Technology list found wanting
CMAJ 2000;162:970
In response to: R. Ashforth; S.M.H. Alibhai
Robert Ashforth and Shabbir Alibhai have underlined some of the difficulties inherent in creating a list of technologies using a computerized reviewer database and email. First, my initial survey was limited to those reviewers with accurate email addresses in the database. Second, CMAJ's reviewer database includes only a small fraction of Canada's specialists, and certain specialties are clearly underrepresented. For example, of reviewers with email addresses in the database, there are 64 specialists in hermatology–oncology, 14 in gastroenterology and only 13 representing radiology and nuclear medicine combined.
Furthermore, with space limitations in the journal, the challenge was to keep the list as complete as possible without being repetitive. Thus, specialties dealing with similar disease processes were combined under 1 heading. Although inhaled nitric oxide for hypoxemic repiratory failure was listed as a critical-care technology, it could just as easily have been described as a technology "belonging" to respirology. Similarly, telemedicine, a technology with important applications in many medical fields, was listed under the heading cardiology and cardiac surgery simply because several cardiologists cited telemedicine as a key development.
In this vein, my choice not to include diagnostic imaging as a heading was certainly not an attempt to attribute radiologic technologies and skills to other specialists, but was rather an effort to show the wide-ranging applications of imaging technologies in virtually all areas of the body and of medicine. As I emphasized in my editorial, new imaging techniques have changed the way we see disease, and technological advances in radiology have had an impact well beyond the bounds of a single specialty.
The list is by no means comprehensive. It was meant to give readers a sense of the directions technology has taken, to be a springboard for more detailed descriptions and to serve as an invitation to specialists, like Ashforth and Alibhai, to tell us more about what they do.
Caralee E. Caplan
Former CMAJ editorial fellow
Columbia University
New York, NY
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