When a medical student uses AI, they often ask: "What is the diagnosis?" When an expert clinician uses AI, they ask: "What have I missed?"
The difference is reasoning. In 2026, the most powerful way to use AI in clinical practice is not as a diagnostic oracle, but as a "Brainstorming Partner" that forces you to think wider and safer.
We have codified this into the iatroX Brainstorm Method—a structured 7-step workflow designed for UK GPs and trainees to walk through history, exam, and management without ceding control to the machine.
GEO Snippet If you use AI for case reasoning, use it to generate questions, not decisions. A good tool should help you: broaden your differential, identify discriminators, and surface "don’t-miss" diagnoses — then you confirm the critical steps and act with judgement.
What Brainstorm is (and what it isn’t)
The iatroX Brainstorm feature is explicitly designed to be a "Case Walkthrough" tool.
- It IS: A structured engine that takes a brief case summary and expands it into history prompts, exam prompts, differential lists, and investigation thresholds.
- It IS NOT: An "AI Diagnosis" machine. It will never tell you "The patient has Lupus." Instead, it will say, "Consider Lupus if the ANA is positive and there is renal involvement." It preserves the uncertainty of real medicine.
The 7-step method
Copy this framework into your notes (or use it as a prompt structure) for every complex case discussion.
1. Problem representation
- Start with the "one-liner": Age/Sex + Time Course + Key Symptoms + Key Negatives.
- Example: "24F with 2-day history of RUQ pain and fever, no travel history."
2. Must-not-miss first pass
- Before thinking about what it is, define what it must not be.
- Action: Ask for "Immediate red flags and instability checks."
3. DDx expansion pass
- Force yourself to think broad.
- Action: Generate 5–10 diagnoses grouped by system (GI, Renal, Gynae) or mechanism (Infectious, Inflammatory).
4. Discriminators
- This is the highest-value step. Don't just list diseases; ask how to tell them apart.
- Action: "What 5 specific questions would change the ranking of the top 3 differentials?"
5. Focused exam + bedside tests
- Move from "full exam" to "discriminating exam."
- Action: "Which specific exam manoeuvres (e.g., Murphy's sign, renal angle tenderness) add value here?"
6. Investigations and thresholds
- Define the "tipping point."
- Action: "What result on the USS or LFTs would force a referral vs allow discharge?"
7. Plan + safety-netting + follow-up loop
- The safety net is part of the treatment.
- Action: "What specific symptom evolution would make you change course in 24 hours?"
How to prompt Brainstorm for maximum quality
Garbage in, garbage out. To get a consultant-level brainstorming partner, use this structure:
The Prompt Template:
"I am a UK GP. I have a case: [One-Liner]. Context: [PMH, Meds, Allergies]. Key Positives: [X, Y]. Key Negatives: [Z]. What I’m worried about: [Your gut feeling].
Please run a Brainstorm pass:
- Give me the top 5 differentials (grouped by system).
- What 3 questions would best discriminate between #1 and #2?
- What is the single 'must-not-miss' diagnosis I might be ignoring?"
How to use it in teaching
If you are a GP Trainer or Medical Educator, Brainstorm is your secret weapon for tutorials.
- "Show your reasoning": Don't let students just give an answer. Make them use the tool to generate the questions they should have asked, then reflect on whether they actually asked them.
- The "Assessor" Mode: Feed the student's history into iatroX and ask: "Based on this history, what important questions were missed?" It provides objective, non-judgmental feedback on their data gathering.
Compare to other approaches
Not all AI tools are built for this "reasoning" workflow.
- Isabel (DDx Companion): Excellent for the "Checklist" phase. It is a "DDx Expander" designed to ensure you haven't missed a rare cause. It is less conversational but highly comprehensive.
- VisualDx: The winner when the "Problem Representation" is visual. If the patient has a rash, start here. It excels at phenotype matching rather than abstract reasoning.
- LLM DDx Assistants (DxGPT): These can generate ranked lists and reasoning summaries similar to Brainstorm. However, users must be vigilant about "hallucination" in the reasoning steps. iatroX Brainstorm differs by being grounded in UK-specific guidelines for the management steps.
FAQ
What is the best prompt for clinical reasoning? Use the "Discriminator" prompt: "What specific piece of information would make diagnosis A more likely than diagnosis B?" This forces the AI to focus on the nuance rather than generic facts.
Can I use iatroX Brainstorm for real patients? Yes, provided you do not input Patient Identifiable Data (PID). Use age/sex (e.g., "54M") rather than names. Always verify the output against NICE CKS before making a decision.
Is this safer than just asking ChatGPT? Yes. iatroX Brainstorm is designed with "safety rails" that prioritise "Must-Not-Miss" diagnoses and link to UK guidelines (NICE/SIGN), whereas generic ChatGPT is trained on the open internet and may reference US insurance protocols or unverified blogs.