Dissertation Research: Managing Diagnostic Uncertainty: An Examination of the Interplay of Technology, Medical Knowledge, and Law in Diagnostic Practice. The Case of Epilepsy.

论文研究：管理诊断不确定性：诊断实践中技术、医学知识和法律相互作用的检验。

• 批准号: 0350015
• 负责人: Vincanne Adams
• 金额: $ 0.79万
• 依托单位: University of California-San Francisco
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2006-01-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=0350015&HistoricalAwards=false
• 关键词: Dissertation; Research; Managing; Diagnostic; Uncertainty

This is a Science and Technology Studies dissertation improvement grant. The project is a comparative, ethnographic analysis of doctors' strategies for managing competing medical and legal demands faced in diagnosis of epilepsy in contemporary American medicine. Funds from this grant will support travel to several conferences. Funds will also support equipment purchases. The researcher will examine the interplay of technology, medical knowledge, and diagnostic practice, within a medical context of high uncertainty, where doctors are not only diagnosticians, but also key players in the legal regulation of driving for people with epilepsy. Ultimately, the researcher will explore implications of diagnostic practice for patients. People diagnosed with various seizure disorders have created support and advocacy groups, which are key sites where they share medical and legal knowledge, react to their experience of diagnosis, and work to challenge legal regulation. This research takes these social groups as an important site for the generation of alternate medical knowledge about epilepsy in cases where doctor's knowledge is sometimes taken as insufficient by patients (as well as doctors themselves). The research activities will be conducted over 16 months, and will include ethnography of: 1.) a comprehensive epilepsy clinic, 2.) a patient support group (Northern California Branch of the Epilepsy Foundation of America), and 3.) several branches of the Northern California DMV Committee that makes decisions to revoke patient's driver's licenses, as well as participant-observation at a number of key scientific and medical meetings. This study will attempt to delineate when and how uncertainty becomes problematic, when and how controversy is closed and when and how it is left open. By detailing how diagnoses are produced, this study may be used by patients to inform themselves about the diagnostic process and may contribute to improved doctor-patient communication.

这是一项科学技术研究论文改进补助金。 该项目是对医生管理当代美国医学癫痫诊断中面临的竞争性医疗和法律要求的策略进行比较、人种学分析。这笔赠款的资金将用于支持参加多个会议的旅费。 资金还将支持设备采购。 研究人员将在高度不确定的医疗背景下研究技术、医学知识和诊断实践的相互作用，其中医生不仅是诊断专家，而且还是癫痫患者驾驶法律监管的关键参与者。 最终，研究人员将探讨诊断实践对患者的影响。被诊断患有各种癫痫症的人们创建了支持和倡导团体，这些团体是他们分享医学和法律知识、对诊断经验做出反应并努力挑战法律法规的关键场所。这项研究将这些社会群体作为产生癫痫替代医学知识的重要场所，以防患者（以及医生本身）有时认为医生的知识不足。研究活动将持续 16 个月，包括以下方面的人种学研究：1.) 综合性癫痫诊所，2.) 患者支持小组（美国癫痫基金会北加州分会），以及 3.) 北加州 DMV 委员会的几个分支机构，该委员会负责做出吊销患者驾驶执照的决定，并在一些重要的科学和医学会议上进行参与者观察。这项研究将试图描述不确定性何时以及如何成为问题，何时以及如何结束争议，以及何时以及如何保留争议。通过详细说明诊断是如何产生的，患者可以利用这项研究来了解诊断过程，并可能有助于改善医患沟通。