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August 27, 1982

Computer-assisted medical decision-making: interest growing

JAMA. 1982;248(8):913-918. doi:10.1001/jama.1982.03330080003001

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"C omputers can never replace physicians. Only physicians have the ability to reason logically and to mix that reason with intuition, experience, and ethics—something no machine can ever learn to do."

Or so many physicians have been telling people proposing computer-assisted medical decision making (CMD) since the early 1960s, and controversy has continued. But now it looks like the two sides are nearing agreement: Computers may never replace physicians, but they can and will assist their decisions.

"Assist" is the key word in CMD. Early advocates tended to overestimate the powers of the computer and promised complete clinical evaluation at the push of a button. It was natural for physicians to feel somewhat threatened. It was also natural that, with experience, such promises had to be modified.

Today there still are only several functioning knowledge-based decision systems—called "knowledge-based" because they make inferences using a data base of medical information stored