Open AccessA Philosophical Foundation for Diagnostic Blocks, with Criteria for Their Validation
Author(s) -
Engel Andrew,
MacVicar John,
Bogduk Nikolai
Publication year - 2014
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12436
Subject(s) - metric (unit) , axiom , consistency (knowledge bases) , medicine , viewpoints , diagnostic test , set (abstract data type) , replication (statistics) , computer science , medical physics , mathematics , artificial intelligence , operations management , art , emergency medicine , geometry , virology , economics , visual arts , programming language
Background In the absence of a suitable reference standard, diagnostic local anesthetic blocks cannot be validated in the manner conventionally used for diagnostic tests. Consequently, diagnostic blocks are vulnerable to criticism for lacking validity, or being “not proven.” Study Design Philosophical essay. Methods Inspired by the “viewpoints” proposed by B radford H ill for testing cause and effect in epidemiology, a set of axiomatic criteria was developed with which the validity of diagnostic blocks could be assessed. Results Eight criteria were established: plausibility, experiment, target‐specificity, effect, duration, consistency, control, and replication. Applying weighted scores to these criteria produces a metric by which the validity of a particular diagnostic block can be quantified. Conclusion The eight criteria provide an axiomatic, philosophical basis for diagnostic blocks in general, and serve to show what empirical evidence needs to be gathered in order to validate a particular block. The associated metric allows the scientific evidence for different blocks to be quantified and compared.