Hypothesis Testing (Hypothesis A vs B)
Definition
Most cases have a list of differentials but how to organise & prioritise? Use the framework – Hypothesis A (leading diagnosis) vs Hypothesis B (alternative diagnosis).
How to Apply
- Hypothesis A – single most likely diagnosis in the clinical context on the balance of probability
- Hypothesis B – 1-2 alternative diagnoses which are less likely but still to be considered
Not only is hypothesis testing effective for thinking but also for handover (I use this framework for my clinical documentation). It also forces you to shorten your differential list to 2-3 diagnoses max!
For example – for chest pain – hypothesis A could be pneumonia with hypothesis B being PE. With practice, your hypothesis testing will encompass much more complex clinical cases (which we will cover in the clinical cases section).
The Acute Mind 