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The Technological Configuration: Another Way to Think of Epidemiological History |
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The ICD is at each historical point associated with a particular configuration of technology. Like much modern information technology it bears traces of its past, inheriting the inertia of the installed base upon which it was built (Hanseth, Monteiro, and Hatling 1996). Computer screens tend to be eighty characters wide, an echo of the eighty columns of the preceding punch-card technology (Norman 1988). Similarly the ICD bears traces of its technological ancestry. The 200 headings restriction inherited from the census forms is the most obvious physical example. Both the form and the implementation of the ICD have been influenced by development of information processing technology. For the former, Blois (1984, 124) remarks that the use of numeric codes in the ICD was directly attached to the development of punch-card technology. As an example of the latter, in the United States coding of more than the single underlying cause of death was a failure before 1968 despite repeated attempts. Such coding became standard when an automated computerized system was implemented for the selection of the underlying cause of death (Israel et al. 1986, 165). |
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Tracing the imbrication of the technological configuration and the form and use of the classification system, the history of the ICD attaches directly to the development of information processing technology this century. The story begins in the nineteenth century, with the rise of large-scale bureaucracies. This development is still under-explored by historians, but one consensus that appears to be emerging is that insurance companies, banks, railway companies, the post office, and the government were at the heart of this development (Chandler 1977, Yates 1994, Campbell-Kelly 1994, John 1994, Friedlander 1995, Bud-Frierman 1994). As companies began to operate over a very large space (railway companies simultaneously created that space and operated within it), a need arose to share information on a standardized form. A mechanical punched-card technology was developed for storing and sorting large quantities of tabulated information. A hole punched on a certain row of a certain column of a card could mean whatever one wanted it to mean: and cards could be mechanically sorted. Among the first applications of this technology was the use of the Hollerith tabulators for the American census in 1890. Without this aid the information gathered at this census would have taken longer than ten years (the period between censuses) to sort using the old methods. |
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