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PubMedDate not supplied

Improving clinical guidelines with logic and decision-table techniques: application to hepatitis immunization recommendations.

Clinical practice guidelines can be clarified, verified, and simplified by the use of logical analysis and the application of decision-table techniques. This methodology is applied to a CDC guideline for the prevention of perinatal transmission of hepatitis B by immunization. Relevant clinical variables are identified and possible values for each variable are defined. An exhaustive enumeration of value combinations is generated. Logically impossible combinations are identified and eliminated. The guideline's recommendations are next translated into a set of rules and compared with the remaining value combinations. Variable combinations that are not covered by guideline recommendations represent incomplete guideline specifications. Inconsistency can be identified by finding identical condition sets in two or more rules. The procedure demonstrates that the hepatitis guideline is incomplete. Logical analysis can improve the quality of clinical practice guidelines by assuring comprehensiveness and consistency.

Decision Support Techniques↗
PubMed1985

Decrements in logical reasoning performance under conditions of sleep loss and physical exercise: the factor of sentence complexity.

Baddeley's Logical Reasoning Test was used in a series of Sustained Operations (SUSOP) studies involving 100 US Marine Corps enlisted subjects, to assess the effects of sleep loss and long-term physical exercise on the ability to process complex information. The percent correct answers to the eight Logical Reasoning sentence types involving different voice (active vs passive), use of negatives, and outcome (true vs false) were analyzed over three days across three levels of exercise and rest conditions in the seven studies. A multivariate analysis of variance indicated no differences on the baseline day among the seven studies. Analyses on the baseline day and throughout the next two continuous workdays (CWs) showed consistently higher percent correct for the actively worded than for the passively worded sentences. The sleep loss over the two CWs resulted in a significant decrease in percent correct for the statements which had active wording. Sleep loss had no effect on statements with passive wording. There were no differences in comprehension between groups which had different rest conditions (no rest, 3- or 4-hr. nap, 8-hr. sleep) between the two CWs for any of the sentences; and there was no recovery from prerest to postrest. Fatigue due to exercise during either CW had no effect on comprehension for any of the sentence types. The sleep loss effects on comprehension seem due to a lessening of the attention given to those more simple sentences in active voice, whereas increased arousal may have been elicited by the more complex sentences in passive voice. The increased attention to the passive statements may have overcome the effects of sleep loss. The present study shows the usefulness of analyzing responses to the logical reasoning test by sentence complexity for indicating selective cognitive changes in the processing of information.

Adult↗
PubMed2006

Repeated questioning for order of events: disparate effects following logical versus random presentation.

In the present study, 72 college-age participants from an introductory psychology course viewed a series of 20 pictures depicting events surrounding a routine activity, i.e., eating at a cafeteria; these pictures were presented either in a logical order. e.g., enter cafeteria, pick up tray, stand in line, and select food, or in a random order. Three successive tests of free reconstruction of order indicated disparate effects of these conditions; random presentation produced significant forgetting of order information across tests, whereas logical presentation produced no change in performance across tests. Whereas randomly presented stimuli produced both reliable intertest recovery (reminiscence) and forgetting, neither result was observed following logical presentation. The implications of these data for eyewitness testimony for general theories of hypermnesia are discussed.

Humans↗
PubMed2006

Logic models used to enhance critical thinking.

Over time, various methods have been used to stimulate critical thinking in undergraduate nursing students, and although many have been successful in helping students integrate the essential knowledge, experiences, and clinical reasoning that support practice, it is also useful to explore new methods. Faculty at the University of Hawaii at Manoa, School of Nursing and Dental Hygiene have taken an innovative approach of using logic models to further enhance critical thinking. This article presents an application of varying experiences and methods of using logic models to support the development of critical thinking and reasoning skills in nursing students. The processes in which logic models are used in the curriculum are described. The models are used to connect concepts from concrete to abstract levels in diverse and often nonlinear diagrams, guided discourse, and written assignments. The specific instructional methods used include concept mapping, concept papers, conceptual linking, and substruction.

