ◽  
Vol 8 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Professional Practice ◽  
Medical Practice ◽  
18Th Century ◽  
Care Society ◽  
Analytical Quality ◽  
Financial Gain ◽  
History Of ◽  
Definition Of

Background The standards of professional practice are constantly shifting to keep pace with acquired knowledge. When the standards fell short of professional expectations, when the practising physician became more concerned with financial gain than effective patient care, society needed a reformer to evaluate the process and to improve it. Study Design Individual physicians and scientists were selected from throughout the history of medicine until the end of the 18th century, who conformed to our definition of reformers, namely, a person who changed the structure or ideology of medical practice. Results This survey demonstrates that reforms are produced by persons whose minds possess analytical quality and critical judgment. Reformers have influenced the directions of medical practice and teaching. Conclusion The improvement in medical practice has been achieved through intuitive leaps, rejection of conventional practice, painstaking research or administrative restructuring.

Who Is the Founder of Psychophysics and Experimental Psychology?

1999 ◽  
Vol 16 (2) ◽  
pp. 1-26
Author(s):  
Omar Khaleefa
Keyword(s):  
Visual Perception ◽  
Experimental Method ◽  
Experimental Psychology ◽  
Visual Illusion ◽  
Eleventh Century ◽  
Central Place ◽  
Psychological Explanation ◽  
Moon Illusion ◽  
New Concepts ◽  
History Of

The study is an investigation of the origins of psychophysics and experimentalpsychology. According to historians of psychology. FrancisBacon had the most crucial influence in the history of the experimentalmethod, because he emphasized the importance of induction, skepticism,quantification, and observation. The present study, however,attempts to show that Ibn al-Haytham laid the foundations of the aboveaspects of the experimental method. Furthermore, a number of historiansof psychology believe that Fechner was the founder of psychophysicswith his application “Filements of Psychophysics” in 1860.This study shows that in the eleventh century, Ibn al-Haytham made anoriginal contribution to the study of vision, wherein his psychophysicsborrowed its structure from physics and its spirit from psychology.Several aspects of visual perception were investigated by him, includingsensation (which occupies a central place in psychophysics), variationsin sensitivity, perception of colors. sensation of touch, perceptionof darkness, the psychological explanation of moon illusion, and binocularvision. This study presents five experiments by Ibn al-Haythamregarding the errors of vision, which is called in contemporary psychology“visual illusion.” These experiments have been applied andverified in Bahrain from both the physical and psychological perspectives.Finally, the study concludes that Ibn al-Haytham deserves the title“founder” of psychophysics as wellp the “founder” of experimentalpsychology. In this respect. Kitab ul-Manazir by Ibn al-Haytham.which appeared in the fmt half of the eleventh century, and not the“Elements of Psychophysics” by Fechner. which was published in thenineteenth century, marks the official “founding” of psychology,because it provides not only new concepts and theories but new methodsof measurement in psychology.

Detergent properties as the basis of the dimexide therapeutic effect in AA-amyloidosis infectious nature (clinical case analysis)

2020 ◽  
Vol 24 (2) ◽  
pp. 60-71
Author(s):  
V. Rameev ◽  
L. Kozlovskaya ◽  
A. Rameeva ◽  
P. Tao
Keyword(s):  
Therapeutic Effect ◽  
Medical Practice ◽  
Clinical Case ◽  
Clinical Observation ◽  
Case Analysis ◽  
Systemic Amyloidosis ◽  
Aa Amyloidosis ◽  
Functional Amyloid ◽  
History Of

The article discusses the current possibilities of postinfectious AA-amyloidosis treatment with dimexide on the example of clinical observation, discribes in detail the problem of functional amyloid and debates the prospects of the principle of amyloid resorption in the treatment of systemic amyloidosis. The history of the use of dimexide in medical practice is given, thenecessary dataon the pharmacology of dimexide are presented.

