Meme Machines

Abstract

Editorials1 November 1986Meme MachinesGEORGE A. DIAMOND, M.D.GEORGE A. DIAMOND, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-5-788 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe same man who so succinctly digested the wisdom of multivariate analysis more than 2000 years before Thomas Bayes, Karl Friedrich Gauss, and Sir Ronald Fisher also served up a good deal of the "predigested" (2) variety in the form of his aphorisms (3). It is unlikely that you will encounter any of the 412 surviving Hippocratic aphorisms on morning rounds, but although most of them are hopelessly dated in content, they remain timeless in style. The clinical "pearl," the rule-of-thumb, the mnemonic, the algorithm, the heuristic, and the decision tree all trace their evolutionary lineage back to these aphorisms....References1. HIPPOCRATES . The book of prognostics. In: Great Books of the Western World, vol 10. Chicago: Encyclopaedia Britannica; 1952:26. Google Scholar2. BIERCE A. The Devil's Dictionary. New York: Hill & Wang; 1957:8-9. Google Scholar3. HIPPOCRATES . Aphorisms. In: Great Books of the Western World, vol 10. Chicago: Encyclopaedia Britannica; 1952:131-44. Google Scholar4. DAWKINS R. The Selfish Gene. New York: Oxford University Press; 1976:203-15. Google Scholar5. . Risk stratification and survival after myocardial infarction. N Engl J Med. 1983;309:331-6. CrossrefMedlineGoogle Scholar6. KAHNEMANSLOVICTVERSKY DPA, eds. Judgment Under Uncertainty: Heuristics and Biases. New York: Cambridge University Press; 1982. CrossrefGoogle Scholar7. BLOIS M. Information and Medicine. Berkeley: University of California Press; 1984. Google Scholar8. GOLDMANWATERNAUXGARFIELD LCF. Impact of a cardiology data bank on physicians' prognostic estimates: evidence that cardiology fellows change their estimates to become as accurate as the faculty. Arch Intern Med. 1981;141:1631-4. CrossrefGoogle Scholar9. SINGERSACKSLUCENTECHALMERS JHFT. Physician attitudes toward applications of computer data base systems. JAMA. 1983;249:1610-4. CrossrefGoogle Scholar10. LEEPRYORHARRELL KDF. Predicting outcome in coronary disease: statistical models versus expert clinicians. Am J Med. 1986;80:553-60. CrossrefMedlineGoogle Scholar11. WHITBECKBROOKS CR. Criteria for evaluating a computer aid to clinical reasoning. J Med Philos. 1983;8:51-65. CrossrefGoogle Scholar12. WASSONSOXNEFFGOLDMAN JHRL. Clinical prediction rules: applications and methodological standards. N Engl J Med. 1985;313:793-9. CrossrefMedlineGoogle Scholar13. DIAMOND G. Monkey business. Am J Cardiol. 1986;57:471-5. CrossrefMedlineGoogle Scholar14. RANSOHOFFFEINSTEIN DA. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978;299:926-30. CrossrefMedlineGoogle Scholar15. MCNEILPAUKERSOXTVERSKY BSHA. On the elicitation of preferences for alternative therapies. N Engl J Med. 1982;306:1259-62. CrossrefMedlineGoogle Scholar16. ROZANSKIDIAMONDBERMANFORRESTERMORRISSWAN AGDJDH. The declining specificity of exercise radionuclide ventriculography. N Engl J Med. 1983;309:518-22. CrossrefMedlineGoogle Scholar17. DIAMONDVASFORRESTER GRJ. The influence of bias on the subjective interpretation of cardiac angiograms. Am Heart J. 1984;107:68-74. CrossrefGoogle Scholar18. JORGENSSCHNEIDER JR. Regulation of medical device software: role of FDA. Proc Am Assoc Med Syst Inf. 1986;5:43-6. Google Scholar19. ASIMOV I. I, Robot. New York: Ballantine Books; 1950:40. Google Scholar20. Firm sues Lotus, claiming software fault led to loss. Wall Street Journal. 1986; July 29:15:8. Google Scholar21. WEISTART J. Legal consequences of standard setting for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol. 1985;6:1191-7. CrossrefGoogle Scholar22. MILLERSCHAFFNERMEISEL RKA. Ethical and legal issues related to the use of computer