Agreed - algorithms won't just plainly discard rare diagnosis the way many physicians do. (especially at 3 am :-) Of course, it should never be top of the list

Agreed - algorithms won't just plainly discard rare diagnosis the way many physicians do. (especially at 3 am :-) Of course, it should never be top of the list - unless it becomes a possibility given the accumulation of negative results of other tests for more common diseases, or the positive results of DNA sequencing. Unfortunately, that's not the way it will happen with an human : rare almost means "ruled out" simply because "poorly taught" or even unknown, and for the best of us "get a second opinion with xxx who specializes in this very disease". DNA sequencing is at most used for a couple of diseases per specialty, and data mining/fishing expeditions are frowned upon (maybe rightly so given the human bias of trying to find meaning and correlation in what may be unrelated). I strongly believe the beginning of true e-medicine will make us look at the current medicine the way we look back at blood letting, holy waters, the four humors imbalances etc.