The nature and extent of group differences in pain tolerance according to age, sex and race were examined. The method of pain tolerance determination was mechanical pressure on the Achilles tendon, performed on 4 1 , 119 subjects as part of the Kaiser-Permanente Automated Multiphasic Screening examination. The results showed that, on the average, a) pain tolerance decreases with age; b) men tolerate more pain than women; and c) Whites tolerate more pain than Orientals, while Blacks occupy an intermediate position. When the results of this study are compared with earlier work, it appears that, with increasing age, tolerance to cutaneous pain increases and tolerance to deep pain decreases.Differences in patients' pain tolerance have been a continuing source of interest and concern to their physicians. Some individuals appear to bear severe pain with surprising equanimity, while others react to more moderate pain with apprehension and emotional turmoil.A test of pain tolerance was included in the routine multiphasic health examination of more than 40,000 subjects in the hope that the findings would be clinically useful. While the clinical value has yet to be demonstrated, rather clear-cut differences in pain tolerance according to age, sex and race were noted. These differences may reflect important cultural and biologic variability in pain reaction.

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This article summarizes the origins of informatics, which is based on the science, engineering, and technology of computer hardware, software, and communications. In just four decades, from the 1950s to the 1990s, computer technology has progressed from slow, first-generation vacuum tubes, through the invention of the transistor and its incorporation into microprocessor chips, and ultimately, to fast, fourth-generation very-large-scale-integrated silicon chips. Programming has undergone a parallel transformation, from cumbersome, first-generation, machine languages to efficient, fourth-generation application-oriented languages. Communication has evolved from simple copper wires to complex fiberoptic cables in computer-linked networks. The digital computer has profound implications for the development and practice of clinical medicine.

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A multiphasic screening program is described which uses automated equipment to provide rapidly comprehensive quantitative testing for a large number of diseases. A statistical method is used which automatically determines whether selected diagnoses are likely to be present or absent based on predetermined criteria. Screening for bronchial asthma is used to illustrate this method.

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The increasing importance of computer-stored databases for clinical research prompted a historical review of their evolution over the past three decades. The special problems associated with the computer processing of clinical research data were reviewed, and the various types of clinical research registers and databases were described.