Sidney M. Baker, MD*

This commentary reflects on the attachment of the word “spectrum” in the past decade to autism, a disorder with etiologies that have, in previous decades, been uniquely controversial – leaving parents to float between various medical opinions. Spectrum is an apt metaphor for medical thinking in which the individual, not the disease, is the target of treatment. Its use may, however, deprive patients and parents of the security offered by the conventional notion of a well defined “disease entity. ” The spectrum metaphor will serve medical language’s aim of precision if information technology can endow its spatial meaning with detail, accuracy and structure. When given place and proximity patients’ narrative and laboratory descriptions provide patients, practitioners, and researchers a collective instrument – a “macrosope” – for letting the data talk about etiology and options for treatment. “Autism Spectrum Disorder” (ASD) has entered common parlance over the recent decade. Parents of newly diagnosed children feel that their child is more lost than found by a term, spectrum, that lacks the precision of a diagnostic entity. For physicians and scientists ASD’s spatial reference of “spectrum” may call attention to our lack of a system of scientific notation for capturing the many details that may be passed-by in the rush to the terminal branch of the differential diagnosis tree. Those details of medical narrative provide the basis for giving each patient a point in a conceptual space. That space differs from traditional nomenclature of disease by inviting information technology to find new ways to capture, store, analyze and report the patient’s story. The author describes an invention and its application in a web-based system, Autism360.org. The system functions as a “macroscope” revealing patterns that answer questions we might not otherwise know to ask. As such it fits within the model of what has been called Fourth Paradigm Data Intensive Science and offers the potential for integration with laboratory data and expansion to practice and research in all chronic illness.

Key Words: autism spectrum disorder, fourth paradigm data intensive science, autism spectrum disorder, fourth paradigm data intensive science, medical information technology, patient-entered data, anonymous medical record

Sidney M. Baker, MD*
71 Ferry Road, Sag Harbor, NY
*Corresponding Author: 71 Ferry Road, Sag Harbor, NY 11963. Tel: 631-725-9547. (Email: sidneymb@gmail.com)

CONFLICT OF INTEREST
None.