Integrative Approach in Law Understanding: the History of the Origin of Ideas and the Current State

2020 ◽  
Vol 2 (1) ◽  
pp. 115-130
Author(s):  
R. R. Palekha ◽  
Keyword(s):  
Central Place ◽  
Scientific Basis ◽  
Integrative Approach ◽  
Current State ◽  
History Of ◽  
Legal Thinking ◽  
Reliable Knowledge ◽  
The Right ◽  
Fat Formulation

Introduction. Right understanding is the most live, interesting and, at the same time, the uncertain and changeable area of researches which takes the central place as in the general theory of the right, and gains the increasing value in industry jurisprudence that is connected with its considerable teoretiko-methodological and applied potential which is shown in spheres of lawmaking and law-enforcement activity. Thus, right understanding represents research tools of the subject of knowledge which allow to study all range legal and, the based on them, state phenomena for the purpose of obtaining reliable knowledge of state and legal reality. In this regard integrative approach in right understanding which has rich history of the formation and development is of special interest, allows to perceive the right as integrally complete phenomenon, as much as possible retrieves its regulatory abilities and, provides achievement of criteria of scientific research: comprehensiveness, objectivity, historicism. Materials and Methods. In article an attempt of the analysis of integrative approach in right understanding from a position of history of origin of his ideas and assessment of the current state is made. A result of studying of scientific literature, generalization and comparison of the different points of view fat formulation of author’s determination of category “right understanding” and submission of the evidence-based integrative theory of right understanding which as much as possible conforms to requirements of time and has essential regulatory and guarding potential. Results. In article the category right understanding is comprehensively considered, different integrative theories of right understanding from a position of their origin and development are submitted, the value of modern integrative approach in right understanding is shown, perspectives of its further development are evaluated. Discussion and Conclusion. The author comes to the conclusion about the theoretical and methodological consistency and inevitability of the integrative approach in law understanding, which acts as a scientifically grounded type of legal thinking capable of comprehending the law on a truly scientific basis.

Generating publicly available progress notes of authentic quality: A crowdsourcing-based approach (Preprint)

2020 ◽  
Author(s):  
Rina Kagawa ◽  
Yukino Baba ◽  
Hideo Tsurushima
Keyword(s):  
Social Capital ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Privacy ◽  
Patient Anxiety ◽  
Physical Status ◽  
High Quality ◽  
Privacy Concerns ◽  
Progress Notes ◽  
Research And Education

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

John among the Apocalypses

2020 ◽  
Author(s):  
Benjamin E. Reynolds
Keyword(s):  
Gospel Of John ◽  
Central Place ◽  
Reception History ◽  
Genre Theory ◽  
Synoptic Gospels ◽  
Book Of Revelation ◽  
Distinctive Features ◽  
History Of ◽  
Definition Of ◽  
And Function

The central place of revelation in the Gospel of John and the Gospel’s revelatory telling of the life of Jesus are distinctive features of John when compared with the Synoptic Gospels; yet, when John is compared among the apocalypses, these same features indicate John’s striking affinity with the genre of apocalypse. By paying attention to modern genre theory and making an extensive comparison with the standard definition of “apocalypse,” the Gospel of John reflects similarities with Jewish apocalypses in form, content, and function. Even though the Gospel of John reflects similarities with the genre of apocalypse, John is not an apocalypse, but in genre theory terms, John may be described as a gospel in kind and an apocalypse in mode. John’s narrative of Jesus’s life has been qualified and shaped by the genre of apocalypse, such that it may be called an “apocalyptic” gospel. Understanding the Fourth Gospel as “apocalyptic” Gospel provides an explanation for John’s appeal to Israel’s Scriptures and Mosaic authority. Possible historical reasons for the revelatory narration of Jesus’s life in the Gospel of John may be explained by the Gospel’s relationship with the book of Revelation and the history of reception concerning their writing. An examination of Byzantine iconographic traditions highlights how reception history may offer a possible explanation for reading John as “apocalyptic” Gospel.

scholarly journals Medical Education From a Theory–Practice–Philosophy Perspective

2021 ◽  
Vol 8 ◽  
pp. 237428952110102
Author(s):  
Susan A. Kirch ◽  
Moshe J. Sadofsky
Keyword(s):  
United States ◽  
Medical Education ◽  
Curriculum Design ◽  
Historical Perspective ◽  
Curriculum And Instruction ◽  
Medical Curriculum ◽  
Educational Theory ◽  
The United States ◽  
History Of ◽  
How People Learn

Medical schooling, at least as structured in the United States and Canada, is commonly assembled intuitively or empirically to meet concrete goals. Despite a long history of scholarship in educational theory to address how people learn, this is rarely examined during medical curriculum design. We provide a historical perspective on educational theory–practice–philosophy and a tool to aid faculty in learning how to identify and use theory–practice–philosophy for the design of curriculum and instruction.

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