X-Message-Number: 4722
From:  (David Stodolsky)
Subject: Computerized prognoses for critically ill hospital patients
Date: Sat, 5 Aug 95 11:09:40 +0200 (CET DST)


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Date: Wed, 02 Aug 95 09:33:44 -0700
From: Lauren Wiener <>
Subject: Computerized prognoses for critically ill hospital patients

The 31 July 1995 issue of _Forbes_ includes an article (pp. 136-7) on the
products of Apache Medical Systems, which predict patient outcomes based on
a database of "400,000 hospital admittances covering 100-odd diseases.  From
these statistics Apache's software can predict patient survival with an
accuracy that can *sometimes* beat that of doctors' hunches."  [fake italics
mine]

The software is intended to guide the doctor's choice of treatment.  Several
examples are given, include a rather chilling one in which the supposed
objectivity of the computer is enlisted to coax a husband for permission to
take his wife off a respirator and let her die.  The doctor who founded the
company (Dr. Knaus) is quoted as saying he created the system because "I
wasn't smart enough to figure out what to do in each situation."  Another
highlight: "Many hospitals adopted the Apache system to cut costs and
measure quality in intensive care units."

The article closes with a brief discussion of the ethical issues, in which
Dr. Knaus says: "If I were [the patient], I would want to be judged on Apache.
It knows only those facts that are relevant to my condition, not race or
insurance coverage, which have been used to allocate care in the past."

In other words, the computerized system is good because it is an improvement
over a deeply flawed, inequitable, and racist system?

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David S. Stodolsky      Euromath Center     University of Copenhagen
   Tel.: +45 38 33 03 30   Fax: +45 38 33 88 80 (C)


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