The computer will see you now

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ENTER the cyberdoctor. British patients suffering from an anxiety illness have been successfully treated by talking to a computer in the USA.

Around 40 patients have telephoned a talking computer in Madison, Wisconsin, to get medical help, advice, assessment and treatment suggestions.

It is the first time treatment has been delivered by a computer down a telephone line to patients and doctors say the results for some people have been as successful as medication orcounselling, with a number of people needing no further treatment.

Unlike some doctors and therapists, the computer is available 24 hours a day, never gets tired or irritable, rarely makes mistakes and always performs at the same level of efficiency. Nor are there any receptionists for patients to negotiate with. If the computer has any doubts, it refers on to a real doctor.

A report, prepared for The Lancet later this year, will show very high success rates for the trial project which has widespread implications for the treatment of mental health problems such as anxiety, depression, and obsessive compulsive disorder (OCD).

"We think it is going to revolutionise therapy. The implications are that treatment will be available to far more people at lower costs," said Professor Isaac Marks of the Institute of Psychiatry at the Maudsley Hospital in London.

The computer has been used to treat more than 40 patients with obsessive compulsive disorder at centres in London, Boston and Madison.

"OCD patients are the people who check door locks over and over again, wash their hands continually and so on," said Dr Lee Baer, of Harvard Medical School. "Therapy is effective with these people. The problem is that people don't all have access to human therapy because of shortages of staff or for financial reasons."

The computer responds to voices and to buttons on the caller's telephone. When they call in on the freephone, it greets them with: "Hi there, how are you? I want to ask you a few questions."

"After the patient responds, the computer branches out to the next appropriate statement or question," said Dr John Greist, senior scientist at the Dean Foundation at Madison, where the computer is located. "It takes them through an assessment process to find out the nature of the trigger for their obsessions. It is programmed with a range of 170 basic triggers, and once it has located the general trigger, it will personalise it to the caller who may hate touching door knobs, for instance. It will find out what kind of door knob causes the anxiety.

"It gives them work to take home, encourages them and helps them troubleshoot. All the things a skilled human therapist would do, we have programmed into the computer and the results have been very impressive. A number of people were so much improved they needed no further help."

After the therapy sessions have been completed, the computer posts a summary of what happened to the patient.