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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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  • Apr 2 2013: Hi Neema:

    You question is really provocative. And, not one that is easily answered. Before trying, however, I wonder whether you have seen this little TED talk: http://www.ted.com/talks/katherine_kuchenbecker_the_technology_of_touch.html

    As for me, I say more technology. My position assumes most doctors are incompetent. There is a kind of blind arrogance that many have. They just make judgments after half reading chats and half listening. Some are fundamentally biased. Knowing this, I would strongly encourage not only more technology, but also data inputs on the patient side that describes symptoms. These inputs can be accomplished in a physician's office, and while the patient is waiting to be seen by his or her doctor. Once these things are inputted, certain triggering analyses may take place to help the physician make best judgment decisions.

    I am actually developing a module that addresses this issue, If interested, feel free to contact me.
    • Apr 2 2013: Ibrahim,

      I think this concept of both practitioner and patient controlling inputs to produce a possible result is absolutely the right direction. I do see a problem, in that so much of our population is not comfortable with technology and I am not sure if they will provide that part of the inputs accurately. I think this has some fantastic aplications in distance treatment of patients or in using sealth care surrogates to expand our service networks and allow more in home attention and time with patients. It might not be M.D. with patient time, but surrogate with patient time that then translates to better information to MD and better use of MD time. Sounds optimal. I would love to see how you envision using this approach.

      As to the arrogance or Messiah complex of many in the health care profession, it is a difficult line to walk. I want a surgeon with b**ls made of iron and as big as grapefruits who is unflustered by whatever he or she meets while I am on the table. But before that, I want a diagnostician who is communicative and questioning and willing to second guess herself. And afterwards, I want a practitioner who is warm and caring and knows how to work with all the devils within my psyche to get me on my feet and on the mend in the fastest possible time.
      • Apr 2 2013: Hello Mark:

        I think most persons, sans the very elderly, critically injured, or those with physical challenges can manipulate a simply designed medical UI. Just think of the millions of people around the world who input data into things like Facebook. They tend to get it right.

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