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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 31 2013: There's a precursor to this question that should consider the quality of a healthy experience. In the US we tend to rely on governance to dictate our expectations of health and in turn our perception of a reasonable diagnosis and outcome. All while using presumptions of freedom to promote and shape our efficacy. Considering the ridiculous things that the FDA, EPA, etc endorse subjecting our bodies to without hesitation, diagnostic conflict and divergence should be expected. Practicioners in every field at some point begin to feel as if their tasks are sisyphean, the burden of proper advocacy falls to them and their ability to positively challenge perception and effectiveness. Similarly confidence is a feature of every bartered trade and product, in medicine safety and security is a more pronounced component in healthcare as opposed to other industries. As such it's also a major point of leverage for bad decision making processes.

    To answer your core question, practicing medicine is a technological process. Be it a stethoscope, or the ability for a patient to effectively communicate their symptoms, depth of knowledge and ability is an immutable constraint of quality. Experiences institutionalized within a defunct system will never be able to keep up with the dangers we introduce into ourselves and our environment. Be it technology co-opted to cause harm or resolve it, the nature of our ethos will always be pitted against the quality of our experience.

    However students of health and medicine will likely continue to misplace their affinity for the field of study as well as their genuine interest in it. As they approach their education as standardized rigor, with less and less direct practicality, their lack of fear and accountability in the pursuit of being practicioners will likely degrade the actual benefit of their participation in the industry.

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