Occam’s razor and Hickam’s dictum: a dermatologic perspective
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Hadassah Stein
and
Eve J. Lowenstein
Abstract
Diagnostic heuristics help ease the cognitive load in our day-to-day work. Occam’s razor or the rule of diagnostic parsimony is a diagnostic heuristic often applied in dermatology. Occam’s razor dictates that all things being equal, one diagnosis (as opposed to several diagnoses) should be sought to explain a patient’s presentation. While this can often be helpful, it can also obscure the full picture. Hickam’s dictum is an aphorism expressing the opposite opinion: “patients can have as many diseases as they damn (or darn) well please.” This acknowledges that multiple simultaneous processes can be at play. This article delves into the implications of use of these approaches and offers tips through cases illustrating the limitations of Occam’s razor and when Hickam’s Dictum should be invoked.
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Research funding: The authors received no funding for this work.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorials
- An equation for excellence in clinical reasoning
- Quantifying diagnostic excellence
- Review
- A scoping review of distributed cognition in acute care clinical decision-making
- Opinion Papers
- Context matters: toward a multilevel perspective on context in clinical reasoning and error
- Occam’s razor and Hickam’s dictum: a dermatologic perspective
- Original Articles
- Differences in clinical reasoning between female and male medical students
- Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
- Bad things can happen: are medical students aware of patient centered care and safety?
- Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
- Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
- Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
- Collective intelligence improves probabilistic diagnostic assessments
- Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
- Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
- Clinician factors associated with delayed diagnosis of appendicitis
- Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
- Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
- Letters to the Editor
- Uncontrolled confounding in COVID-19 epidemiology
- VAPES: a new mnemonic for considering paroxysmal disorders
- Congress Abstracts
- SIDM2022 15th Annual International Conference
