Generate differential diagnosis list
AI analyzes symptoms and creates ranked differential diagnosis list with supporting reasoning for each diagnosis.
Generate differential diagnosis list
River's Differential Diagnosis Generator creates organized, ranked differential diagnosis lists from patient symptoms and findings. You provide chief complaint, key symptoms, exam findings, and relevant history, and the AI generates comprehensive DDx list with most likely diagnoses ranked first and supporting/opposing reasoning for each. The list includes common diagnoses you can't miss, typical presentations, and less common but important considerations. Perfect for medical students learning diagnostic reasoning, residents managing complex cases, or any clinician wanting systematic differential diagnosis lists.
Unlike unorganized or incomplete differential lists, this tool structures diagnostic thinking systematically. Good differential diagnosis considers multiple possibilities, ranks them by likelihood, identifies must-not-miss diagnoses, and evolves as new information emerges. The AI helps you think through diagnostic possibilities comprehensively, avoid premature closure, and document your clinical reasoning. When differentials are thorough and ranked, they improve diagnostic accuracy and support sound medical decision-making.
This tool is perfect for medical students developing diagnostic reasoning skills, residents working through complex presentations, attending physicians teaching differential diagnosis, or any clinician wanting to think through diagnostic possibilities systematically. If you find yourself fixating on single diagnosis or missing important considerations, this helps generate comprehensive differentials. Use it for challenging cases, educational purposes, or documenting your clinical reasoning process.
Building Strong Differentials
Strong differential diagnosis starts with systematic symptom analysis. List key features of presentation: main symptom, associated symptoms, timing, context, risk factors, and relevant negatives. Then generate possible diagnoses that could explain this constellation of findings. Think broadly initially, then narrow based on likelihood. Consider common diagnoses first (when you hear hoofbeats, think horses not zebras), but don't forget serious diagnoses you can't afford to miss (life-threatening or time-sensitive conditions). For chest pain, acute MI must be on differential even if likelihood seems low.
Rank your differential by probability. List most likely diagnosis first, followed by other reasonable possibilities in descending order of likelihood. For each diagnosis, note supporting features (what fits) and opposing features (what doesn't fit). Example: 'Pneumonia: supports = fever, cough, abnormal lung sounds; opposes = no infiltrate on CXR, symptoms only 1 day.' This structured thinking helps you evaluate each possibility fairly and identify which diagnosis best explains all findings. It also helps you know what additional testing you need to confirm or exclude diagnoses.
Good differentials are dynamic. As you gather more information (additional history, exam findings, test results), your differential should evolve. Diagnoses move up or down the list. Some drop off entirely. New possibilities emerge. Document your differential at key decision points. This shows your thinking process, educates learners, and protects you legally by demonstrating you considered multiple possibilities. Avoid premature closure (latching onto first diagnosis that comes to mind). Keep differential broad initially, narrow it thoughtfully with evidence, and always ask 'what else could this be?'
What You Get
Ranked differential diagnosis list
Most likely diagnoses listed first
Supporting and opposing features for each diagnosis
Must-not-miss diagnoses highlighted
Organized clinical reasoning
Ready to paste or use for documentation
How It Works
- 1Provide clinical informationShare chief complaint, symptoms, and key findings
- 2AI generates differentialCreates ranked DDx list with reasoning in 2-3 minutes
- 3Review and refineConsider diagnoses, add others you think of
- 4Use for decision-makingGuide your workup and diagnostic plan
Frequently Asked Questions
How many diagnoses should be on differential?
Typically 3-6 diagnoses for most presentations. Include most likely possibilities and must-not-miss diagnoses even if less likely. Very broad differentials (15+ diagnoses) become unwieldy and don't help prioritize. Very narrow differentials (1-2 diagnoses) risk premature closure. Find balance between comprehensive thinking and practical focus. As you narrow down with testing, differential naturally becomes shorter.
How do I rank diagnoses by likelihood?
Consider epidemiology (what's common?), patient risk factors, how well the diagnosis explains all findings, and clinical experience. Common diagnoses should rank high unless features strongly suggest otherwise. Compare each possible diagnosis to the full clinical picture. Which explains the most findings with fewest assumptions? That's likely top of differential. Use clinical prediction rules and decision support tools when available. Trust clinical judgment developed through experience.
What are must-not-miss diagnoses?
Life-threatening or time-sensitive conditions that require immediate consideration even if probability is lower. For chest pain: acute MI, aortic dissection, pulmonary embolism, tension pneumothorax. For headache: subarachnoid hemorrhage, meningitis, increased ICP. For abdominal pain: ruptured AAA, ectopic pregnancy, perforated viscus. These diagnoses carry high morbidity/mortality if missed and may require urgent intervention. Keep them on radar even when other diagnoses seem more likely.
How does differential diagnosis relate to clinical decision-making?
Your differential guides diagnostic workup. Tests you order should help confirm or exclude diagnoses on differential. If pneumonia is on differential, chest X-ray makes sense. Treatment decisions also stem from differential. If you can't yet narrow to one diagnosis, you might treat empirically for most likely possibilities. Document your differential and reasoning. This shows thoughtful clinical decision-making and helps others understand your thought process if they're taking over care.
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