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Arch Hellen Med, 25(3), May-June 2008, 389-395


Knowledge-based medicine

Laboratory of Clinical Epidemiology, School of Nursing, University of Athens, Athens, Greece

Scientific medicine is characterized by a theoretical framework (theory of medicine), which is rational, and the deployment in this framework of knowledge that derives from science. Genuine scientific medicine is, by its definition, knowledge-based medicine (KBM) and not evidence-based medicine (EBM). Of course scientific knowledge is based on empirical evidence, but evidence is not knowledge. Evidence may be specific (ad hoc) or general (previous experience). Specific evidence is constituted by the patient profile (diagnostic or etiognostic or prognostic), and this is interpreted -translated to gnostic probability- in the light of the general, ideally scientific, evidence (profile-specific prevalence, profile-specific rate ratio or profile-specific rate difference). The two forms of evidence, which are empirical (synthetic statements), constitute the premise of gnostic inference. The conclusion of inference is the unknown hypothesis. When the hypothesis or one of the premises for the inductive inference contains a concept of statistical probability (synthetic statement), the probability of the conclusion is logical probability (analytic statement) and expresses the logical relation between the conclusion (hypothesis) and the premise (evidence).

Key words: General evidence, Inductive logic, Logical probability, Specific evidence.

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