Attitude of Health Personnel↗
PubMed1995

Fuzzy logic in drug delivery.

The first article in this series concentrated on the definition of terms and the methods that are applied in fuzzy logic. This article discusses the advantages of fuzzy logic in drug-delivery applications. The derivation of membership functions, linguistic variables, and drug-delivery control rules are shown for various delivery devices. A specific solution is discussed, which uses fuzzy logic decision-support methods for optimized treatment through respiratory drug delivery.

Administration, Inhalation↗
PubMed1975

Logical operations and role-taking abilities in two cultures: Norway and Hungary.

9 Piagetian measures of conservation, classification, and role taking, and a task designed to test verbal egocentrism were administered to children in 3 social settings in rural Hungary. The work is an extension of research carried out by Hollos and Cowan in Norway. In each setting 45 male and female children with equal numbers of 7-, 8-, and 9-year-olds were tested. Factor analysis yielded a logical-operations factor and a role-taking factor. Age and setting effects were significant for both factors. The socially isolated children performed less well on role-taking tasks but did significantly better on logical operations at all ages than village and town children. The results are almost identical with the findings of the Norwegian study, further supporting a threshold hypothesis regarding the amount of social interaction needed for the development of logical operations. Language stimulation and the effect of linguistic role marking in Hungarian do not seem to be significant factors, nor is schooling.

Child↗
PubMed2001

Normal forms for description logic expressions of clinical concepts in SNOMED RT.

Modern clinical terminologies organize concepts into multi-hierarchy structures that are defined by logic-based expressions, enabling compositional representation of clinical statements and supporting more complete and consistent retrieval of clinical data. The Systematized Nomenclature of Medicine, Reference Terminology (SNOMED RT) gives each concept code a semantic definition stated in description logic. The process of development, testing and distribution of these definitions has highlighted the fact that a concept definition may take many different but logically equivalent forms, and has revealed a need for a set of normal forms for authoring, distribution, and other purposes. This paper describes the difference between a choice of syntax and a choice of normal form, and defines several different normal forms, including a short canonical form, a long canonical form, and a distribution normal form.

Clinical Medicine↗
PubMed2002

[Medical ethics, a counter-weight to the logics of the Perruche decree].

FROM A CONTRACTUAL LOGIC TO A PROBABILISTIC APPROACH: Since 1936, reflections on the relationship between the physician and the patient have progressed within the context of a contractual legal concept. Its contents have been based more on jurisprudence than on the physicians' reflections with regard to their practice. Associated with this contractual logic, some confusion exists between a lesion, a medical concept, and a handicap, which is the social consequence of one's status of health. This has been reinforced by the scientific progress made in medicine, which privileges a probabilistic approach based on scientific data, rather than the uncertainty, inscribed in the dialogue and singularity of the encounter. REGARDING THE PERRUCHE DECREE: We analyzed the reports submitted to the court of cessation regarding the Perruche affair, together with the first chapter of the law concerning the rights of the patients and the quality of health system, by studying the extent to which this decision was inscribed or not in the continuity of past legal decisions, and whether the characteristics described above were present. In this decree, the predominating contractual logic is that the notion of handicap is not analyzed, and the scientific and probabilistic conception of medical practice is involved in the debate. THE NECESSITY FOR REFLECTION: Our discussion insists on the necessity of constructing a reflection on the medical presentation; society cannot accept that this be reduced to the strict respect of the elements of the contract, defined by legal decisions. It should be carefully thought out by health professionals, and in collaboration with human science.

Persons with Disabilities↗
PubMed1990

[Formal thinking, logical-discursive operations and schizophrenia: experimental study of a clinical case].

