IMPASSIVE DICTATING: A Mnemonic Acronym for Systematically Generating Differential Diagnoses

Systematically generating differential diagnoses facilitates a clinician's history, physical exam, and clinical evaluation. IMPASSIVE DICTATING is an acronym for pathophysiologies to consider in a differential diagnosis: immune reactions and dysregulation, metabolic, psychiatric, allergic, structural, social, infectious, vascular, endocrine/exocrine, degenerative, iatrogenic, congenital, traumatic, autoimmune, toxic, idiopathic, neoplastic, and genetic. We suggest that this mnemonic includes several improvements on previous pathophysiology-based acronyms and have informally validated this new mnemonic with two lists of common diseases. By emphasizing mechanisms of disease rather than clinical experience, IMPASSIVE DICTATING may be particularly useful in preclinical education, other teaching contexts, and complex patient presentations. We demonstrate the use of IMPASSIVE DICTATING with several common syndromes and underscore its utility and application compared to other methods of creating differential diagnoses.