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Top-down och bottom-up resonemang i diagnostiska sammanhang

Claréus, Benjamin LU (2014) PSYK01 20132
Department of Psychology
Abstract
The purpose of this study, divided into two parts, was to research and review on how nosological methods are used and can be developed in a clinical environment. A survey was performed, where 26 students that have completed a course in psychiatric diagnostics answered true or false statements about the presence of specific symptoms and their logical connection in three selected diagnoses from ICD-10. The study found large variations between respondents in the percentage number of symptom statements answered wrong, and the statements concerning logic. Partly, the large variation can be attributed to the use of top-down reasoning in the diagnostic process, and the validity of which can be affected by belief bias, strain on working memory,... (More)
The purpose of this study, divided into two parts, was to research and review on how nosological methods are used and can be developed in a clinical environment. A survey was performed, where 26 students that have completed a course in psychiatric diagnostics answered true or false statements about the presence of specific symptoms and their logical connection in three selected diagnoses from ICD-10. The study found large variations between respondents in the percentage number of symptom statements answered wrong, and the statements concerning logic. Partly, the large variation can be attributed to the use of top-down reasoning in the diagnostic process, and the validity of which can be affected by belief bias, strain on working memory, and availability and representativeness heuristics. The study is followed up by a theoretical hypothesis which focuses on bottom-up reasoning as an alternative approach to diagnostics, and the presentation of fuzzy logic algorithms for 186 different diagnoses as presented by ICD-10. Whilst this kind of bottom-up approach cannot fully replace top-down reasoning, there is a possibility that bottom-up reasoning and fuzzy logic algorithms can be used as a guideline in psychiatric evaluations to increase inter-judgment reliability. (Less)
Abstract (Swedish)
Syftet med denna uppsats var att via en studie undersöka hur nosologi används i diagnostiska sammanhang, och teorisera om hur denna process kan utvecklas. Studien undersökte individers korrekthet i bedömningen av från-eller närvaron av symtom i ICD-10, samt deras logiska förhållande. 26 respondenter som under sin utbildningstid avslutat en kurs i psykiatrisk diagnostik genomförde en enkätundersökning, där de fick läsa om tre utvalda diagnoser från ICD-10 och sedan svara på påståenden som var sanna eller falska. En stor variation fanns i antalet felaktiga svar för när-eller frånvaron av symtom, samt för deras logiska samband. Denna variation kan åtminstone delvis attribueras till top-down resonemang, vars validitet kan begränsas av belief... (More)
Syftet med denna uppsats var att via en studie undersöka hur nosologi används i diagnostiska sammanhang, och teorisera om hur denna process kan utvecklas. Studien undersökte individers korrekthet i bedömningen av från-eller närvaron av symtom i ICD-10, samt deras logiska förhållande. 26 respondenter som under sin utbildningstid avslutat en kurs i psykiatrisk diagnostik genomförde en enkätundersökning, där de fick läsa om tre utvalda diagnoser från ICD-10 och sedan svara på påståenden som var sanna eller falska. En stor variation fanns i antalet felaktiga svar för när-eller frånvaron av symtom, samt för deras logiska samband. Denna variation kan åtminstone delvis attribueras till top-down resonemang, vars validitet kan begränsas av belief bias, hög belastning och begränsningar i arbetsminnet, samt tillgänglighets- och representationsheuristik. I den efterföljande teoretiska analysen föreslås bottom-up resonemang som en alternativ approach till diagnostisering, och presenterar därigenom fuzzy logic-algoritmer för 186 diagnoser enligt ICD-10 som kan användas till att skapa ett grafiskt hjälpmedel för diagnostisering. Medan en bottom-up approach antagligen inte kan ersätta top-down resonemang, finns det möjlighet att bottom-up resonemang och algoritmer baserade på fuzzy logic kan användas som en riktlinje för att skapa valida, interbedömarreliabla diagnoser inom psykiatrisk vård. (Less)
Please use this url to cite or link to this publication:
author
Claréus, Benjamin LU
supervisor
organization
alternative title
Top-down and bottom-up reasoning in the diagnostic process
course
PSYK01 20132
year
type
M2 - Bachelor Degree
subject
keywords
Nosologi, nosology, top-down, bottom-up, ICD-10, algoritm, algorithm, fuzzy logic, diagnostics, diagnostisering, belief bias, tillgänglighetsheuristik, availability heurstics, representationsheuristik, representativeness heuristic, arbetsminne, working memory
language
Swedish
id
4437527
date added to LUP
2014-05-16 15:41:15
date last changed
2014-05-16 15:41:15
@misc{4437527,
  abstract     = {The purpose of this study, divided into two parts, was to research and review on how nosological methods are used and can be developed in a clinical environment. A survey was performed, where 26 students that have completed a course in psychiatric diagnostics answered true or false statements about the presence of specific symptoms and their logical connection in three selected diagnoses from ICD-10. The study found large variations between respondents in the percentage number of symptom statements answered wrong, and the statements concerning logic. Partly, the large variation can be attributed to the use of top-down reasoning in the diagnostic process, and the validity of which can be affected by belief bias, strain on working memory, and availability and representativeness heuristics. The study is followed up by a theoretical hypothesis which focuses on bottom-up reasoning as an alternative approach to diagnostics, and the presentation of fuzzy logic algorithms for 186 different diagnoses as presented by ICD-10. Whilst this kind of bottom-up approach cannot fully replace top-down reasoning, there is a possibility that bottom-up reasoning and fuzzy logic algorithms can be used as a guideline in psychiatric evaluations to increase inter-judgment reliability.},
  author       = {Claréus, Benjamin},
  keyword      = {Nosologi,nosology,top-down,bottom-up,ICD-10,algoritm,algorithm,fuzzy logic,diagnostics,diagnostisering,belief bias,tillgänglighetsheuristik,availability heurstics,representationsheuristik,representativeness heuristic,arbetsminne,working memory},
  language     = {swe},
  note         = {Student Paper},
  title        = {Top-down och bottom-up resonemang i diagnostiska sammanhang},
  year         = {2014},
}