The variable-field-length (VFL) format for computer processing of clinical data has been described previously. This technique allows medical narrative and numerical data to be collected efficiently in a form acceptable as computer input for subsequent storage, analysis, and retrieval.1,2 The role of the physician is sufficiently important in this context to be considered prior to discussion of progress in application of this method.
The possibility of "machine diagnoses" and the physician being "replaced by a computer" has been frequently discussed.1-4 Our experience indicates that any computer application to medicine relies primarily upon the ability, ingenuity, and intelligence of experienced physicians to ensure that computer usage will be practical, reliable, and offer advantages not otherwise obtainable. It is the physician who can most reliably select and systematize data to be introduced into the machine. It is the physician who can most successfully devise meaningful questions and definitions for interrogation