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Editorials |

Killip and Forrester Classifications : Should They Be Abandoned, Kept, Reevaluated, or Modified?

John E. Madias, MD
Author and Funding Information

Affiliations: Elmhurst, NY 
 ,  Dr. Madias is Chief of Cardiology at Elmhurst Hospital Center, Mount Sinai School of Medicine.

Correspondence to: John E. Madias, MD, Chief of Cardiology, Elmhurst Hospital Center, 79–01 Broadway, Elmhurst, NY 11373



Chest. 2000;117(5):1223-1226. doi:10.1378/chest.117.5.1223
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To question the past is human; to do so is even imperative in the domain of science. Classifications have a certain “life span”: they come and go as their utility is surpassed by increasing scientific insight and experience. New classifications replace the old ones, just declared outmoded. At best, they can be retained in a modified form.

The science of classification was invented by Linnaeus, the Swedish naturalist-physician. His taxonomy has been at the heart of all attempts to bring some order to science in general, and the biological realm in particular, by emphasizing similarities in members of a class, while ignoring their individual attributes. Classification is a prerequisite for language and abstract thought. Scholars maintain that classifying in “pairs of opposites” is inherent to our brain’s basic function. However, implicit to classification is its artificiality and arbitrariness. There is nothing inherent to a body of information that calls for a single and unique way of classification. An infinite number of classifications can be imposed onto a set of data. Thus, it is a corollary of the above that results of various“ outcomes” from the analysis of a given database will be different, depending on the classification system implemented.

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