Surgeons look at medical instrumentation in the twentieth century: progress, problems, and prospects. Part I

To obtain expert opinions as to the great medical breakthroughs of the twentieth century and of the decade of the seventies, personal letters were sent to 683 leading surgeons of the United States and Canada. Letters lost or returned by the post office reduced the survey to 487. There were some 320 immediate responses (66%). Additional inquiries solicited by respondents brought the total to 428. The CT scanner, "computers," and biocompatible materials were the medical breakthroughs most frequently mentioned. The patterns of research and development appear to have changed from small operation of innovator/engineer/manufacturer of important devices and components to large operations embracing many sophisticated disciplines, devices, and components. The transition has been and is being expedited by voluntary consensus standards. The pattern of the late twentieth century breakthroughs is likely to extend this integrated multidisciplinary mode further. Likely areas are the dynamic spatial reconstructors, DNA engineering, artificial blood, nerve and spinal cord bridges, and new communication modes.