Scientific methodology in temporomandibular disorders. Part III: Diagnostic reasoning

Temporomandibular disorders (TMD), as a cluster of individual diseases and disorders, pose new intellectual challenges to the diagnostic skills of dentists. New technologies enable dentists to avail themselves of paraclinical data such that diagnosis can and should be disease specific or etiology specific. The importance of logic in diagnostic reasoning is discussed. Studies of the reasoning process of doctors with reputations for having good clinical judgement have resulted in protocols of diagnostic reasoning. Three specific strategies are presented and discussed-probabilistic, causal and deterministic. The difference between intellectual and managerial decisions are explained relative to utility of the strategies.