MedGaugeCapabilities / D · Medical practice
D.18 Diagnostic reasoning and differential Proposed
Given case material, the agent fills a structured assessment form listing differential diagnoses, each with a status (excluded, to be excluded, considered) and supporting evidence, and gives the order of tests needed to distinguish them. Graded by checkpoints on each listed diagnosis, status and test order; logging of missing information is scored under X.5, not here.
Proposed. This capability is under RFC and does not yet carry levels.
Evidence: planned. Only planned benchmark cards list this capability so far; no frozen benchmark version exists for it.
- Domain
- D · Medical practice
- Evidence form
- checkpoint
- Veto constraints
- —
- Depends on
- A.1 Medical semantic understandingA.4 Multi-source cross-analysisA.5 Temporal and knowability reasoning
- Required by
- D.19
- Internal task families
- —
- External anchors
- MedQA, PhysicianBench
- Version
- 0.1.0 · 0.1.0
Definition in detail
Safe diagnosis means keeping dangerous alternatives open until they are excluded, and ordering tests to separate them. An explicit differential with status and evidence makes that reasoning checkable.
Inputs a task gives
- Case material such as history, examination and initial results
- The list of tests available in the setting
- The status vocabulary for the assessment form
Artifact required
An assessment form: differentials[] (diagnosis, status as excluded, to be excluded or considered, supporting evidence and refuting evidence as verbatim excerpts) and test_order[] (test, the diagnoses it distinguishes).
How it is graded
Checkpoints cover each reference diagnosis (present or not), its status and the relative order of required tests; where a task cites grading references, there is one checkpoint per reference. Logging of missing information is scored under X.5, not here.
In scope
- Listing relevant differential diagnoses, including dangerous ones
- Assigning a status supported by evidence
- Ordering tests that distinguish the candidates
Out of scope
- Logging missing information - graded under X.5
- Urgency and disposition - graded under D.17
- Choosing and appraising treatment - graded under D.19
Typical failures
Expected failure patterns; not measured rates.
- Marking a dangerous diagnosis excluded without the evidence that excludes it
- Listing many diagnoses without status, which does not satisfy the form
- Ordering a confirmatory test before the test that rules out the dangerous alternative
Standards: std-aha-acc-2021-chest-pain · std-wses-2020-appendicitis
Benchmarks
- Paired Population Cases Planned
Grading references
No grading reference is mapped to this capability.