Mainstream medicine ready for computer-aided diagnosis

Mainstream medicine ready for computer-aided diagnosis

First products likely in cardiology and cancer

Computer-aided diagnostics—the use of software-based data analysis to enhance clinical diagnoses, often at the point of care—is showing signs of moving out of the laboratory and into mainstream medicine. Once of interest primarily to academic institutions, these decision-support tools are gaining ground among healthcare providers, along with the growing wave of point-of-care technologies.

"Five years ago nobody wanted anything to do with it," said Robert Cothren, director of the Center for Medical Image Analysis at TRW Healthcare Solutions in Pleasanton, CA, and a presenter at the Society for Computer Applications in Radiology meeting. "The perception was that all these computers were trying to replace radiologists."

That perception has changed, he said, although it still depends on whom you ask. Practicing physicians with extensive experience are less likely to embrace CAD than the new generation of physicians who grew up with computers and are comfortable with computer technology.

"It makes sense," Cothren said. "If you've been a practicing physician for 25 years and you've looked at thousands of mammograms, you don't need to interrupt your normal way of doing things. You're pretty good at what you do."

Even so, some industry watchers see increased CAD acceptance among practicing physicians. More than 50% of healthcare organizations that participated in the most recent HIMSS leadership survey cited point-of-care and decision-support applications among their top IT priorities. This shift is being pushed by two factors, according to Cothren. One is the current financial state of medicine and the enormous pressure on physicians to be not only faster but also more efficient.

"A better tool like CAD helps you do your job faster without missing anything," he said.

The other factor is that patients are becoming more educated about their medical care and are demanding better technologies, Cothren said. Thus even the physicians who are less likely to accept technology are being pushed in that direction by patients.

Even the FDA is showing signs of acceptance, as revealed by the 1998 premarket approval granted R2 Technology for its M1000 ImageChecker. Cothren said this means the medical community was interested enough that the FDA approved a CAD solution for general use, instead of keeping CAD confined to the academic arena.

Now that physicians are becoming more comfortable with the idea of CAD, Cothren sees an interesting future for it, beginning perhaps in screening for lung cancer. TRW is also looking to move CAD into cardiology, a field traditionally more attuned to cutting-edge technologies than radiology. Cothren said the idea is to advance CAD technologies and products enough that they don't slow people down.

"You need to automate things so that CAD folds comfortably into standard practice and you're adding information without detracting from the way medicine is being practiced," he said.