Sutton's law
Encyclopedia
Sutton's law states that when diagnosing, one should first consider the obvious. It suggests that one should first conduct those tests which could confirm (or rule out) the most likely diagnosis. It is taught in medical school
s to suggest to medical students that they might best order tests in that sequence which is most likely to result in an accurate diagnosis, hence treatment, while minimizing unnecessary costs. It is also applied in pharmacology, when choosing a drug to treat a specific disease you want the drug to reach the disease. It is applicable to any process of diagnosis
, e.g. debugging
computer program
s. Computer-aided diagnosis
provides a statistical and quantitative approach.
A more thorough analysis will consider the false positive
rate of the test and the possibility that a less likely diagnosis might have more serious consequences. A competing principle is the idea of performing simple tests before more complex and expensive tests, moving from bedside tests to blood results and simple imaging such as ultrasound
and then more complex such as MRI then specialty imaging.
The law is named after the bank robber Willie Sutton
, who reputedly replied to a reporter's inquiry as to why he robbed banks by saying "because that's where the money is." He denied ever saying that, in a 1976 book he co-authored, Where the Money Was.
A similar idea is contained in the physician's adage, "When you hear hoofbeats behind you, think horses, not zebras
."
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
s to suggest to medical students that they might best order tests in that sequence which is most likely to result in an accurate diagnosis, hence treatment, while minimizing unnecessary costs. It is also applied in pharmacology, when choosing a drug to treat a specific disease you want the drug to reach the disease. It is applicable to any process of diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, e.g. debugging
Debugging
Debugging is a methodical process of finding and reducing the number of bugs, or defects, in a computer program or a piece of electronic hardware, thus making it behave as expected. Debugging tends to be harder when various subsystems are tightly coupled, as changes in one may cause bugs to emerge...
computer program
Computer program
A computer program is a sequence of instructions written to perform a specified task with a computer. A computer requires programs to function, typically executing the program's instructions in a central processor. The program has an executable form that the computer can use directly to execute...
s. Computer-aided diagnosis
Computer-aided diagnosis
Computer-aided detection and computer-aided diagnosis are procedures in medicine that assist doctors in the interpretation of medical images. Imaging techniques in X-ray, MRI, and Ultrasound diagnostics yield a great deal of information, which the radiologist has to analyze and evaluate...
provides a statistical and quantitative approach.
A more thorough analysis will consider the false positive
Type I and type II errors
In statistical test theory the notion of statistical error is an integral part of hypothesis testing. The test requires an unambiguous statement of a null hypothesis, which usually corresponds to a default "state of nature", for example "this person is healthy", "this accused is not guilty" or...
rate of the test and the possibility that a less likely diagnosis might have more serious consequences. A competing principle is the idea of performing simple tests before more complex and expensive tests, moving from bedside tests to blood results and simple imaging such as ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
and then more complex such as MRI then specialty imaging.
The law is named after the bank robber Willie Sutton
Willie Sutton
William "Willie" Sutton was a prolific U.S. bank robber. During his forty-year criminal career he stole an estimated $2 million, and eventually spent more than half of his adult life in prison...
, who reputedly replied to a reporter's inquiry as to why he robbed banks by saying "because that's where the money is." He denied ever saying that, in a 1976 book he co-authored, Where the Money Was.
A similar idea is contained in the physician's adage, "When you hear hoofbeats behind you, think horses, not zebras
Zebra (medical)
Zebra is a medical slang term for a surprising diagnosis. Although rare diseases are, in general, surprising when they are encountered, other diseases can be surprising in a particular person and time, and so "zebra" is the broader concept....
."