Computerized encounter registers in primary care research: Is there a gold standard?

Howard Brody

Research output: Contribution to journalArticlepeer-review


Computer technology as well as the need to conduct research in primary care settings, has stimulated the creation in the U.S. of information networks linking private physicians' offices and other primary care practice sights. These networks give rise to several problems which have philosophic interest. One is a "numerator problem" created by the difficulty in primary care of using the more complicated or invasive diagnostic technologies commonly employed in tertiary care research. Another is a "denominator problem" arising from the difficulties in determining which and how many patients constitute the population from which a practice is drawn. Finally, this mode of research raises questions about the social construction of medical reality and how "objective" medical truth is actually based on carefully selected patient experience. All these questions combine to challenge the "gold standard" view on medical research: the idea that some sorts of medical knowledge are epistemologically privileged and can serve as a bench-mark to determine whether new data are valid.

Original languageEnglish (US)
Pages (from-to)129-139
Number of pages11
JournalTheoretical Medicine
Issue number2
StatePublished - Jun 1988
Externally publishedYes


  • Computer registers
  • Concepts of disease
  • Diagnostics
  • Epidemiology
  • Family practice
  • Information networks
  • Personal registers
  • Primary care
  • Research
  • Validity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health


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