Medical diagnostic reasoning: Epistemological modeling as a strategy for design of computer-based consultation programs

Giovanni Barosi, Lorenzo Magnani, Mario Stefanelli

Research output: Contribution to journalArticlepeer-review


The complexity of cognitive emulation of human diagnostic reasoning is the major challenge in the implementation of computer-based programs for diagnostic advice in medicine. We here present an epistemological model of diagnosis with the ultimate goal of defining a high-level language for cognitive and computational primitives. The diagnostic task proceeds through three different phases: hypotheses generation, hypotheses testing and hypotheses closure. Hypotheses generation has the inferential form of abduction (from findings to hypotheses) constrained under the criterion of plausibility. Hypotheses testing is achieved by a deductive inference (from generated hypotheses to expected findings), followed by an eliminative induction, constrained under the criterion of covering, which matches expected findings against patient's findings to select the best explanation. Hypotheses closure is a deductive-inductive type of inference very similar to the inferences operating in hypotheses testing. In this case induction matches the consequences of the generated hypotheses against the patient's characteristics or preferences under the criterion of utility. By using the language exploited in this epistemological model, it is possible to describe the cognitive tasks underlying the most influential knowledge-based diagnostic systems.

Original languageEnglish
Pages (from-to)43-55
Number of pages13
JournalTheoretical Medicine
Issue number1
Publication statusPublished - Mar 1993


  • artificial intelligence
  • cognitive science
  • expert systems
  • inferences
  • medical diagnosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine (miscellaneous)


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