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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: I don't think machines can replace good doctors, whose diagnoses are made by coupling facts with experience. As far as I can tell, there are two broadly defined ways of thinking about making diagnoses:

    1) One that emphasizes experience over fact. Ayurveda and other "eastern" ways might fall into this category because they draw on extremely long traditions of observation and experience. For example, like Jayprakash mentioned, an Ayurvedic doctor can take an almost insignificant fact (subtle variations within the pulse), and relate it to the centuries of experience that has gathered in the course of the Ayurvedic tradition.

    2) One that emphasizes fact over experience. The western tradition falls into this category. Here, doctors gather masses of factual data, and look for trends. One's experience is limited to how often one has seen a trend, and since technology is capable of furnishing us with such copious factual information (upon which we base our experience), western medicine has become very technological.

    Naturally, these gross simplifications do not capture the reality, even if they may help to organize our thinking about the topic. I believe there are many permutations of fact and experience.

    A parting thought: there is an idea that any technology we use is an amplification and extension of our natural senses and abilities. Moreover, this kind of intensification changes our behaviour. A gangster behaves much differently with a gun than with a stick. It seems that the march of technology proceeds without much thought given to its effect on our behaviour.

    How has our medical behaviour changed?
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      Mar 31 2013: I agree that technology cannot replace good doctors, and that we need to continue to train our doctors to interact with patients when making their diagnoses. However, one can not deny that technology has greatly enhanced the entire medical field. It is now much easier to detect certain diseases with the use of technology, and many new successful treatments have been developed against historically un-treatable diseases using the latest advances in technology. Obviously, technology has its faults and their diagnoses can be mistaken - but so can humans. Doctors are sued all the time for malpractice. I believe that by combining technology with the expertise and care from doctors, then we can greatly reduce mis or mal diagnoses and greatly improve the medical world.
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        Apr 2 2013: I do not believe the medical profession has become too dependent on machines and technology when it comes to making medical decisions. Although I have no experience as a doctor or surgeon, I know that technology has only enhanced my engineering education and work outside of school. For this reason, I want to see technology as limitlessly useful in all fields.

        Although I believe Karl Meyer was making a different point, I agree that technology is an amplification and extension of ourselves. Further, it is also an excellent defense against malpractice lawsuits which plague today's doctors and surgeons, as mentioned by Lauren Bayer.

        If learning about the risks of relying to heavily on CDSS makes you nervous about your doctor or surgeon, it is important that you research your doctor or surgeon before trusting them. Speak with them, research their practice and investigate the hospital they may work in in order to learn about their experience and reliability, especially when using this technology.
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      Mar 31 2013: I believe the experience of a doctor must always be used in order to validate and justify the findings of technological equipment. I think this issue you bring up goes far beyond just the medical field. How much can we as humans rely on technology, machines, and 'robots'? Machines are designed and programmed to do their job and only their job, doctors are trained to use their education, experience, and decisions to make clinical decisions. Such traits hopefully enable a doctor to make the correct diagnosis, but unfortunately that's not always the case. Hundreds of test can be run with different kinds of machinery, but it takes the keen eye of a doctor to make the resolute decisions. Unfortunately, both the machine and doctor are subject to error, but without one or the other, I don't think any patient can truly be treated properly.

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