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Colegio de Medicina Interna de México.

2024, Number 9

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Med Int Mex 2024; 40 (9)

The dilemma in diagnostic reasoning: Ockham’s razor or Hickam’s opinion

Arriaga IDY

Language: Spanish
References: 11
Page: 603-605
PDF size: 284.98 Kb.


ABSTRACT

The influence of the principle of parsimony (Ockham’s razor) in diagnostic reasoning started from the foundation of modern medical education by Sir William Osler and, until today, it is the most widely used heuristic method in the clinical practice. In this context, the principle proposes that the minimum number of causes that explains all the symptoms and not multiple individual diagnoses should be sought. However, it has been the object of multiple criticisms for its absolute authority in clinical judgment; the main one is Hickam’s dictum that establishes “a patient can have as many diseases as he wants”, emphasizing that more than one disease can be responsible for the signs and symptoms. This paper offers a historical and critical perspective of the dilemma in diagnostic thought that allows it to be used as a tool for reflection in medical action.


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