This study, based on a single case experimental design, examined logical reasoning in a schizophrenic meeting the DSM-III criteria. The quantitative assessment carried out by 32 psychiatrists on a rating scale for logical thinking disorders (nine items, six points) of the retranscribed clinical interview showed 1. that the assessments varied in a statistically significant way according to items and psychiatrists, and that these variations were independent of their degree of experience--the correlations between the different items of the rating scale proved to be weak and not significantly different from zero; and 2. the study of the most contradictory statements carried out by a logician using reasoning analysis procedures concluded that there were in fact logical relationships between the subjects the schizophrenic talked about. The results are discussed in relation to the methodology of assessing formal thought in schizophrenia.

Adult↗
PubMed1988

[Logical structure and meaning in information processing].

Investigating the influence the dimensions "Meaning", and "Logical Structure" feature in the process of solving verbally-presented problems is the purpose of this study. 120 13-year-old boys and girls were administered 12 problems built around two different logical structures with six different "Meaning" dimensions. The results indicate that the logical structure of the problems is an important factor when information processing is at stake.

Adolescent↗
PubMed1987

Early function concepts: their development and relation to certain mathematical and logical abilities.

Cognition of functions (i.e., y = f(x)) has been identified as an achievement of early childhood. To investigate the development of function concepts and their relation to mathematical and logical abilities typically acquired during the age period of 5-7 years, 72 children in this age range were tested on nonnumerical function tasks (functions as exchange of properties, functions as displacement of positions, and functions as preservation of structure), numerical tasks (number conservation and arithmetic problems), and aspects of logical reasoning (class inclusion, class vicariance, and seriation). Orderly developmental trends were found in function task performance, with younger children manifesting limited success through trial-and-error strategies and older children achieving substantial success with anticipatory strategies. Moreover, certain function abilities were associated with the numerical domain, whereas others were associated with the logical domain. The findings are consistent with the developmental model of Piaget et al. according to which cognition of functions lays the groundwork for reversible operations, but also suggest that this development occurs through parallel processes within separate conceptual domains.

Child↗
PubMed1987

Young children's sensitivity to logical necessity in their inferential search behavior.

Young children's ability to evaluate the logical necessity of 2 types of inferences was studied in 2 experiments involving 68 3-7-year-olds. Children searched the doors of model houses in order to determine whether a house matched a description specifying certain numbers and types of occupants. A search task used in Experiments 1 and 2 allowed children to search for additional information if initial information was insufficient to support a logically necessary inference about whether the house was correct or incorrect. A judgment condition used in Experiment 2 required a "can't tell" response to insufficient information. Even 3-year-olds showed some ability to evaluate the logical necessity of an inference that confirmed a house was correct. Developmental changes involved increased reliability of individuals' performance and increased range of application of children's inference evaluation procedures to include more difficult, disconfirmatory inferences and cases where greater certainty in reasoning seemed to be required. Results are discussed in terms of an account of the gradual development and consolidation of an ability to evaluate the necessity of inferences, perhaps first apparent in preschoolers' sensitivity to conditions of sufficient and insufficient information in information-acquisition problems.

Age Factors↗
PubMedDate not supplied

[The logic of a traditional health belief: solar eclipse and pregnancy in Ocuituco, Mexico].

An analysis of the logic of one of the commonest health beliefs in rural areas of Mexico is made, taking as a starting point testimonies collected in the area of Ocuituco, in the state of Morelos. This belief suggests that a pregnant woman is in danger of having a harelipped baby during a solar eclipse. The importance of the knowledge about the logic of this kind of beliefs is discussed from a public health perspective. These beliefs are associated with specific forms of suffering and give way to particular preventive measures which must be taken into account if the efficacy of health programs is to be increased. The interrelation of these beliefs with other traditional elements (such as the "loss of the shadow" and the "hot-cold theory") is discussed. Also, some of the already existing interpretations of this belief which seek to link the "loss of the shadow" with the solar eclipse belief are reviewed. Finally, an alternative interpretation of this belief is made from a structuralist methodological perspective. This interpretation is grounded in the Nahuatl myth on the creation of the sun and the moon, and in an analysis of the nature of rabbits in the Nahuatl culture, according to historic secondary sources. It is suggested that the belief about the danger of a solar eclipse must be interpreted in connection to the "hot-cold theory", but not to the "loss of the shadow". This paper concludes by emphasizing the importance of this type of research within the public health field, as it enables us both to understand the underlying logic of this type of conceptions, and to reinforce the dialogue between modern and alternative medicine, so that the daily encounter between these two types of medicine can be facilitated.

