To: Sigmund who wrote (1052 ) 1/10/1998 4:00:00 PM From: Frank Buck Read Replies (1) | Respond to of 1894
Sigmund, I too believe that given sufficient time, automation will eventually work its way into more and more areas of human existence. Just as the industrial-revolution of the 1800's was a pivotal time in the development of labor-history and progress, so too will this current integrated-circuit era become the next chapter-heading in societal development. One only has to consider the IC chips unquestionable acceptance into areas where safety is already a prime consideration: Navigational radar, aeronautics, other areas of medical-equipment, automobiles, traffic-signal control, telecommunications, home and industrial safety-sentries, etc. But as we are all aware there are occasional break-downs. We have learned to "live" with these, acceptable losses . Yet isn't that an oxymoron? The fire-tempers-the-steel , not the other way around. Given time the economic incentive to get it right will prevail. One only has to look at the the long-road of "technological-developments" that we have since come to accept. A note-worthy example, calculation and calculators: Look how long the time table spanned starting with the almost 17-hundred year old abacus, Pascal's (17th-century) mechanical adding machine, Babbages (19th-century) analytical-number machine, punch-card adding machines, slide-rules, this century's development of the ENIAC and EDVAC, right up to the silicon-chip with its logic gateways and such. A wrong calculation from a flawed chip could cause potentially fatal problems. Intel in '94 had a flawed Pentium chip. The floating point decimal gave erroneous answers (I had one). They were recalled. The liability factor was too great for them not to. Notice empirically that the majority of improvements came along in a moderately short period of time. Are we to look at the productivity, qualitative-enhancing, medical diagnostic equipment field and not draw a similiar inferral? Cisco's recent post Can Automation CURE the Pap Smear? By Dorothy L. Rosentahl, M.D., F.I.A.C. makes some interesting observations. They are that: * Of the 70M Paps per year (in the U.S.)-about 5M are "not negative" * +/- 4M are "false-positives" * .7M are confirmed for "follow-up" * < 20,000 (3%) are > "invasion" * Only 0.4% = malignant Given the example provided of 4,800 deaths @ a 10% failure rate, the cost would be $2.5B to detect the 480 false-negative Paps. Until the; Medical-Insurer (Actuaries), the Cost-Analysis Accountants for the 5,000 Cytology Labs (U.S.), the Medical Professionals in the Cytopathology Field, the Federal Regulatory Agency for public-safety, and the Medical Diagnostic Equipment Manufacturers all see eye to eye, the use of full-automation will be considered suspect. The mission statement of the I.A.C. should be the thread that unites this splintered-group. That being.. Introduction of automated procedures to clinical cytology should under no circumstances lead to a lowering of standards of performance. An automated procedure, in principle, [should] not expose any patients to new risks, nor should it increase already existing inherent risks. END The general populace will continue to accept whatever method is provided them. As mentioned before, the economics or the end-reward should provide the incentive to continue refining, until the numbers are acceptable to all. However, in the meantime, the intermediary development of augmenting automated assisting technologies such as AccuMed develops, should fill an important slot in the evolutionary time-table, culminating in automated primary screening. The business plan of AccuMed makes it clear that they envision that area to be wrought in controversy. So far they have been right. I for one am glad that they had the fore-sight to envision the intermediary auto-assisting stage occuring before the fully-automated primary process. Frank