Logical analysis of clinical medicine. Part 2.

UK : University of London, 1975.

1 encoded moving image (38 min.) : sound, black and white.

00:37:38

University of London

Unrestricted

CC-BY-NC

Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

In English

Presented by Professor Wilfrid Card, University of Glasgow. Produced by David Sharp.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Opening credits. Prof. Card summarises Part 1 of 'Logical analysis of clinical medicine'. He then discusses treatment analysis and definition of outcomes. A table showing the set of outcomes used in a study of severe brain damage is seen and Card explains the data. Then he talks about adding other values such as cost of treatment, to the process and how to measure the value of different treatments. A chart showing possible treatment courses for a duodenal ulcer is shown. Time start: 00:00:00:00 Time end: 00:05:05:23 Length: 00:05:05:23

Segment 2 Card explains how to relate probabilities of outcomes to the state of the patient. A hypothetical case of patients with myocardial infarction is discussed mathematically. Distributions of patients who died and survived are shown in charts and Card discusses the variants and weights. Time start: 00:05:05:23 Time end: 00:10:24:00 Length: 00:05:18:02

Segment 3 Card shows an example from an actual study of a large number of patients showing the predictions of who would survive and who would not. He discusses the data and also talks about another study of the effects of severe head injury. He discusses the problems involved in attaching numbers to a given state of health. He talks about a hypothetical case of a dangerous operation performed to treat complete blindness. Mathematical tables show the utilities and values of the different states of health of the patient. Time start: 00:10:24:00 Time end: 00:15:17:00 Length: 00:04:53:00

Segment 4 Another hypothetical case involving a male patient who loses the sight of one eye is discussed. Charts show the patient's states of health. The doctor can then discuss with the patient the different treatments that can affect each state of health. Next, he discusses the results of a survey of gastroenterologists who were asked how they would treat patients with a range of disabilities. Time start: 00:15:17:00 Time end: 00:20:11:02 Length: 00:04:54:02

Segment 5 Complex mathematical diagrams are shown, and Card describes a decision tree used to treat a patient with myocardial infarction. He goes on to talk about assigning monetary value to the state of health of human life. He explains that this is necessary because of the way the National Health Service is run. He discusses how economists calculate the average value of life and looks at the cost to treat a patient with renal failure. Time start: 00:20:11:02 Time end: 00:26:05:00 Length: 00:05:54:23

Segment 6 Card discusses the use of computers alongside human doctors in diagnosis and performs a probability test using two bags full of black or white beans. Time start: 00:26:05:00 Time end: 00:31:17:00 Length: 00:05:12:00

Segment 7 Prof. Card continues to talk about the use of computers and probability in diagnosis. He then discusses how the development of a mathematical and logical approach would affect the practise of medicine. Time start: 00:31:17:00 Time end: 00:37:38:07 Length: 00:06:41:07