, Volume 1, Issue 2, pp 177–194

Hypothetico-nomological aspects of medical diagnosis Part I: General structure of the diagnostic process and its hypothesis-directed stage

  • Jan Doroszewski

DOI: 10.1007/BF00883113

Cite this article as:
Doroszewski, J. Metamedicine (1980) 1: 177. doi:10.1007/BF00883113


In medical diagnostic examination three main stages may be distinguished: (a) initial exploration, (b) hypothesis-directed investigation, and (c) final diagnosis making. The purpose of this work is to study some methodological problems concerning the second of the above stages of the diagnosis and to prepare a background for a mathematical model [30] of this process.

In diagnostic problem solving, the reasoning proceeds along the main lines traced by some initial suggestions and passes through various intermediate elements which are connected with one another forming ramifying chains and nets of inferences and hypotheses. Such a complex mental construction is based on laws which form medical knowledge and reflect various regularities and relations, causal, structural, functional, and others.

The main components of diagnostic reasoning may be divided into several classes according to their function and content: leading hypotheses, working hypotheses, main diagnostic hypotheses, statements accepted as certain, intermediary and reserve hypotheses, therapeutic suggestions of immediate consequence. In an example of diagnostic problem solving these types of propositions are defined and analysed.

In diagnostic reasoning, as in every other process of rational problem solving, explanation of the observed symptoms and signs and testing of the explaining hypotheses play a predominant role. These procedures form successive, frequently numerous and diversified steps and stages of the reasoning, leading to the construction of a mental model of the patient's state. Some problems relative to the scheme of explanation, especially to that which is based on causal laws, are discussed.

Key words

Methodology of diagnosisLogical structure of diagnosisStages of diagnosisExplanation of symptomsVerification of diagnostic hypotheses

Copyright information

© D. Reidel Publishing Company 1980

Authors and Affiliations

  • Jan Doroszewski
    • 1
  1. 1.Dept. of Biophysics and BiomathematicsMedical Centre of Postgraduate EducationWarsawPoland