Cleft Lip↗
PubMed1995

Bion's use of modern logic.

This paper introduces the reader to modern logic, more particularly the branch of logic called 'Model Theory', which is extensively used by Bion. Logic today is no longer described as the study of 'valid inference', but rather by the notion of consistency of beliefs. This central concern of the logician with consistency is also seen to be that of the psychoanalyst when he aims for eventual resolution of conflict between a patient's contradictory beliefs. Models are explained as the use of the already familiar to explain the unfamiliar, as when, for example, we invoke our familiar planetary system to understand the complex structure of the atom. In psychoanalysis we seek to find the old childhood models underpinning a patient's contemporary model of himself and others. Thus both Model Theory and psychoanalysis are interested in how we 'see the new in terms of the old'. Finally, the creation of models is assimilated to the integrative tendency of depressive activity and the dissolving or collapsing of models linked to paranoid-schizoid activity. As these two processes in the individual are linked by Bion we can see human beings as continually oscillating between creating and destroying models of their inner and outer worlds.

Humans↗
PubMed1995

Projection, identification, and bi-logic.

The work and postulations of Matte-Blanco are explained in some detail, especially regarding the logical functioning of the conscious and unconscious mind, asymmetrical and symmetrical logic, and bi-logical thought structures. A case serves as an example for the clinical application of Matte-Blanco's ideas to theoretical conceptualization and to the technique of interpretation.

Adult↗
PubMed1994

[Logic and analogy in psychiatry. Their "common root"].

Logic and analogy pose a fundamental problem in psychiatry. The latter is at the moment renewed by the existence of fuzzy logics. The authors put forward the hypothesis of a common root using the systemal method, an original strategy and a particular test. Several questions are tackled: definitions, hierarchy, linking, linearity or circularity, closed of open aspect of thought process, integration, separation or continuity, ways of appearance, discrete organization or organization in networks, different or common origin, importance of modal and non monotonous logics. A discussion and the consequences of this hypothesis are specified.

Humans↗
PubMedDate not supplied

[Fuzzy logic and postoperative pain].

OBJECTIVE: To apply a fuzzy logic expert control system for the treatment of postoperative pain in a clinical setting. MATERIAL AND METHODS: A system was designed consisting of a perfusion pump guided by a fuzzy logic computer interface to regulate the perfusion of alfentanil in accordance with the patient's pain response. The system was also equipped with a safety device that halted perfusion in case of desaturation, bradypnea or heart rate or blood pressure variations greater than 25%. The system was used in the first 90 minutes after surgery in a patient who underwent bilateral saphenectomy. RESULTS: All system functions worked properly, maintaining the target analgesic values (visual analog scale < or = 2) 77% of the time. CONCLUSION: It is possible to use fuzzy logic to obtain adequate treatment of postoperative pain.

Adult↗
PubMed1998

Probability logic and probabilistic induction.

This article reviews some philosophical aspects of probability and describes how probability logic can give precise meanings to the concepts of inductive support, corroboration, refutation, and related notions, as well as provide a foundation for logically sound statistical inference. Probability logic also provides a basis for recognizing prior distributions as an integral component of statistical analysis, rather than the current misleading practice of pretending that statistics applied to observational data are objective. This basis is important, because the use of realistic priors in a statistical analysis can yield more stringent tests of hypotheses and more accurate estimates than conventional procedures.

Epidemiologic Studies↗