
Differential Diagnosis Clinical Reasoner for Primary Care
Generates prioritized differential diagnoses with red-flag filtering for primary care
What You Can Do
You construct methodical differential diagnoses using a validated three-tier framework that separates don't-miss conditions from high-probability and lower-probability diagnoses. Claude integrates patient context, vital data, and epidemiologic patterns specific to primary care settings to generate actionable diagnostic branches with targeted next steps for confirmation or exclusion of each condition.
Features
automatically identifies and prioritizes life-threatening or serious conditions that require immediate action or urgent workup
organizes diagnoses by probability based on patient demographics, presentation pattern, and epidemiologic prevalence in primary care
systematic framework counters diagnostic anchoring and premature closure by forcing comprehensive consideration of alternatives
incorporates comorbidities, medication effects, social factors, and vital signs to personalize the differential for individual patients
provides targeted history questions, physical exam findings, and diagnostic tests needed to confirm or exclude each diagnosis branch
generates concise, organized differentials suitable for team communication, consultations, and trainee education
structured reasoning for ambiguous, complex, or overlapping symptom patterns where bias risk is highest
Example Output
Clinical Scenario: 58-year-old male with 3 days of substernal chest pain, mild dyspnea, and hypertension history.
Red-Flag Diagnoses:
- Acute coronary syndrome (STEMI/NSTEMI) — chest pain with dyspnea, age, risk factors; ECG and troponin required urgently
- Aortic dissection — sudden onset, substernal, can radiate; check BP differential, consider CTA chest
- Pulmonary embolism — dyspnea with chest discomfort; assess D-dimer, VTE risk factors
High-Probability Diagnoses:
- Unstable angina — exertional pattern, multiple CAD risk factors; serial troponins, stress testing
- Musculoskeletal chest pain — reproducible with palpation, pleuritic component; normal ECG/biomarkers support
Lower-Probability Diagnoses:
- Gastroesophageal reflux disease — atypical for 3-day duration; trial of antacid, upper endoscopy if refractory
- Anxiety — rule out cardiac causes first given age and risk profile
What's Included
- SKILL.md instruction file with the three-tier diagnostic reasoning framework and clinical decision rules:
- Differential diagnosis template with red-flag, high-probability, and lower-probability categories:
- Red-flag conditions checklist for common primary care presentations (chest pain, dyspnea, abdominal pain, headache, dizziness):
- Clinical reasoning workflow for integrating patient context, vital signs, and epidemiologic data into prioritization logic:
- Diagnostic confirmation/exclusion guide with targeted history, exam, and testing branches for each condition tier:
Who It's For
- Primary care physicians (MD/DO) managing undifferentiated presenting complaints
- Resident physicians and medical students seeking structured diagnostic reasoning practice
- Urgent care and walk-in clinic providers evaluating acute presentations under time pressure
- Hospitalists conducting patient handoffs or curbside consultations with primary care teams
- Physician assistants and nurse practitioners in primary care settings building clinical decision-making skills
Best For
- Chest pain, dyspnea, and abdominal pain evaluation in the primary care setting
- Complex patients with multiple comorbidities and overlapping symptom patterns
- Atypical or ambiguous presentations where cognitive biases risk premature diagnostic closure
- Educational discussions and trainee supervision on diagnostic reasoning methodology
- Systematic confirmation of working diagnosis to ensure no dangerous alternatives are missed







