In a news item appearing elsewhere in this issue there is an announcement of a very interesting and intriguing competition—the design and construction of a real tricorder. A tricorder, for those below a certain age, is a device from the 1960’s science fiction TV show, “Star Trek.” The character Dr. Leonard, “Bones” McCoy would pass it over the body of a subject and instantly discover whatever exotic malady was ailing the person. Now the X Prize Foundation and the Qualcomm Foundation have announced a $10 million prize for the team that can actually build and demonstrate such a device. It is a testimony to the state of technology as well as to the vision of developers in the medical field that such a thing can actually be seriously proposed and attempted.

Tom WIlliams, Editor-in-Chief

There is, however, one small disturbing item in the context of the contest, and that is the use of the word “diagnose.” The contest stipulates that, “the winner will be a device that can most ac- curately diagnose a set of 15 diseases across 30 consumers in three days.” It further states that these diagnoses will leverage technology innovation in areas such as artificial intelligence and wireless sensing to make medical diagnoses independent of a physician or healthcare provider. While I’m not a lawyer, it appears that this could be getting into questionable legal territory—like practicing medi- cine without a license. Of course, just saying, “My tricorder says you have beri beri,” is not going to get anyone in trouble, but acting on that judgment without the input of a physician just might. After all, even in the Star Trek series the tricorder was always wielded by Dr. McCoy, who was a medical doctor—as in, “Dammit Jim, I’m a doctor, not a bricklayer!”

The ever-growing number of today’s medical electronic devices give us data. They do not con- tain the large amount of artificial intelligence gleaned from four years of medical school, internship, residency and experience, to shape that data into a reliable diagnosis for much of anything beyond the sniffles. There is some further hubris in the contest material that talks of, “transforming health- care by turning the ‘art’ of medicine into a science.” Now, really. Anyone who has seen even a few episodes of “House” should be able to appreciate how subtly difficult it can be to arrive at a reliable diagnosis even with vast amounts of data and test results. I can easily imagine MDs taking offense at such a suggestion.

Interestingly, though it appears that the Competition Guidelines will soon state the full details, there does not presently appear to be a list of exactly which diseases are to be diagnosed. It does say, “This diagnosis must be performed in the hands of a consumer independently of a healthcare worker or facility.” That’s where things could potentially get dicey.

I think it is important that we understand just what these devices are supposed to be. They are extensions of the physician’s knowledge, skills and art—not substitutes for it. They can be extremely valuable in a world where those skills are at a premium and where we can delegate large amounts of routine data gathering and, yes, some analysis to machines. But until we arrive at the stage where we have actual medical knowledge and experience in the form of a virtual doctor on our holodeck, as in the later series, “Star Trek Voyager,” let us please keep perspective.

I am excited to see what comes out of this ambitious competition. I am certain the effort will result in some very impressive advances, and we will be looking forward to reporting on them in these pages. But if we get too arrogant about our devices, we may face Spock looking down his nose and shaking his head at our obsession with our “beads and rattles.”