Brief · Template
Diagnosis.
LiveDiagnosisFind out what is actually happening and what most likely explains it: the problem in measurable terms, competing explanations tested against the evidence, and what would confirm or refute the most likely one.
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When to use it
Something is late, wrong or falling short, you do not yet know why, and you do not want to act on the first explanation that comes to mind.
Who it is for. Leads who own a problem: market access, clinical operations, pharmacovigilance, quality, regulatory and commercial leads who need a defensible account of the cause before they commit resources.
Why diagnoses go wrong
A study of diagnostic error in internal medicine found that the mistakes had cognitive causes in most cases, and that premature closure, settling on an answer too early, was the most frequent of them. The same trap catches commercial, clinical and quality problems. This template states the problem in measurable terms, weighs more than one explanation against the evidence, and says how sure it is.1
What you get
The problem in measurable terms. Five labeled lines that restate the problem as something you could check: what, how much, since when, against what expectation, and who is affected.
What is actually happening. The facts, from sources, separated from the story told about them. Where a sourced table supports it, a chart sits beside the sentence.
Competing explanations, tested against the evidence. At Comprehensive length, a matrix scores each explanation against each piece of evidence as consistent, inconsistent, neutral or not tested. Evidence that fits every explanation tells you nothing, and the matrix lets you see that. The scores are analyst judgment.2
The likely cause, with contributing factors and a confidence level. One cause or a short chain of causes, with the contributing factors and how sure the specialist is. A cause chain is drawn only if every link has a source.2,4
What would confirm it, and what would refute it. Observable signs to watch for, set before you look, so the diagnosis can be wrong in a way you will notice.3
Where the effect concentrates. At Comprehensive length, a Pareto view of where most of the effect sits, drawn only if a sourced breakdown exists.
What to rule out. The closing section lists the explanations the evidence does not yet exclude, so nobody takes the diagnosis for a verdict.
What is in it, by length
| Section | Brief | Standard | Comprehensive |
|---|---|---|---|
| The problem as statedThe problem restated in measurable terms | – | ● | ● |
| What is actually happeningThe facts, with their sources | – | ● | ● |
| Competing explanationsEach explanation, tested against the evidence | – | – | ● |
| The likely causeThe most likely cause, contributing factors and confidence | – | ● | ● |
| What would confirm itWhat would confirm it and what would refute it | – | ● | ● |
| Where the effect concentratesWhere most of the effect sits | – | – | ● |
| What to rule outWhat the evidence does not yet exclude | – | ● | ● |
A Standard diagnosis reads in about 1,200 words. A Comprehensive diagnosis reads in about five. Brief is not offered for a Diagnosis.
Choosing a length
Choose Comprehensive when you want competing explanations weighed side by side, which is what most diagnoses need. Standard states the problem, the facts, the likely cause, what would confirm it and what to rule out, without the explanation matrix.
The standards and practice behind it
The structure and the checks come from published work on diagnostic error, structured analysis and incident review. These are the references we drew on and what we took from each. None of their authors has reviewed the template.
| What we took | From | Where it shows |
|---|---|---|
| Guard against settling on an answer too early | Diagnostic error in internal medicine (Graber, Franklin and Gordon, 2005)1 | Competing explanations are weighed before a cause is named, and the closing section lists what to rule out |
| Let the hypotheses compete, and rank them by the evidence that is inconsistent with them | Analysis of Competing Hypotheses, in Psychology of Intelligence Analysis (Richards Heuer, CIA, 1999)2 | The evidence matrix of Consistent, Inconsistent, Neutral and Not tested |
| Make assumptions explicit and challenge each one; list signs to watch for | A Tradecraft Primer: Structured Analytic Techniques for Improving Intelligence Analysis (CIA, 2009)3 | The likely cause states its assumptions, and What would confirm it sets the signs before the evidence is read |
| Describe an incident as a timeline, contributing factors, impact and follow-ups, without blaming people | Postmortem Culture: Learning from Failure (Google, Site Reliability Engineering)4 | The contributing factors are causes in the system and not faults of individuals |
| Choose the chart for the question and draw it only from sourced data | The Financial Times Visual Vocabulary5 | The chart of what is happening and the Pareto view are drawn only from sourced tables |
What it will not do
It does not prove the cause. It names the most likely cause, says how sure it is, and says what would show it to be wrong.
It does not assign blame. It looks for contributing causes in the system, in the way a blameless postmortem does.
It does not act. Deciding what to do about the cause is a different question; a Decision Memo is the template for it.
References
- [1] Graber, M. L., Franklin, N. and Gordon, R. Diagnostic error in internal medicine. Archives of Internal Medicine, 2005;165(13):1493–1499. DOI 10.1001/archinte.165.13.1493. The finding about cognitive causes and premature closure was confirmed against the paper’s text in the template review of 7 October 2026; the publisher page could not be opened for this page.
- [2] Heuer, R. J. Jr. Psychology of Intelligence Analysis, chapter 8: Analysis of Competing Hypotheses. Center for the Study of Intelligence, CIA, 1999. The table of contents lists chapter 8; the procedure was confirmed against the extracted text in the template review of 7 October 2026.
- [3] Central Intelligence Agency. A Tradecraft Primer: Structured Analytic Techniques for Improving Intelligence Analysis. 2009. The Key Assumptions Check and the indicators technique are in the diagnostic techniques section; the steps were confirmed in the template review of 7 October 2026.
- [4] Google. Postmortem Culture: Learning from Failure. Chapter 15, Site Reliability Engineering, O’Reilly Media, 2017. Read on 9 October 2026.
- [5] Financial Times Visual Journalism Team. Visual Vocabulary. Financial-Times/chart-doctor repository.
Links checked 9 October 2026
These are the sources the template drew on. None of their authors or issuers has reviewed it.
About the Brief service
A Brief is a written answer from one specialist, at the depth you asked for. It arrives with its sources, and it closes by saying plainly what would change the conclusion. Nothing is hidden behind a summary, and anything the expert could not source is marked as a gap rather than filled in.
Use cases for the Diagnosis
7 ready-to-run use cases. Each opens its own page with the question, the specialists, the standards and the references.
To edit a saved template, open New → Brief → From template, or the library rail on the service form.