Medicine: Dr. Robot

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Many patients feel that physicians have come to rely too much on gadgets, have grown too mechanical in their approach. Latest advance in mechanical medicine: a machine that diagnoses disease.

Developed by French Ophthalmologist François Paycha, it is a compact, shiny affair like the business machines that keep records on punch cards. A student of cybernetics and automation, Paycha picked diseases of the cornea for his test effort. He punched hundreds of cards for the various symptoms and characteristics of corneal disease. Then he examined a patient, asked the usual questions and recorded the findings by hitting selected keys from 200 on the machine's keyboard. Examples: no ulceration (a negative sign can be as important as the positive), deep-seated opacity, deep-seated blood vessels, no edema, normal sensitivity. Then the machine sorted the cards, rejecting those that did not match the patient's symptoms. It offered half a dozen as meeting all the requirements, e.g., congenital syphilis, result of an old injury or chemical burn—more likely from an alkali than an acid. From these, Paycha could make a careful diagnosis.

To a large extent, the machine relies on the talents of the doctor using it. If an inexperienced physician had made the examination, he would have punched fewer keys and been flooded with confusing cards. But, when Paycha's robot doctor was displayed at the World Cybernetics Congress in Namur, Belgium, expert ophthalmologists welcomed it because its memory is infallible. To brief his machine on the cornea, Dr. Paycha fed it a whole textbook plus references to articles in medical journals. Next project: glaucoma and diseases of the iris. Inventor Paycha believes his robot will work for any organ. His ultimate goal: to have a medical publishing house prepare sets of the cards so that mass health surveys as well as medical colleges and hospitals may use cybernetic diagnosis.