Differential diagnosis and BMJ Best Practice

Issue: BCMJ, vol. 59, No. 2, March 2017, Page 132 College Library

“When you hear hoofbeats, think of horses, not zebras.”

“When you hear hoofbeats, think of horses, not zebras.” This well-worn medical aphorism attributed to Dr Theodore E. Woodward addresses the clinician’s most essential skill—differential diagnosis. Drawing on all of a physician’s training, experience, and abilities—careful observation, interview skills, and evaluation of evidence—differential diagnosis is key to providing the best care to patients.

A busy clinician may find some welcome relief through the evidence-based decision support provided by Best Practice. The tool is available online through the College Library website (www.cpsbc.ca/library) or as an app for your tablet or smartphone.

Best Practice’s easy-to-read tabbed layout provides an overview of each disease module and allows the clinician to quickly select a subtopic of interest. Once in the module, select the Diagnosis tab and then the Differential Diagnosis link. The table is organized into common/uncommon diagnoses, and, within each category, from most to least frequently occurring conditions. The clear, well-organized layout allows physicians to view possible diagnoses at a glance and quickly prioritize the selection of any tests or treatments.

While nothing can replace the combination of a clinician’s experience and training, the differential diagnosis table in Best Practice can provide evidence-based support in a busy medical practice. For more information or assistance with downloading the app, please contact the College Library. We’re always happy to help!
—Paula Osachoff


This article is the opinion of the Library of the College of Physicians and Surgeons of BC and has not been peer reviewed by the BCMJ Editorial Board.

Paula Osachoff. Differential diagnosis and BMJ Best Practice. BCMJ, Vol. 59, No. 2, March, 2017, Page(s) 132 - College Library.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply