Reflections on outcome analyses: Introducing the concept of near misses


  • Marc R de Leval International Congenital Cardiac Centre, Harley Street, London, UK


[first paragraph of article]

Medical audit is a form of acquisition of new knowledge related to outcomes of medical treatments.

Philosophers and scientists remain divided with regard to the acquisition of new knowledge. Some maintain that the basic purpose of a scientific theory is to predict the outcomes of an experiment. This view is called ‘instrumentalism’ as it implies a theory is no more than an instrument for making predictions. Positivism, which was the prevailing theory of scientific knowledge in the 1930s and remains present in the views of many philosophers, is an extreme form of instrumentalism, it holds that all statements other than describing or predicting observations, are not only superfluous but meaningless. The basic purpose of a scientific theory is not to explain anything but to predict the outcomes of experiments.