White coats and fingerprints: diagnostic reasoning in medicine and investigative methods of fictional detectives.

Our underlying premise is that the current trend towards mass use of sophisticated diagnostic tools in routine practice—accompanied by a blind faith in technology and predefined diagnostic algorithms—is threatening to kill off the science and art of clinical reasoning. Besides burning a lot of public and private money to make diagnostic work rather superficial, doctors also risk losing the intellectual pleasure that comes from careful diagnostic reasoning. Clinical analogies with detective fiction generally revolve around Sherlock Holmes. 2 However, like medicine, detective fiction has subspecialties and intellectual trends. A rapid overview of the analogies between diagnostic reasoning and the investigative strategies found in detective literature may provide us with some clues on how to confront the problems posed by the burgeoning number of available technologies.