Big Data in the 1800s in surgical science: A social history of early large data set development in urologic surgery in Paris and Glasgow

Abstract

Big Data'' in health and medicine in the 21st century differs from ''Big Data'' used in health and medicine in the 1700s and 1800s. However, the old data sets share one key component: large numbers. The term ''Big Data'' is not synonymous with large numbers. Large numbers are a key component of Big Data in health and medicine, both for understanding the full range of how a disease presents in a human for diagnosis, and for understanding if one treatment of a disease is better than another treatment or better than just leaving the patient on his or her own without therapy. In this paper, we examine the first considerations of Big Data in medicine in Paris in the early 1800s when urologic surgeon Jean Civiale collected the first large numbers. Civiale collected the large numbers to defend the efficacy of his urologic instrument, the lithotrite, and the surgical procedure he developed, lithotrity, for the removal of bladder stones compared with earlier, more invasive surgical approaches. We examine how large numbers were adjudicated in social decision-making in the Académie des sciences, Paris, when a dispute arose among French urologic surgeons about the importance of large numbers in surgical science. After Civiale's successful defense of his instrument and procedure in Paris, we examine how his approach to Big Data (large numbers) impacted data collection by George Buchanan in his use of the procedure at the Royal Hospital Infirmary in Glasgow.

Operating list composition and surgical performance

“…There is the potential for large routinely collected clinical data sets to improve healthcare delivery. More specifically, systematic and statistical examination of operating records could provide novel insights into surgical practice. Given that operating theatres are one of the costliest elements of a hospital, these advances present important new opportunities for understanding how to improve surgical quality and efficiency.…”