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Biomedical subjects

F J Flier

Publications and source records attributed to F J Flier.

6 recordsLinked to original sources
PubMed1999

Nosology and causal necessity; the relation between defining a disease and discovering its necessary cause.

The problem of disease definition is related to the problem of proving that a certain agent is the necessary cause of a certain disease. Natural kind terms like 'rheumatoid arthritis' and 'AIDS' refer to essences which are discoverable rather than predeterminate. No statement about such diseases is a priori necessarily true. Because theories on necessary causes involve natural kind semantics, Koch's postulates cannot be used to falsify or verify such theories. Instead of proving that agent A is the necessary cause of disease D, we include A in a theoretical definition of D, take this to represent the real meaning of 'D', and discard the pretheoretical definition. This is illustrated by Koch's own attempt to prove he had discovered the necessary cause of tuberculosis. Methodological arguments about disease causation require a clear view of our use of diagnostic terms. Medical lexicographers should do more to provide such a view.

Diagnosis, Differential↗
PubMed1998

Three types of IS-A statement in diagnostic classifications: three types of knowledge needed for development and maintenance.

Update mechanisms for diagnostic classifications should capture changes in medical knowledge but also allow for comparability across versions. This paper provides a basis for such a mechanism by describing types of IS-A statement and types of knowledge used in the construction of diagnostic classifications. Three types of IS-A statement are used: 'A is by definition a B', 'A is probably a B' and 'A is in theory necessarily a B'. Each relates to a different type of knowledge: knowledge of linguistic conventions, of probabilities, and of empirical theories and their status, respectively. Consequently, the development and maintenance of diagnostic classifications requires a collaboration of medical terminologists and medical scientists. The role of the latter is especially important during updating. Updating is necessitated by changing probabilities and by the introduction or changing status of empirical theories. The linguistic notion of hyponymy oversimplifies the issue.

Artificial Intelligence↗
PubMed1995

The challenge of an international classification of procedures in medicine.

This paper reviews the international developments with respect to the classification of medical procedures in light of recent work by CEN/TC251 and the situation in the Netherlands. The historical background is outlined, some advantages and disadvantages of ICPM are discussed, and some new initiatives are reported. Recent initiatives all tend towards the same sort of structure for the classification of medical procedures. So far, no international body is taking responsibility for the standardization of the contents of these structures. A questionnaire was sent out in order to investigate the existence or emergence of national coding centers, their wishes with respect to procedure classification, and their willingness to collaborate in the development and use of one international classification. The response to the questionnaire is briefly discussed and some further steps are proposed.

Classification↗
PubMed1986

[Postanesthetic recall ability, anxiety and dreams in surgical patients. A clinical study].

The recall of stimuli registered during general anaesthesia is described. Patients were interviewed 2 days after surgery, concerning their experiences during anaesthesia. In a second series of observations, the interview was preceded by a short inquiry, which took place in the recovery room as soon as the patient awoke. Anxiety was also assessed by pre- and postoperative tests. Of 140 patients, 2 described recall of awareness during anaesthesia. There was no evidence that external stimuli had been incorporated into dream content.

Adolescent↗