
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, May 25, 1995                   TAG: 9505260018
SECTION: EDITORIAL                    PAGE: A16   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

TAKE TWO BYTES ...

MARCUS WELBY it's not, but a new interactive computer system has been designed to explain obstetric and gynecologic procedures to patients. And, unlike the live variety, this doc in the box will make sure patients understand the risks and alternatives. It gives a test at the end.

So patients had best listen up.

PACE, for Patient Advise and Consent Encounter, uses animation and an actor-doctor narrator to explain 13 procedures, their risks and treatment alternatives. A patient can skip over what she thinks she knows and concentrate on areas she doesn't fully understand.

If she doesn't know as much as she thinks she does, that will be evident in the results of the test at the end of each section. The computer will make a printout of the session for both patient and physician, and the doctor presumably will then notice signs of confusion and clear up misunderstandings.

Thus, according to a report in Science News, the computer can enhance communication between doctor and patient. The machine is hardly a threat to the medical degree - just yet, anyway.

Another expensive, high-tech frill that will drive up medical costs for dubious benefits? Not if it does, indeed, assure that patients understand their options, know the risks they are facing and give truly informed consent to their treatment. (And, one can't help but note in these litigious times, leave a paper trail of evidence showing this.)

That can actually lower the cost of practicing medicine. At least one malpractice insurer is betting that the system will pay off in fewer claims, and has offered a 5 percent discount on premiums for practices that use PACE.

In the same issue, Science News reports about another computer system that helps analyze mammograms and may help radiologists cut the number of missed breast-cancer diagnoses in half.

Physicians who look back at false-negative mammograms find that as many as two-thirds show subtle signs of trouble that human interpreters overlooked. The program can't replace human judgment, but it can point out areas on an X ray that should be double-checked. Three studies show it significantly increases diagnostic accuracy.

The program falls short of perfection, but it's only inhuman.

by CNB