精神病学中的操作范式:它有多有效?
1Clinica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Journal of evaluation in clinical practice
|October 20, 2023
概括
诊断中的操作标准 (OC) 是以有效性为准而制定的,而不仅仅是可靠性. 验证工作已经从专家驱动演变为数据驱动,寻求改善诊断准确性的潜在因果关系.
科学领域:
- 精神病学是一个精神病学.
- 科学哲学的哲学科学哲学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 诊断标准,特别是自DSM-III以来,因优先考虑评价者之间的可靠性而不是有效性而受到批评.
- 尽管受到批评,但在制定这些标准时,努力将有效性要求纳入其中.
- 在操作标准范式的认识论基础上,仍然存在着严重的误解.
研究的目的:
- 分析操作标准 (OC) 出现的认识论背景.
- 检查操作标准自创立以来所经历的验证过程.
主要方法:
- 运营标准发展的历史和哲学分析.
- 审查使用的验证方法,从最初的专家驱动方法到以后的数据驱动策略.
- 检查对运营标准发展的影响,包括哲学和医学专业贡献.
主要成果:
- 虽然讨论了Hempel对操作标准的影响,但主要开发人员 (圣路易斯集团,DSM-III编辑) 没有公开承认.
- 与常见的假设相反,自从它们的概念以来,一直在不断尝试验证操作标准.
- 验证从工具性,以实用性为重点的方法发展到通过生物/心理因果关系寻求现实的有效性,并纳入诸如家族聚合和预后指标等措施.
结论:
- 运营标准的制定涉及影响的复杂相互作用,以及对验证的持续,尽管不断变化的承诺.
- 验证操作标准的方法变得越来越复杂,转向数据驱动的方法和外部构造措施.
- 了解认识论基础对于理解当前诊断范式的优点和局限性至关重要.
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