Navigation Links
Hickam's dictum


Hickam's dictum is a counterargument to the use of Occam's razor in the medical profession.[1] The principle is commonly stated: "Patients can have as many diseases as they damn well please". The principle is attributed to John Hickam, MD.[2]

When discussing Occam's razor in contemporary medicine, doctors and philosophers of medicine speak of diagnostic parsimony. 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. However, this principle has very important limits in medical practice. 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. The principle of Occam's razor, or parsimony, does not demand that the diagnostician necessarily opt for the simplest explanation, but instead guides the medical practitioner to seek explanations, without unnecessary additional assumptions, which are capable of accounting for all relevant evidence.

A key reason for using Hickam's dictum as a limiting principle to that of Occam's razor is, it is often statistically more likely that a patient has several common diseases, rather than having a single rarer disease which explains the myriad of their symptoms. Another key reason is that, independently of statistical likelihood, some patients do in fact turn out to have multiple diseases. In such cases multiple categories of diagnosis may indeed have independent causes rather than a single source, i.e. may be due to separate events or combinations of events to which the patient may have been subjected or exposed. Thus Hickam's dictum provides physicians with a counterbalancing principle to the unfettered use of Occam's razor in diagnosis.

An example of the utility of Hickam's dictum is Saint's Triad of hiatus hernia, gallbladder disease and diverticulosis. C. F. M. Saint was a South African surgeon. His triad has no known pathophysiologcal relationship nullifying the usefulness of Occam's razor.[3] Hickam's dictum is similar in principle to Willian of Chatham's anti razor.

Notes

  1. ^ See, e.g., "Hickam's Dictum versus Occam's Razor: A Case for Occam." W. Bradley Fields, MD, University of Michigan Health System, Ann Arbor, MI (2005) ([1] )
  2. ^ Hickam was a faculty member at Duke University in the 1950's, and was later chairman of medicine at Indiana University.([2] )
  3. ^ Hilliard A. A., Weinberger S. E., Tierney L. M. Jr., Midthun D. E., and Saint S. (2004): Occam's Razor versus Saint's Triad., N Engl J Med 350:599-603

'"/>


(Date:3/30/2015)... Daily sun exposure, stressors and environmental factors all ... and other giveaways of age. However, advances in surgical ... hit the pause button, delaying the impact of the ... hack to rejuvenate any facial feature. , The ... (AAFPRS) explores the intricacies of The Aging Face with ...
(Date:3/30/2015)... United States (PRWEB) March 30, 2015 Poo ... there anything that could be better than Paleo, or better ... checking out Poo - just released on the app store! ... and step counting, there is a whole other half to ... , With Poo, users do the dirty work, and ...
(Date:3/30/2015)... Mo. (PRWEB) March 30, 2015 ... a mobile library of medications used in behavioral ... for iPhone, iPad and Android—is a convenient, electronic ... annually since 1999. The useful resource provides up-to-date ... purpose, dosage and frequency, side effects, emergency conditions, ...
(Date:3/30/2015)... CA (PRWEB) March 30, 2015 Cutting-edge ... for Health 2015 Conference because of the opportunities to ... This year’s conference will highlight parents of recovered children, ... parent, Mary Romaniec, will debut her book Victory over ... Whole Family. Free copies of Victory over Autism will ...
(Date:3/30/2015)... (PRWEB) March 30, 2015 ... recognized designer and manufacturer of ergonomic seating ... upholstery options. The new upholsteries bolster the ... and custom seating, providing disinfectable, green choices. ... by renowned textile purveyor CF Stinson. Six ...
Breaking Medicine News(10 mins):Health News:New AAFPRS Infographic Addresses Concerns and Provides Aging Face Solutions 2Health News:Popular Publication on Behavioral Health Medications Now An App 2Health News:AutismOne and Focus for Health Highlight Victory over Autism at Major Chicago Conference Following Autism Awareness Month 2Health News:AutismOne and Focus for Health Highlight Victory over Autism at Major Chicago Conference Following Autism Awareness Month 3Health News:BioFit Adds Bleachable Upholstery Options to Seating Line 2
... , LOS ANGELES , Feb. 3 ... style and attitude with The Apprentice business savvy has finally arrived!   ... competition show has been reached... "The Complete Package," as created by ... , the health, fitness and lifestyle company best recognized for its exclusively ...
... ... rising popularity of television shows dealing with criminal justice, whether law enforcement ... to study and work in this ever-changing and expanding industry. Because ... there are numerous and interesting career paths to follow. Making the ...
... ... compartmentalization, liberal arts and humanities degrees are sometimes overlooked and undervalued as ... more classical education, a liberal arts or humanities degree can be the ... general arts and the humanities. A liberal arts education opens the ...
... FREEHOLD, N.J. , Feb. 2 Speedus Corp. (Nasdaq: ... it received notice from Nasdaq, in the form of a staff determination ... the extension granted to the Company on December 11, 2009 ... (the "Rule"), which requires the Company to maintain either (1) a minimum ...
... , , , , , ... Ltd. ( SVA),("Sinovac" or the "Company"), a leading China ... share offering was,closed on February 2, 2010 . Sinovac ... underwriting discounts and commissions and,estimated offering expenses payable by the ...
... cancer may increase a man,s risk of suicide or ... new study published online February 2 in the ... study the risks men diagnosed with prostate cancer in ... Channing Laboratory, Department of Medicine, Brigham and Women,s Hospital, ...
Cached Medicine News:Health News:'THE COMPLETE PACKAGE' NEW REALITY SHOW SETS STAGE AND NEW STANDARD 2Health News:'THE COMPLETE PACKAGE' NEW REALITY SHOW SETS STAGE AND NEW STANDARD 3Health News:'THE COMPLETE PACKAGE' NEW REALITY SHOW SETS STAGE AND NEW STANDARD 4Health News:OnlineEducation.com Announces the Addition of Fully Accredited Law and Criminal Justice Degree Programs to its Current Website Offerings 2Health News:OnlineEducation.com Announces the Addition of Fully Accredited Law and Criminal Justice Degree Programs to its Current Website Offerings 3Health News:OnlineEducation.com Announces the Addition of Fully Accredited Law and Criminal Justice Degree Programs to its Current Website Offerings 4Health News:OnlineEducation.com Announces Expansion of Liberal Arts & Humanities to its Accredited Online Degree Programs 2Health News:OnlineEducation.com Announces Expansion of Liberal Arts & Humanities to its Accredited Online Degree Programs 3Health News:OnlineEducation.com Announces Expansion of Liberal Arts & Humanities to its Accredited Online Degree Programs 4Health News:Speedus Receives and Appeals Nasdaq Notice 2Health News:Sinovac Announces Closing of Common Share Offering 2Health News:Sinovac Announces Closing of Common Share Offering 3Health News:Immediate risk of suicide and cardiovascular death after a prostate cancer diagnosis 2
Other medicine definitionOther Tags