

Andrew S. Lea
A fascinating history of the first attempts to computerize medical diagnosis.
Beginning in the 1950s, interdisciplinary teams of physicians, engineers, mathematicians, and philosophers began to explore the possible application of a new digital technology to one of the most central, and vexed, tasks of medicine: diagnosis. In Digitizing Diagnosis, Andrew Lea examines these efforts—and the larger questions, debates, and transformations that emerged in their wake.
While surveying the continuities spanning the analog and digital worlds of medicine, Lea uncovers how the introduction of the computer...
A fascinating history of the first attempts to computerize medical diagnosis.
Beginning in the 1950s, interdisciplinary teams of physicians, engineers, mathematicians, and philosophers began to explore the possible application of a new digital technology to one of the most central, and vexed, tasks of medicine: diagnosis. In Digitizing Diagnosis, Andrew Lea examines these efforts—and the larger questions, debates, and transformations that emerged in their wake.
While surveying the continuities spanning the analog and digital worlds of medicine, Lea uncovers how the introduction of the computer to medical diagnosis reconfigured the identities of patients, diseases, and physicians. Debates about how and whether to apply computers to the problem of diagnosis, he demonstrates, were animated by larger concerns about the nature of medical reasoning, the definitions of disease, and the authority and identity of physicians and patients.
In their attempts to digitize diagnosis, these interdisciplinary groups of researchers repeatedly came up against fundamental moral and philosophical questions. How should doctors classify diseases? Could humans understand, and come to trust, the opaque decision-making processes of machines? And how might computerized systems circumvent—or calcify—bias? As medical algorithms become more deeply integrated into clinical care, researchers, clinicians, and caregivers continue to grapple with these questions today.
In Digitizing Diagnosis, Lea has written a thoughtful study of how the computerization of different tools within the medical profession has transformed not only medical care but the idea of the patient, the doctor, and of disease itself.
Physicians have promised for decades that computers will transform medicine, but the promised land has not been reached. In this brilliant analysis Lea traces the hopes and fears that have characterized medical computing for decades. Efforts to transform medicine into computerized algorithms have paradoxically revealed how human medicine must be.
If a central medical practice is to identify and name pathology—to diagnose that which ails us—how diagnosis has shifted since computational medicine has received scant scholarly attention. In his stunning book, Andrew Lea charts the clinical usage of computational media as it becomes instrumental to care. An essential read for anyone interested in medicine, both in its history and as it is practiced now.
Beautifully written and full of insight, Digitizing Diagnosis explores the unmet potential of the digital computer as a tool to transform health care. Lea's clear voice as a historian and clinician demonstrates that technological failings and moral panics explicit in early medical computing continue to haunt attempts to deliver digital health today.
Acknowledgments
Introduction
Part I: Patient
1. Indexing the World
2. The Statistical Patient
Part II: Disease
3. The Disease Concept Incarnate
4. The Medical Mind
Part III: Physician
5. MYCIN Explains Itself
6
Acknowledgments
Introduction
Part I: Patient
1. Indexing the World
2. The Statistical Patient
Part II: Disease
3. The Disease Concept Incarnate
4. The Medical Mind
Part III: Physician
5. MYCIN Explains Itself
6. "Hidden in the Code"
Conclusion
Abbreviations of Cited Archival Sources
Index
Notes
with Hopkins Press Books