The Computer as Clinical Consultant

Edward H. Shortlife, MD, PhD
Arch Intern Med. 1980;140(3):313-314. doi:10.1001/archinte.1980.00330150027008.
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Although computing technology is playing an increasingly important role in medicine, systems designed to advise physicians on diagnosis or therapy selection have received poor clinical acceptance. Despite diverse research efforts, and a literature on computer-aided diagnosis that has numbered at least 1,000 references in the last 20 years, clinical consultation programs have seldom been used other than in experimental environments.

The reasons for attempting to develop such systems are self-evident. Growth in medical knowledge has far surpassed the ability of the single practitioner to master it all, and the computer's superior information processing capacity thereby offers a natural appeal. Furthermore, the reasoning processes of medical experts are poorly understood; attempts to model expert decision making necessarily require a degree of introspection and a structured experimentation that may, in turn, improve the quality of the physician's own clinical decisions, making them more reproducible and defensible. New insights that result may also


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