The diagnosis of many medical problems is relatively simple since most patients present with common ailments. There are, however, frequent situations where reaching an accurate conclusion is not easy. Hence the batteries of expensive tests that are prescribed.
The acronym CAD generally refers to a tool used by engineers and stands for 'Computer Aided Design'. The same letters could well refer to a 'Computer Aided Diagnosis' tool used by physicians. In fact, Computer Aided Diagnosis does exist but is limited to the interpretation of x-ray images.
Few would dispute that the corpus of medical knowledge has grown so large that no physician or surgeon can retain it all in memory. Why, then, do we not see computers, in examining rooms, programmed to search a database of symptoms and able to suggest potential diagnoses together with the tests required for confirmation?
Can it be that doctors are so arrogant that they believe that they can remember everything? Or are they so insecure that they believe that their patients would lose confidence in them if they were to be seen consulting a database?
The medical profession's resistance to the use of information technology ("IT") is only very slowly being overcome. Part of that is the conservative nature of most doctors. A greater obstacle, however, is the fact that doctors do not receive any payment for the high costs of adopting IT and, even worse from the perspective of a practice manager, less intervention is likely to lead to lower revenue.
There is little doubt that we would get better quality medicine, at lower cost, if doctors were to use modern information technology: electronic records that are accessible to every one of a patient's doctors, together with computer aided diagnosis, would be a useful beginning. Unfortunately, the perverse financial incentives that dominate the American health care system will ensure that nothing happens soon.
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Dear Hugh, you are not quite aware of the state of the art in the area of CAD when you write that "Computer Aided Diagnosis does exist but is limited to the interpretation of x-ray images." Take a look, for example, at the scientific program of the Computer-Aided Diagnosis conference at SPIE Medical Imaging at http://spie.org/medical-imaging.xml. What you miss in your analysis is that it is not so easy to develop software that analyzes medical images and suggests possible diagnoses. This is one of the reasons this is not widespread yet. This will change undoubtly.
Thank you for the comment. My concern is the lack of Computer Aided Diagnosis in the Internist's, Family Practice, General Practitioner's offices.
There was no intent to critize the state of computer aided medical imaging diagnosis. The field is young but it will only get better.
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