Coping with Complexity and Uncertainty: Insights from Studying Epidemiology in Family Medicine

Abstract

Family medicine’s epidemiology is complex, it shows a power-law or Pareto distribution of consultation outcomes. Eighty percent of consultations end with an “uncertain diagnoses” [more accurately these consultations end with descriptive terms of symptom, group of symptoms or disease picture (or syndromes)] and only 20 % have a well-defined diagnosis. Robert N. Braun developed a pragmatic approach—a hierarchy of diagnostic certainty, and diagnostic protocols—to help general practitioners/family physicians to cope with the discipline’s complexities in everyday practice, and elaborated critically on the limitations of heuristics and Bayesian approaches as tools for clinical decision-making.