Medical therapeutics: from induction to scientific evolution

Perspect Biol Med. 2013 Autumn;56(4):568-83. doi: 10.1353/pbm.2013.0036.

Abstract

The field of medical therapeutics may be characterized as having suffered major scientific evolution in the last decades. The publication of landmark studies has been important enough to produce shifts in patient care. However, the scientific evolution in this field does not necessarily imply a progressively greater degree of certitude. In fact, it is not uncommon for new knowledge, when reflected in clinical practice, to weaken previous knowledge. In medical therapeutics, strict inductive reasoning implies the existence of empirical intervention data, typically clinical trial data. In many instances, however, such data does not exist-leaving room for a mixture of inductive and "pseudo-deductive" reasoning. It is often necessary to establish treatment on the basis of incomplete and inconclusive information, more so when the clinical situation is grave, but when no valid information exists, no treatment may be an option. In many instances, the rule "I wish not to impose on others" has superseded the concept "Do not impose on others what you yourself do not desire."

MeSH terms

  • Cardiology / ethics
  • Cardiology / trends*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / therapy*
  • Diffusion of Innovation*
  • Endpoint Determination
  • Evidence-Based Medicine / ethics
  • Evidence-Based Medicine / trends*
  • Guideline Adherence / trends
  • Humans
  • Patient Safety
  • Patient-Centered Care / trends
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / trends
  • Precision Medicine / trends
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome