Talk:Hickam's dictum

The new WP:Instant_delete policy at work
Create an article, three-and-a-half minutes later some editor googles it and decides not notable? Is this the WP:Google_standard or just on a mission to clean up Wikipedia by scoping out newly created articles?? As it happens the principle is a modern development in medicine that is taken as a counterbalance to the principle of Occam's razor and reflects the opposing side of a tension in medical practice about the use of Occam' razor in diagnosis. If you want to delete it, by all means put it up for deletion officially. In the meantime, lacking a justification other than non-notability according to WP:Google_standard, I will remove the template..Kenosis 05:36, 24 May 2006 (UTC)
 * Unless you can provide another source that proves this is notable. Google is a good standard for measuring notability of modern things.  If you find next to no information about it on google, with a tiny amount of hits, then there is a good chance its not notable.  Non-notability IS a reason for deletion. You might consider simply adding the information to Occam's Razor until such a time that this becomes notable. --Crossmr 06:02, 24 May 2006 (UTC)


 * Re: "Unless you can provide another source that proves this is notable.": Unless another source proves??? I would imagine that this "proof" requested here should be defined in a way that does not limit itself to associating solely with the kind of junk we all can find on the web that is infinitely googleable.  I would also imagine that "proof" should be seen as proof to more than the satisfaction of just one editor who happens to be passing through and apparently has no interest in the subject of this article.
 * Thats correct. As much as we'd all love to take someone's word that something is a notable topic there needs to be a credible source proving something's notability. Otherwise I could make articles all day and claim that they are indeed notable and should be left. --Crossmr 15:30, 24 May 2006 (UTC)


 * Re: "Google is a good standard." What kind of arbitrary standard is this?  Wikipedia has a wide range of options available by consnsus!!  The level of web-popularity of a concept is not, or if it is should immediately cease to be, a sole criterion.  I already explained well enough just above why this is an important enough topic to reasonably merit an expansion of the concept in its own article.  Meanwhile, something in the range of half the million-plus articles on Wikipedia are personal spam or one sentence long or about someone's 50-bed summer camp or or small-business spam or made-up concepts that are googleable only because they started on Wikipedia.  There they all sit, languishing for the scrutiny of WP:Instant_delete requests...Kenosis 14:22, 24 May 2006 (UTC)
 * Then put them up for deletion. Using every article has to stand on its own merit. You can't say that article over there is crap so this should get to stay. --Crossmr 15:30, 24 May 2006 (UTC)


 * This topic is notable not because of its level of popularity on the web, but because of its intimate connection as a polarity to a topic of central importance in diagnostic medicine. ...Kenosis 14:22, 24 May 2006 (UTC) And, I apologize for getting angry... Kenosis 14:32, 24 May 2006 (UTC)


 * So can we get rid of the up for deletion sign or what? there are links to reputable journals refering to Hickam's dictum and that should be more than enough than is needed for a wiki entry. It needs its own entry to fully define the dictum as well as give references and a history of etc.etc. In fact lets take down that sign right now ;-) Gergprotect 19:53, 26 May 2006 (UTC)


 * Also, I quite like the way I wrote it in the first instance ;-):
 * == Iccam's Dictum ==
 * In the world of daignostic medicine Occam's razor is frequently applied; if a single disease can explain several sympotms then it is the most likly cause of them. However, the use of Occam's Razor is often frowned upon by more hardened, experienced and world weary diagnosticians, who riposte with the use of the rather more colourful "Iccam's Dictum": "Patient's can have as many bloody diseases as they like!" The concept being that while it is more likely that a particularly disease can account for a given patients symptoms, it is also possible that the e.g. three symptoms are the result of e.g. three independant, co-existing ailments (multiple disease burden is especially common in the elderly). The colour used by the hardened, experienced and world weary diagnosticians when teaching their naive juniors of Iccam's Dictum is there because when they were naive juniors, they thought they could cleverly explain multiple symptoms with a fancy rare diagnosis that made them look very clever, but in fact they kept getting caught out by the little old lady who had a pneumonia, heart failure, renal failure and COPD and not a rare form of fibrosing alveolitis that they were sure of. Which made them the hardened, experienced, world weary bastards that they all are.


 * Ignoring the whole "hickam's Dictum" thing. Gergprotect 19:49, 26 May 2006 (UTC) Oh, and why is it that you can't find this page when you search for it?

It seems to me that the logic of Hickam's Dictum is seriously flawed. An explanation for a certain set of symptoms in a patient has to include how that patient got infected. If the patient is a virgin, STDs are not an option, due to the complexity in which one has to formulate a theory of infection. Occam's Razor works perfectly if you take the entire situation into consideration. It seems silly to me to first totally misuse the principle of parsimony and then attack ones own misuse. boxed 14:29 CET, 2006-05-31
 * It does seem unfortunate. But there are multiple parties involved in the debate.  Some physicians have taken Occam's razor to an extreme.  An example is "Osler's Rule" named after William Osler, which is paraphrased "one disease to a patient".  The opposite polarity in the discussion is Hickam's dictum.  Agreed that proper use of Occam's razor, cautiously shaving away unnecessary assumptions (not blanket removal of inconvenient hypotheses) would render both of these extreme viewpoints unnecessary.  But physicians are human, and of varying degrees of sharpness about the process of diagnosis, thus the awareness of the extreme positions has become part of the polemics of the theoretical discussion of diagnostic methodology.  C'est la vie. I would speculate that it would be extremely rare to happen across a physician today who believes solely in one extreme or the other. ... Kenosis 05:20, 1 June 2006 (UTC)
 * boxed - you hit the point bang on the nail: "if you take the entire situation into consideration", this is, almost by definition, never the case in medical practice. This is why applying occams razor is so dangerous, it is truly a rare event that you have sufficient information to allow to say "this is the best explanation". It is a very common event, however for doctors to think that they have enough information. Which is the whole point of hickams dictum; to prevent the simple minded application of tool which could lead you to exclude the very disease that a patient has. You have to remember that most doctors are entirely simple people :-) Gergprotect 00:14, 30 August 2006 (UTC)


 * Thankfully, the move to delete was voted down. Consider this for diagnosing a patient. A 51 year old woman presents with the following history: hyperlipidemia, mildly obese, visual changes over a short time frame, bilateral trigger finger on all digits, moderate Reynaud’s phenomenon, heel spur, lumbar disc disease, osteoporosis and GERD of sufficient severity that stomach secretions caused facial burns. Occam is failing miserably, due to the constellation of symptoms. A hint that assisted Occam is, diabetes is more likely with trigger finger, changes in vision, heel spur and hyperlipidemia, however fails to account for the other issues. In this instance, the patient was discovered to be diabetic. Her visual difficulties resolved, as her glucose control was reestablished and the trigger finger issues are resolving slowly. Raynaud's phenomenon remains, but she is also positive for rheumatoid factors, which is unrelated to diabetes or lipid counts. GERD, again, is unrelated, as is the osteoporosis and lumbar disc disease. If it looks like a duck and swims like a duck, it could still be a misidentified gosling.24.127.137.154 (talk) 21:46, 1 February 2012 (UTC)

Just an Idea
Could we maybe have a short mention of the tv series House (played by Hugh Laurie)? I think it's somewhat relevent.