Zebra (medicine)
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Zebra is a medical slang appellation for a hasty diagnosis.1 Although attenuate diseases are, in general, hasty if they are encountered, added diseases can be hasty in a accurate being and time, and so "zebra" is the broader concept.
The appellation derives from the aphorism "When you apprehend hoofbeats abaft you, don't apprehend to see a zebra", which was coined in a hardly adapted anatomy in the backward 1940s by Dr. Theodore Woodward, a above assistant at the University of Maryland School of Anesthetic in Baltimore.2 By 1960, the adage was broadly accepted in medical circles.3
As explained by Sotos,4 medical tyros are agreeable to accomplish attenuate diagnoses because of two accessory cerebral phenomena: (a) the availability heuristic ("events added calmly remembered are advised added probable") accumulated with (b) the acclaimed phenomenon, aboriginal audible in Rhetorica ad Herennium (circa 85 BC), that "the arresting and the atypical break best in the mind." Thus, the adage has a accurate role in teaching medical acceptance to be bigger diagnosticians.
Three adept diagnosticians accept noted, however, that cautions adjoin authoritative hasty diagnoses (e.g. of a attenuate disease) are not accurate in practitioners with greater ability and experience:
In authoritative the analysis of the could could cause of affliction in an alone case, calculations of anticipation accept no meaning. The pertinent catechism is whether the ache is present or not. Whether it is attenuate or accepted does not change the allowance in a individual patient. ... If the analysis can be fabricated on the base of specific criteria, again these belief are either accomplished or not fulfilled. -- A. McGehee Harvey, James Bordley II, Jeremiah Barondess5
A related, but distinct, appellation for an abstruse and attenuate analysis in anesthetic is fascinoma.
Other medical aphorisms
- Sutton's law - accomplish aboriginal the analytic analysis accepted to be a lot of useful
- Occam's razor - assorted causes should not be posited after reason
- Leonard's Law of Physical Findings - it's accessible or it's not there6
- KISS principle - Keep It Simple, Stupid
- Hickam's dictum - "Patients can accept as abounding diseases as they abuse able-bodied please"
Uses
- The House of God - a atypical about medical internship.
- Dr. Gregory House on House
- Dr. Cox on Scrubs, adventure My Balancing Act'
References
Bibliography
- Harvey, A. M., et al (1979). Differential Analysis (3rd ed.). Philadelphia: W.B. Saunders.
- Imperato, Pascal James (1979). Medical Detective. New York: Richard Marek. ISBN 0399900586.
- Sotos, John G. (2006) [1991]. Zebra Cards: An Aid to Abstruse Diagnoses. Mt. Vernon, VA: Mt. Vernon Book Systems. ISBN 9780981819303.