Modifica di Logic of medical language (sezione)

==Ambiguity and Vagueness in Medical Language==
Ambiguity in medical language occurs when terms have multiple meanings, leading to errors and inconsistencies in diagnosis. Both ambiguity and vagueness are underexplored in clinical practice, despite their significant impact on clinical guidelines.<ref>{{Cita libro | autore = Schick F | titolo = Ambiguity and Logic | anno = 2003 | editore = Cambridge University Press }}</ref><ref>{{Cita libro | autore = Teigen KH | titolo = The language of uncertainty | anno = 1988 }}</ref>

Doctors' interpretations of vague medical terms often differ, reducing uniformity in clinical practices compared to guidelines.<ref>{{Cita libro | autore = Codish S | autore2 = Shiffman RN | titolo = A model of ambiguity and vagueness in clinical practice guideline recommendations | url = https://pubmed.ncbi.nlm.nih.gov/16779019/ | anno = 2005 }}</ref>

Ambiguity and vagueness are important concepts in understanding challenges in clinical communication and diagnosis. Despite being discussed in linguistic and philosophical contexts, they are underexplored in medical practice, with significant impact on clinical guidelines and diagnostic decisions.

'''Ambiguity''' occurs when a word or phrase has multiple meanings. In medical language, it can appear in several forms:<blockquote>'''Syntactic ambiguity:''' When a sentence structure allows different interpretations. For example, "the pain is caused by inflammation" could mean that pain is directly caused by inflammation, or that inflammation is just one contributing factor<ref>Codish, S., & Shiffman, R. N. (2005). A model of ambiguity and vagueness in clinical practice guideline recommendations. AMIA Annual Symposium Proceedings, 2005, 146-150.</ref>.

'''Semantic ambiguity:''' Terms like "neuropathic pain" can refer to either peripheral nerves or the central nervous system, leading to confusion without further specification<ref>Schick, F. (2003). Ambiguity and Logic. Cambridge University Press.</ref>.

'''Pragmatic ambiguity:''' When the context does not provide enough information, such as when a doctor says "this is a suspicious diagnosis" without specifying which diagnosis is being considered<ref>Teigen, K. H. (1988). The language of uncertainty. Acta Psychologica, 67, 129-138.</ref>.</blockquote>'''Vagueness''' refers to cases where there is no clear distinction between categories:<blockquote>'''Clinical vagueness:''' The term "fever" is vague, as a temperature of 37.8°C might be considered febrile for an immunocompromised patient but not for a healthy individual<ref>Jääskeläinen, S. K. (2019). Differential Diagnosis of Chronic Neuropathic Orofacial Pain: Role of Clinical Neurophysiology. Journal of Clinical Neurophysiology, 36(6), 467-473.</ref>.

'''Diagnostic vagueness:''' A concept like "syndrome" is often vague, such as with chronic fatigue syndrome, where symptoms are general and markers are unclear, leading to varied interpretations by different physicians<ref>Porporatti, A. L., et al. (2017). Pain from Dental Implant Placement, Inflammatory Pulpitis Pain, and Neuropathic Pain Present Different Somatosensory Profiles. Journal of Oral & Facial Pain and Headache, 31(3), 229-236.</ref>.

'''Clinical Implications:''' Ambiguity and vagueness can negatively affect adherence to clinical guidelines, causing diagnostic errors and inconsistent treatments. For example, "conservative management" can be interpreted differently by doctors, leading to discrepancies in patient care<ref>Codish, S., & Shiffman, R. N. (2005). A model of ambiguity and vagueness in clinical practice guideline recommendations. AMIA Annual Symposium Proceedings, 2005, 146-150.</ref>.</blockquote>Examples:

'''Ambiguity:''' "Orofacial pain" could mean a temporomandibular disorder (TMD) to a dentist, but neuropathic pain to a neurologist, leading to different diagnoses and treatments<ref>Sadegh-Zadeh, K. (2012). Handbook of Analytic Philosophy of Medicine. Springer.</ref>.

