1. I want to start off by highlighting a movie called “Idiocracy”, one of my favorite comedies, in which the future has become ultra-commercialized and we’ve intellectually devolved into extremely stupid corporate pawns that are not able to solve even the most basic of problems.


2.  In this movie, when someone goes to the doctor they are greeted with a touchscreen full of buttons for the most common of complaints seen in an emergency or primary care setting.


3.  Once you select your complaint you are then probed by something that looks like a medical carwash and after, given a diagnosis by your “doctor”. Well ladies and gentlemen, the future is now, at least according to…


4. “Visual Diagnosis” or “Visual Dx”.   As a new resident I’ve had difficulty building differentials, especially when attempting to bring some more of those esoteric diagnoses into play.  Visual diagnosis is software to help you do just that.  VisualDx calls itself a “diagnostic clinical decision support system designed to enhance diagnostic accuracy, aid therapeutic decisions, and improve patient safety.  They tout a powerful search function and claim to have a catalog of the world's best medical images.

5.  The software hinges upon a search box in which the user can enter a symptom, medication, or diagnosis.  After this they can enter demographic information and add on findings in order to narrow the search.

For an example…


6. For example if you were to have a patient whos digits were becoming cyanotic and this patient was just started on an anticoagulant, you might want to come up with a differential.  This example differential is displayed for free on their website.  You’ll first notice that when you put in findings you will be given a DDX Strength which I believe correlates to the number of diagnoses that will be displayed.  I showed a “Weak” strength differential to highlight the number of diagnoses they’ll give you.

7. As you can see here on the top right we were given 127 total diagnoses, what to consider first, second, emergencies, infectious, and drug induced. Currently we’re looking at the first of 122 drug induced pathologies included in the differential.

8. More severe diagnoses are “warning” triangle next to them.  Coumadin necrosis is probably a more common diagnosis that you would think of in this scenario but if it didn’t fit you could look into something more rare.

9. Here we have the diagnosis of cholesterol emboli which might be what our patient has.  If we were to click on this tile a new window pops up.

10. Within this window is a listing of all the images available for a given diagnosis on the left with a synopsis in the center.  You’’ll find links to citations and more information on the right.

11. If you think this is something you could find valuable there is a one month free trial available.  After that for residents you pay about $27 per month or $264 dollars a year.