Hickam's Dictum

Hickam's dictum is a counterargument to using Occam's razor in the practice of medicine.

Hickam's Dictum Essential facts:
  • "Patients can have as many diseases as they well please".
  • The principle is attributed to John Hickam, MD. (faculty member at Duke University in the 1950s).
  • The actual process undertaken when diagnosing a patient is a continuous generation of hypothesis and then testing of that hypothesis, followed by then modifying the hypothesis, and so on.
  • The principle of Hickam's dictum considers that a particular diagnosis should not be excluded solely because it doesn't appear to fit the principle of Occam's razor.
  • It is frequently statistically more likely that a patient has several common diseases, rather than a single rarer unifying disease.
  • Thus Hickam's dictum is useful in providing physicians with a counterbalancing principle to the uncritical use of Occam's razor in diagnosis.
Saint's triad (example in clinical practice):
  • Saint's triad is the common combination of hiatus hernia, gallbladder disease, and diverticulosis (ascribed to C. F. M. Saint, British surgeon).
  • The triad components have no known pathophysiological interrelationship - and thus the triad is counter to the usefulness Occam's razor.

Posted by ALCHEssMIST.
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