'''Vagueness:''' The term "disease" varies depending on the context, such as hypertension being classified as a disease with organ damage, but seen as a manageable risk factor without complications<ref>Jääskeläinen, S. K. (2019). Differential Diagnosis of Chronic Neuropathic Orofacial Pain: Role of Clinical Neurophysiology. Journal of Clinical Neurophysiology, 36(6), 467-473.</ref>.

This leads to inefficiencies in decoding the "machine message" transmitted by the system, as in the case of Mary Poppins' orofacial pain. Next, we delve into the concept of "encrypted machine language" in the subsequent chapters.

===Encryption===
Imagine a brain sending a message in machine language (wave trains, ion field packets), and that this carries a message like "Ephaptic," which must be decrypted to translate into verbal language. Both the patient, with epistemic vagueness, and the doctor, constrained by their field of expertise, contribute to the distortion of the machine's original message.

Often, the system's message remains encrypted until symptoms become severe enough for a diagnosis to be made.

{{q2|Why is the patient's key the REAL one?|Answer: Consider the Gate Control phenomenon.}}
However, this concept brings our attention to an extraordinarily explanatory phenomenon called Gate Control. When a child is hit on the leg while playing soccer, in addition to crying, the first action they take is to rub the painful area extensively, to alleviate the pain. The child acts unconsciously, stimulating tactile receptors and closing the "gate" to the nociceptive entry of C fibers, thus reducing the pain; this phenomenon was discovered only in 1965 by Ronald Melzack and Patrick Wall.<ref>{{cita libro 
 | autore = Melzack R
 | titolo =  The McGill Pain Questionnaire: major properties and scoring methods 
 | url = https://pubmed.ncbi.nlm.nih.gov/1235985/
 | volume = 
 | opera = Pain
 | anno = 1975
 | editore = 
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 | DOI =  10.1016/0304-3959(75)90044-5 
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 | PMID = 1235985
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 }}</ref><ref>{{cita libro 
 | autore = Melzack R
 | titolo =  Phantom limbs and the concept of a neuromatrix 
 | url = https://pubmed.ncbi.nlm.nih.gov/1691874/
 | volume = 
 | opera = Trends Neurosci
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 | DOI = 10.1016/0166-2236(90)90179-e 
 | oaf = <!-- qualsiasi valore -->
 | PMID = 1691874
 | LCCN = 
 | OCLC = 
 }}</ref><ref>{{cita libro 
 | autore = Melzack R
 | titolo =  From the gate to the neuromatrix 
 | url = https://pubmed.ncbi.nlm.nih.gov/10491980/
 | volume = 
 | opera = Pain
 | anno = 1999
 | editore = 
 | città = 
 | ISBN = 
 | DOI = 10.1016/s0304-3959(99)00145-1 
 | oaf = <!-- qualsiasi valore -->
 | PMID = 
 | LCCN = 
 | OCLC = 
 }}</ref><ref>{{cita libro 
 | autore = Melzack R
 | autore2 = Wall PD
 | titolo = On the nature of cutaneous sensory mechanisms 
 | url = https://pubmed.ncbi.nlm.nih.gov/14472486/
 | volume = 
 | opera = Brain
 | anno = 1962
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 | DOI = 10.1093/brain/85.2.331 
 | oaf = <!-- qualsiasi valore -->
 | PMID = 14472486
 | LCCN = 
 | OCLC = 
 }}</ref><ref>{{cita libro 
 | autore = Melzack R
 | autore2 = Wall PD
 | titolo = Pain mechanisms: a new theory
 | url = https://pubmed.ncbi.nlm.nih.gov/5320816/
 | volume = 
 | opera = Science
 | anno = 1965
 | editore = 
 | città = 
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 | DOI = 10.1126/science.150.3699.971 
 | oaf = <!-- qualsiasi valore -->
 | PMID = 5320816
 | LCCN = 
 | OCLC = 
 }}</ref>.

In the case of encrypted language, much like in computers, the brain also encrypts and decrypts information. For example, researchers have explored how synaptic memory might be digitally stored in the brain.<ref>{{Cita libro | autore = Petersen C | autore2 = Malenka RC | titolo = All-or-none potentiation at CA3-CA1 synapses | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC22559/pdf/pq004732.pdf | anno = 1998 }}</ref>