A step-by-step guide to create a clinical mind map using the Epi-logical approach
Pick a patient presentation or a chief complaint.
Define the presentation clearly, especially if it is vague.
Build a list of probable diagnoses or differentials which may contain the chief complaint. This should preferably be one of the salient features of the differential diagnoses, and not a rare symptom found as a part of the disease. For example, patients with celiac disease may develop gluten ataxia, but the frequency or prevalence of this feature is quite rare. So celiac disease may not necessarily be included in the causes of ataxia unless a very comprehensive mind map is being generated.
Divide differentials into chunks based upon one of the several principles.
listed in a section, such as the prevalence, the patho-physiological category, the demographics such as age and gender, high yield questions representing clinical features such as the duration which divides differentials between acute vs chronic, the anatomical characteristics of the symptom such as location, and life threatening or non-life threatening diagnoses. Any of these methods is useful as long as the rest of the clinical mind map is consistent with the approach adopted.
Perform a literature search or find an authentic source to look for additional salient symptoms and signs of each diagnosis. Gather data on frequency estimates of individual symptoms and signs for the diseases. Enter symptoms and signs with significant frequencies (this may be those most common findings associated with the disease or rare but highly specific findings associated with the disease). Use a specific font color for the associated text, such as the color green used in this book.
Enter significant physical exam findings next to the symptoms for each disease using a different font color for the associated text, such as the color brown used in this book.
Enter the gold standard or commonly performed labs and/or tests to confirm the diagnoses in front of the diseases. Use another font color for the associated text, such as the color purple used in this book.
Build the Epi-logical Approach box on one side. This box contains a standardized format explaining how to use a particular clinical mind map following the Epi-logical approach. Each box starts the same way, advising to first memorize a list of differentials to build a list of probable diagnoses (the 1st step of the approach), then addressing urgent/emergent situations (the 2nd step of the approach) which are typically written in the color red in this book. Next is a list of high yield questions, which are the questions that help narrow the differentials into broad categories, and then the list of medium yield questions, followed by advice on performing the physical exam and the lab and/or tests (the 3rd and 4th steps of the approach). Answers to the high yield questions and the medium yield questions must be written in front of the individual diagnoses so that these answers can be differentiated from one another. Building clinical mind maps based upon the above approach and then using these maps during encounters should improve diagnostic success.
Color Coding of Clinical Mind Maps:
Many of the clinical mind maps on this site and in the book use color to help distinguish between different elements needed to make a diagnosis. Below is the key to what each color represents. This key is mostly followed, but there may be occasional exceptions based upon the situation
Black – Probable Diagnosis
Red – Urgent/Emergent Situations.
Green – High and Medium Yield Questions, Additional Features of Specific Diseases.
Brown – Physical Exam Findings.
Purple – Diagnostic Testing (X-ray, CT, Bacterial Culture, etc.)