A Case for the Computer: A History and a Projection

The growth of numerical methods in medicine is traced in this article. Many developments have been both profitable and acceptable but others have resulted in emotive confrontations with traditional points of view. The historic sequence of the latter group begins with the application of randomized clinical trials, passes through the development of error–measuring techniques, and attains the current level of turmoil arising from proposals for regular numerate studies of the effectiveness of health services organizations and systems of delivery of all kinds. Computers arrived on the scene during this period of adjustment and their own emotion–provoking properties have compounded the difficulties, first by facilitating these still controversial techniques, second by threatening to replace medical functions. In fact this is probably not a serious immediate threat and the main applications of computers in medicine, certainly in the short and intermediate terms, are to those functions which were sufficiently formalized to be delegated, and to new functions, previously not carried out at all in any explicit matter, especially in the area of simulation.