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13. Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342:1887–1892. Pocock SJ, Elbourne DR. Randomized trials or observational tribulations? N Engl J Med. 2000;342:1907–1909. Ciccone AM, Meyers BF, Guthrie TJ, Davis GE, Yusen RD, Lefrak SS, Patterson GA, Cooper JD. Longterm outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J Thorac Cardiovasc Surg. 2003;125:513–525.

Ferguson 6 The Age of Information These surgical efforts in the late nineteenth and early twentieth centuries ushered in the beginning of an era of scientific investigation of surgical problems. This was a period of true surgical research characterized by both laboratory and clinical efforts. It paralleled similar efforts in nonsurgical medical disciplines. Such research led to the publication of hundreds of thousands of papers on surgical management. This growth of medical information is not a new phenomenon, however.

An example is multiple diagnoses for a single patient, or multiple patients with a single diagnosis. In addition to collection of data such as those above that are routinely generated in the process of standard patient care, new technological advances are providing an exponential increase in the amount of data generated by standard studies. An example is the new 64 slice computed tomography scanner, which has quadrupled the amount of information collected in each of the x–y–z axes as well as providing temporal information during a routine CT scan.

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A New Interpretation of Information Rate by J.L.Kelly.

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