Computer Aided Diagnosis in Mammography: Its Development and Early Challenges

This article discusses the development of a technology of "computer vision" designed to assist medical practitioners diagnosing breast cancer in the 1980s and 1990s. A CAD system was designed to augment human vision by digitizing mammograms, enhancing computer-selected "regions of interest" and offering a protocol to recommend a course of action (follow up examination, biopsy, etc.). One issue that emerged following the introduction of CAD was that human vision - previously the "gold standard" for diagnostic accuracy - was influenced by the prompts the computer provided the interpreter, illuminating the paradoxes of de-skilling and the problems mediating visualization and expert decision making.