Case-based reasoning

Abstract

The clinical case has been central to the practice of medicine since its inception, but the perceived value of the case, both a source of knowledge and as the basis for clinical decision making, has declined in the era of evidence-based medicine. Thinking in cases, however, is necessary for the practice of person-centered healthcare, ensuring that the individuality of the case-at-hand is recognized and incorporated into diagnostic and therapeutic decisions. The case-at-hand will be compared to other cases, derived from clinical research, pathophysiologic understanding, and clinical experience, as these kinds of cases serve as the repository of medical knowledge. Utilizing analogy and argument, clinicians derive and negotiate warrants relevant to particular patients, in order to make diagnoses, recommendations, and decisions. Case-based reasoning provides a rigorous and explicit framework for delivering person-centered care to individuals seeking healing.