Occam's Razor and Medical Diagnosis with Mike Benjamin

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Welcome to 2016! For our first event of the year, Mike Benjamin will be leading a discussion around medical diagnosis and the principles of Occam's Razor.

We have several new announcements to make at this event for our 2016 calendar and event format, so don't miss out!

Without further ado, here's Mike!

Event Description

As medical diagnostic tools advance technologically, more and more data is available to physicians to theoretically make more accurate and timely diagnoses. The problem is the increased complexity that comes with greater access to this data.

Historically diagnostic medicine’s most important tool has been the “History of Present Illness (HPI)", the interview with the patient of symptoms. (See below for description.) This interview is still important to decide what tests to do, but even with these tests, there is still the problem of integrating and analyzing all of the information in a logical process and come up with an accurate diagnosis.

This is getting even more complex as we have more tools which provide more data on each patient, making it more difficult for physicians to benefit form the advancing technology. I would even say, based on my own experience, that the diagnostic process becomes more difficult and physicians, overwhelmed with data fallback to oversimplification of the diagnosis and miss important correlations. (Occam’s Razor vs. Hickam’s Dictum)

How do we address these increasing complexities. What technological solutions can we come up with to integrate and order this information to allow physicians to make more accurate and timely diagnoses? (i.e. AI, Data Informatics, etc.)

A Brief History of Present Illness (HPI):

It is also common wisdom in medical education that the most powerful diagnostic information is the patient interview, specifically the History of Present Illness (HPI).

The HPI is the portion of the patient’s story of illness in which the patient tells the symptoms, time frame, relationship of the various symptoms, and his or her interpretation of them. The physician’s task in this portion of the interview is to understand the patient’s story in the context of the nonverbal clues for such things as anxiety, anger, or depression that are also present.

The physician must facilitate a story from a patient experiencing one of these uncomfortable emotions. This cumulative task requires enormous skill, which is not encouraged in much of the curricula of medical school. Many studies in the medical education literature report that medical students become worse at these tasks as medical school progresses.

If the doctor can successfully obtain the story (HPI) in a rational sequence, and put it together appropriately, he or she must then apply a rigorous logic to this information in order to arrive at the correct diagnosis. Without a sense of this logic, problems leading to improper diagnoses can — and often do — attend the HPI.”

Relationship to Occam’s Razor

In medical terms it is often translated into the law of diagnostic parsimony – to try to come up with a ‘unifying’ diagnosis that can explain all the patient’s problems (i.e. to invoke Occam’s Razor)

Diagnostic parsimony advocates that when diagnosing a given injury, ailment, illness, or disease a doctor should strive to look for the fewest possible causes that will account for all the symptoms.

Hickam’s Dictum

The actual process that occurs when diagnosing a patient is a continuous flow of hypothesis and testing of that hypothesis, then modifying the hypothesis, and so on…In the context of this method, the principle of Hickam’s dictum asserts that at no stage should a particular diagnosis be excluded solely because it doesn’t appear to fit the principle of Occam’s razor.

YOUR EXPERT: MICHAEL BENJAMIN

Michael Benjamin is a physicist, founder of The Science Mic (http://www.thesciencemic.com/), and co-organizer of XPRIZE Think Tank NYC. He'll be leading our discussion and providing guidance during brainstorms surrounding medical diagnosis.

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