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Neema Aggarwal

Electrical Engineering Student, The Cooper Union for the Advance,

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Do we rely too heavily on technology for medical diagnosis?

This week in my bioelectricity class, we discussed electric fields that can be measured on the body (eg the brain, skin, eyes) and the ability to interpret signals for diagnosis, lie detection etc. Currently, there exists clinical decision support systems (CDSS), which are interactive computer software systems designed to aid doctors with medical decisions. Various test results and other data from the patient is inputted into a CDSS which then processes it and provides a list of possible diagnosis and options for treatment. The problem is, like all machines, they can often make crucial mistakes.

Dr. Lisa Sanders, a physician at Yale School of Medicine, and technical adviser for the popular TV show, House, wrote a book called “Every Patient Tells a Story” dealing with the uncertainty doctors face when analyzing a patient’s symptoms. Sanders says that misdiagnoses account for as much as 17% of medical errors. She discusses how despite the many technological advances made recently, sometimes these diagnostic tools are to blame. Relying too heavily on machines and lab results can result in symptoms being missed. Or on the other hand, sometimes exam results are normal; blood tests, electrocardiograms, CT scans, all may suggest a healthy body even when that is not the case. It can take a trained, experienced eye to notice small details in the patients’ behavior to unravel the mysteries of an unknown illness. Sanders states, “For all the data they collect, machines lack important components for diagnosis. They cannot hear a patient’s story, touch a patient’s skin, or look into a patient’s eyes.”

My question is, have we become too dependent on machines and technology to make medical decisions for us? Have doctors been lured into a false sense of security by allowing tools like CDSS to provide answers? How can the value of intuition which comes only from experience be balanced with technology without being lost? Can machines ever be a good enough substitute for doctors?

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    Mar 27 2013: The mark of the good doctor, I should think, is to use both intuition and the results of medical tests to come to her best conclusion but also to consider and communicate other possible diagnoses that may explain the symptoms the patient presents. Some doctors likely have great confidence in their intuition (whether those intuitions are in fact good or bad) and others are probably more reliant on other sources of data, including the possible interpretations of medical tests.
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      Mar 28 2013: Hi Fritzie,
      I absolutely agree, ideally some kind of combination of intuition and tests would likely yield the best results. But what happens if doctors become to comfortable just sitting back and letting the tests and machines speak? What if intuition is slowly ignored and forgotten?
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        Mar 28 2013: I think doctors understand that tests help by providing some measures, but that the narrative including those data and other observations is for the doctor to construct with the help of his/her experience, intuition, and training. There would be nothing gratifying in sitting back and letting machines speak.

        I think many people are quick to suggest other people might have the inclination to become comfortable and sit back lazily. A useful reality check might be to ask yourself, if you trained to make professional judgments by using your intuition together with the data tools can provide, do you imagine you would then just sit back comfortably and let tests and machines speak? If you believe you would not, why would you suspect such an inclination in others?

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        • Mar 31 2013: I wish we could rely on doctors being motivated by their work.

          Unfortunately, a great many doctors are motivated by money. Many doctors who are not primarily motivated by money work for people who are motivated by money, and the employer determines the conditions of their employment and places limits on the way they work.

          The motivation for money is not evil. We all work for a paycheck. Doctors and nurses are not evil because they want their children to go to good schools.

          The problem with the medical industry is that our culture continues to believe in the illusion of a "health care system." When we recognize that we are dealing with an industry and start using the economics of that industry to improve the results, we will get better results. Medical professionals must compete.

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