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The process of making a diagnosis is a problem-solving activity carried out in the human brain by thinking recursively using a strategy of “explore and exploit” under the condition of Uncertainty that arises from multiple sources. Required for success are a knowledge base, a set of reasoning skills, and the ability to obtain the appropriate data in the case of a specific patient. Context and the use judiciously of perspective are the keys to minimizing the anxiety that can overcome us in the cognitive gap between information and knowledge. Failures at diagnosis are due to systematic error and are both predictable in nature, if not in time, and avoidable potentially if one understands the process.

On the nature of thought processes and their relationship to the accumulation of knowledge, Part XVI—The process of making a diagnosis