{"title":"Understanding the role of induction, intensions and extensions in pragmatic clinical research and practice","authors":"Jean Raymond , Tim E. Darsaut","doi":"10.1016/j.neuchi.2024.101609","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Pragmatic clinical research methods are poorly understood, but essential to practice outcome-based medical or surgical care. Pragmatic research aims to verify the connections between medical knowledge and the reality of practice. Its methods can be understood by reviewing the problems of induction, as well as the related linguistic and mathematical notions of intensions and extensions.</div></div><div><h3>Methods</h3><div>We briefly review the source of problems with using inductive methods to gain knowledge, and the relationships between language, mathematics and reality. We discuss linguistic 'sense’ and ‘reference’, and the set-theory terms ‘intensions’ and ‘extensions’, which define the relationship between individuals and whichever pertinent collection these individuals comprise. Both concepts are essential to understand pragmatic medical research and evidence-based practice.</div></div><div><h3>Results</h3><div>Pragmatic clinical research can be explained in terms of testing (in reality) the repeatability of various inductive referential and inferential steps used in clinical practice - from reliability, diagnostic accuracy, and prognostic studies to pragmatic trials. All pragmatic studies aim to verify the relationship between the extensions of the notions of symptoms, diagnoses, prognoses, treatments, and outcomes. The concepts of intensions and extensions also serve to understand ‘statistical significance’ in analyzing trial results, as well as problems related to eligibility criteria and subgroup analyses. The results of clinical studies can be generalized to the extent that they have been tested in numerous and widely different individuals.</div></div><div><h3>Conclusion</h3><div>The notions of sense and reference, and of intensions and extensions, help explain the role pragmatic clinical research methods can play in optimizing care.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 1","pages":"Article 101609"},"PeriodicalIF":1.5000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0028377024000808","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Pragmatic clinical research methods are poorly understood, but essential to practice outcome-based medical or surgical care. Pragmatic research aims to verify the connections between medical knowledge and the reality of practice. Its methods can be understood by reviewing the problems of induction, as well as the related linguistic and mathematical notions of intensions and extensions.
Methods
We briefly review the source of problems with using inductive methods to gain knowledge, and the relationships between language, mathematics and reality. We discuss linguistic 'sense’ and ‘reference’, and the set-theory terms ‘intensions’ and ‘extensions’, which define the relationship between individuals and whichever pertinent collection these individuals comprise. Both concepts are essential to understand pragmatic medical research and evidence-based practice.
Results
Pragmatic clinical research can be explained in terms of testing (in reality) the repeatability of various inductive referential and inferential steps used in clinical practice - from reliability, diagnostic accuracy, and prognostic studies to pragmatic trials. All pragmatic studies aim to verify the relationship between the extensions of the notions of symptoms, diagnoses, prognoses, treatments, and outcomes. The concepts of intensions and extensions also serve to understand ‘statistical significance’ in analyzing trial results, as well as problems related to eligibility criteria and subgroup analyses. The results of clinical studies can be generalized to the extent that they have been tested in numerous and widely different individuals.
Conclusion
The notions of sense and reference, and of intensions and extensions, help explain the role pragmatic clinical research methods can play in optimizing care.
期刊介绍：
Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal.
With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published.
Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.
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