Cheap Blood Clot Detection Device

Gearoid_Murphy writes "The BBC details the news of a cheap handheld device to detect blood clots on the surface of the brain. The device uses infrared light to penetrate 3 cm into the body; light that has passed through clotted blood changes detectably. A doctor who is testing the device in India said, 'We found a 98% accuracy for showing blood clots or haematomas.'"

Woah..

[Thyrteen (1084963)]

I have a feeling that some surgeons will be sleeping alot better post-operation when they can monitor something like this more effectively.

Star Treknology

[reporter (666905)]

Increasingly, actual technology is converging toward technology fantasized by Gene Roddenberry. This scanner for blood clots resembles the tricorder often used by Dr. McCoy or Mr. Spock.

What's next? Warp drive [slashdot.org]?

Re:

[Anonymous McCartneyf (1037584)]

Let's hope this thing works like McCoy's medical tricorder, rather than Dr. Beverly Crusher's.

Re:

[dwater (72834)]

> Hey, isn't it true sci-fi comes up with what science goes on to create?

I don't think so, though I'm usually wrong. Engineers (try to) create things; scientists (try to) explain things.

Re:

[ScrewMaster (602015)]

Surgeons will go for the CT scan every time. It costs more.

And provides a lot more information than this handheld gadget can. Given a choice, I'd opt for some real imaging rather than a high-tech studfinder.

Re:Woah..

[Thyrteen (1084963)]

Although the CT Scan would be useful, you need to remember. Your friend has a brain tumor. They operate, and remove it successfully, and close the opening. At this point, you wait, and pray that there's no clotting. Perhaps if this probe could be attached (I don't see why not), for a night after surgery, if clotting starts, the surgeon could get a much faster start on the patient, rather than waiting for "symptoms" to occur. A CT Scan can be useful in determining a problem, but the constant monitoring is useful for a separate scenario.

Re:

[ScrewMaster (602015)]

Very true ... kind of like the Holter and cardiac event monitors they use for heart patients.

Errr...

[by Anonymous Coward]

I don't entirely agree...

Aside from the fact that a lot of the time, we're more worried about post-op *bleeding* (which we'd see on CT) than simple clotting, I'm not sure how you'd tell appropriate clotting from dangerous clot, *except* through monitoring symptoms. Its not the clots after surgery that are dangerous, but when the clots are in areas that suffocate healthy tissue (ischemia).

And a CT looking for new infarct would be useless. An MRI might help, but not a CT.

And, yes, IAAD.

Re:

[Anonymous McCartneyf (1037584)]

So they actually do trepanning in England?

Re:Woah..

[clickclickdrone (964164)]

Well, India, rather than England but if it does the job... Heck in the UK they still use leeches c/o the NHS and it's not uncommon to use maggots on badly infected wounds because they eat the bad stuff and leave the good stuff far better than any other treatments. Just because something sounds medieval, don't write it off.

Re:Woah..

[TheLink (130905)]

The wait for a CT scan could be too long. There can be far more of these devices than CT scanners.

This will help determine if patients need immediate attention.

As long as the false positive rates aren't high and this device is sensitive enough to detect the common cases, it will be useful.

Re:

[Silver Gryphon (928672)]

Since the CT scan is expensive, time consuming and often has an hour-long wait even in emergency rooms, they now use the CT scan only if they are fairly certain there's a problem and are often discouraged from doing more than one a day on a single patient. A device like this could be used like the O2 Saturation monitors or cardiac monitors: preventative, non-invasive and don't require scheduling of the million-dollar equipment.

I can see this tech being used some day to detect clots in legs, arms, etc.

Re:

[jamesh (87723)]

What are the running costs like on a CT machine? If the thing has a high utilization anyway then it's a moot point, but if the ROI depends on how much it gets used, wouldn't it make sense to use it as much as possible? Of course if it costs an extra 100k or something per scan then it isn't such a sensible idea...

Re:

[Ihlosi (895663)]

Had one about six weeks ago. Cost...something like seven grand, including scan, interpretation, etc.

Was that in the US ? If so, then maybe the insurance companies over there should think about sending the less urgent cases on an all-expenses-paid vacation to Europe that includes the MRI scan. It'd save them a whole lot of money. Maybe they can even include a business class flight, too.

Re:

[clickclickdrone (964164)]

Yup - I had a CT scan a couple of years ago - the bill was ISTR about £800.

To stem the statistical comments:

[cgenman (325138)]

Inevitably someone is going to say "Well yeah, that means 2% died. Rough lot of good that did them."

Before that person is you, think of the 98% that lived. I bet they're pretty happy that their chances of detection and survival went way up. And if you were sitting on an operating table in rural India with a poorly underfunded doctor wondering what's going wrong with you, wouldn't you like to take those odds too?

Re:To stem the statistical comments:

[pytheron (443963)]

To put statistics into perspective, you need to consider the following (for arguments sake).
Say 98% lived with this new tech. What percentage lived without it ? Maybe 94%. You can't infer that the previous methods of detection/avoidance were mediocre just because the new method has a high success rate. The article certainly gives no comparisons.

