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Is "Star Trek" technology already here?

"Trekkers" (the correct term for serious "Star Trek" fans) have probably marveled at the little hand-held device used by the doctors on the starship Enterprise to diagnose all manner of illness. A recent San Diego hospital study suggests that a hand-held computer might someday supplement the diagnostic decisions of emergency room physicians. The experiment pitted doctors against an artificial intelligence program in diagnosing heart attacks among patients coming into the emergency room-and the computer won hands down.

The doctors quickly put together their information from physical symptoms, health histories and electrocardiograms. From these, they were instantly able to diagnose only 28 of the 36 heart attacks among 331 patients admitted with chest pain. Feeding exactly the same information into the computer produced a correct diagnosis in all but one of the heart attack patients. Laboratory tests of blood enzyme levels, which take several hours to process, finally confirmed the diagnoses.

"Artificial neural network" is the technical term for the computer program developed to process the doctors' preliminary data. An editorial in the December 1, 1991, Annals of Internal Medicine called the results impressive," adding, "the study ... is an early contribution in what we expect will be a series of applications of neural networks in clinical practice."

The computer program was developed using the same logic that a doctor uses in arriving at a diagnosis. The computer programmer feeds as much immediate information as possible from the patient, as well as from tests that can give prompt results (such as the EKG), into the computer. The programmer then tells the computer which patients had heart attacks, based on the later laboratory results. The computer thus learns to distinguish a heart attack from other problems by being presented many examples of each along with the correct identification.

Doctors may be reluctant, of course, to trust a computer to make a diagnosis. However, as the editorial points out, doctors often make diagnoses based on those of experts whose "thought processes cannot be explicitly passed on to others." In other words, the computer can be taught, just as doctors are taught, how to diagnose illness. Because it is not subject to emotion or other pressures that often beset the emergency room physician, its "thought processes" are always consistent.
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Title Annotation:using computers to diagnose patients
Publication:Medical Update
Date:Feb 1, 1992
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