Dr Lee B. Lusted died on February 7.

1994, after a valiant battle with cancer of the upper

respiratory tract. Born in Mason City, Iowa, he received his BA degree from Cornell College,
Mount Vermon, Iowa, in 1943. After studying physics at Harvard Graduate School,
Cambridge, Mass, he received his MD degree from Harvard Medical School, Boston, in 1950.
Lee then served a residency in radiology at the University of California Hospitals, San
Francisco, and spent a year working with Dr Robert Stone. He then served as assistant
radiologist at the National Institutes of Health (NIH), Bethesda, Md, during which time he
chaired the NIH committee responsible for the establishment and funding of the initial
University Medical Computing Centers. In 1959, in collaboration with Dr R. S. Ledley, Dr
Lusted authored their seminal paper Reasoning Foundations of Medical Diagnosis. After
several rejections, the article appeared in Science. Introduced in that article were concepts of
symbolic logic and probability, not methods in general use at that time. From 1959 to 1962,
he was on the faculty at the University of Rochester, NY, in radiology and biomedical
engineering.
Dr Luted then joined the Oregon Regional Primate Research Center, Beaverton, for about 5
years and had a series of papers published on computers in radiology and on logical analysis.
He then developed applications of signal detectability theory to diagnostic radiology, resulting
from analysis of false-positive and false-negative interpretation of chest radiographs for
tuberculosis. As he describes it, Signal detectability theory is a thoroughly Bayesian theory
that I introduced into medicine... In 1948, his major work Introduction to Medical Decision
Making was published.
From 1969 to 1978, he served as professor of radiology and vice chairman of the Department
of Radiology at the University of Chicago, III. During this period, he was able to show that
the false-positive to false-negative performance curves were realized to be receiver operator
characteristic (ROC) curves. This concept was incorporated into the idea that an abnormal xray image or abnormal medical manifestation could be considered a signal analogous to a
radar signal. With the help of Ward Edwards, a distinguished Bayesian psychologist, signal
detectability was translated into more general Bayesian language and into medical decision
making. These observation were supported experimentally and resulted in a long series of
articles that involved ROC analysis under the direction of Charles E. Metz, PhD, and his
colleagues.
In 1970, Dr Lusted became the chairman of Committee on Efficacy Studies for the American
College of Radiology. Its goal was to minimize use of unnecessary radiography for the
protection of the public health. A formal definition of efficacy was developed and is used to
this day.
Dr Lusted was most anxious to formalize the development of medical decision making by
forming it into a discipline unto itself. With help from the Bureau of Radiological Health,
Rockwille, Md, he and I convened an inital interested group in 1976. The Society for Medical
Decision Making was incorporated in Ohio in 1979. The journal, Medical Decision Making,
was first published in 1981, with Dr Lusted as its first editor, a position he held for 5 years.
In addition to the academic appointments noted above, he was chairman of radiology at the
Stritch School of Medicine at Loyola University, Chicago, III, from 1968 to 1969. He served
as professor of radiology at the University of Oregon, Eugene, from 1962 to 1968. He was
clinical professor of radiology at the University of California, San Diego, and adjunct
distinguished member of the Department of Academic Affairs and Department of Radiology,
Scripps Clinic and Research Foundation, La Jolla, Calif, beginning in 1978. He received the
honorary degree of Doctor of Science from Cornell College in 1963. Dr Lusted served as
historian for the Society for Medical Decision Making from 1985 until his death. The Lee B.
Lusted Student Award given by that Society was initiated in 1985 and continues today.

We may ask: What were the unique characteristics and the great contributions of Dr Lee
Lusted? In preparation for his career, he was solidly grounded in biophysics, mathematics,
and engineering. His 2 years at he NIH amplified his earlier experiences and led to that
seminal paper. In 1960, he was appointed charman of the NIH Advisory Committee on
Computers in Research and was able to stimulate the rapid expansion of the use of computers
in medicine. When one contemplates today that computers have entered and in many ways
control all aspects of the radiologic sciences, it is valuable to recognize the vision of Dr
Lusted.
During his entire career, Dr Lusted utilized all of the contacts and experiences that he had
developed to integrate medical decision making into the general framework of medicine, thus
providing him with his unique outlook for establishment of these essential techniques for
analysis of new proposals. In this current period of intense instrospection as to the future of
clinical practice, the principles and methods first developed by Dr Lusted are a key in the
determination of the applicability of guidelines and patterns of care. The entire career of Lee
B. Lusted can serve as a beacon for the paths of future radiologists.
He is survived by his wife, Winifred, two sons; and a granddaughter.
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Eugene L. Saenger, MD