Re:To stem the statistical comments:

[Repton (60818)]

I'd also be interested in the false positive / false negative rates, and the overall rate of blood clots.

Eg, suppose 1 in 10 patients develop blood clots under some circumstances. You could get a 90% accuracy by making a device that just reports "No clots" every time. If you're classifying 98% of clots as clots and 98% of nonclots as nonclots, over 1000 tests you'll have 98 blood clots correctly identified, 2 missed, and 18 nonclots misclassified as clots..

(obviously I have no idea what the true rate of blood clots is)

Of course, the engineers who made the device and the scientists who test it almost certainly know all this, so I'm not being particularly insightful. If they call it a breakthrough or think it will be useful, then they're probably right. We just can't tell either way from the article...

("Mainstream news article lacks useful details: film at 11!")

Re:

[by Anonymous Coward]

In fact, they are using CTs to confirm the diagnosis...so the implication is that the hand held device is missing 2% of the cases that the CT is catching...at a great cost savings (what was that speech from fightclub about the recall formula?)...that might be the reason why the device isn't cleared for use in the states.

Re:

[by Anonymous Coward]

In developing a new technology, it's common to compare it's performance to the current 'gold standard'. Also, the device doesn't have to be perfect to be useful. It could be used as a first pass, and then a subsequent CT scan could be done on the patients that get a negative test result. It would be nice if the article gave the sensitivity and specificity so we would know what makes up its '98% accuracy'.

Re:To stem the statistical comments:

[fukitznukin (1088811)]

The other way to look at it is to compare infrared to the current modalities. For example, MRI which provides very sophisticated images, picks up 96% of brain injuries including blood clots. However, this is a very expensive test and is time consuming. In my hospital, I can get a STAT MRI and a radiologist's report in 1-2 hours. If it's after hours, a team has to be called in to do the test and then you can add at least another 45 minutes. Infrared testing on the other hand is a bedside test that can be done very quickly and inexpensively. From a general perspective, 98% is not just adequate it is much better than most tests used in medicine. An EKG that is done for heart attacks for example can miss up to 50% and most people are relieved when they are told that the EKG is normal. 98% accuracy is almost unheard of in medical testing. The term accuracy includes the effects of false negatives and false positives so 98% accurate does not necessarily mean that 2% of the true positives are missed, the test could be picking up all the true positives but also some false positives (it overcalls the number of abnormal test results). Additionally, a test that is 98% accurate does not mean that 2% of the people die unless of course you are referring to a uniformally fatal disease of which blood clots on the brain do not belong. A subdural hematoma is one type of blood clot on the brain and its mortality is about 60%. Additionally, if you think about it, the 2% of blood clots that are going to be missed (let's say the miss rate is 2%) will be the smallest 2% of the blood clots and therefore the least lethal. Yes, size does matter when it comes to blood clots on the brain.

Please mod parent up

[cgenman (325138)]

My original comment was made with broad generalizations in an attempt to counterbalance the lack of perspective on medical percentages that many people seem to exhibit. On the other hand, parent appears to actually know something, so please mod him / her up.

You don't understand, grasshopper

[Moraelin (679338)]

You don't understand the accuracy complaints, grasshopper, and proceed to bravely fight (maybe involuntarily) a complete straw-man that exists only in your imagination. Remember: just because you don't understand something, doesn't mean everyone else is an idiot. It just means you need to get some more data, and maybe engage the brains.

The complaints about accuracy are for cases where the false positives are (A) a lot more than the new positives detected by the new method, and (B) the consequences for a fal

Company Website...

[appleguru (1030562)]

http://www.infrascanner.com/ [infrascanner.com]

Looks like they're based in PA, USA... But due to US regulations, they aren't allowed to test the device on patients in the US, and have outsourced such clinical testing to India.

Re:

[Reader X (906979)]

One wonders what other such testing is 'outsourced'...

Re:Company Website...

[maxume (22995)]

The bastards, sending a device they believe will work to hospitals with no alternative just because there is less government interference. I bet they kick puppies too.

Re:

[hazem (472289)]

he bastards, sending a device they believe will work to hospitals with no alternative just because there is less government interference.

Ever see the movie Constant Gardener?

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[alienmole (15522)]

the device is not dangerous(or at the very least, is incredibly unlikely to be dangerous)

An infrared beam that penetrates 3 cm, through the skull? I could imagine that being dangerous. For example, it might have enough energy to damage tissue. I assume that they've tried to rule that out, but sometimes the messy reality doesn't match the theory.

My reply was a snipe at the first poster, specifically because there really isn't any reason to bring in that particular rant in this thread;

If you're not fam

Re:

[zippthorne (748122)]

You assume it penetrates 3cm because of high power levels. It's entirely possible for the skull to be transparent enough at the frequencies they are using that not much power is needed at all. Perhaps not much more than the amount received in those bands from natural sources.

Though the specific power levels are not mentioned in TFA, the fact that it's a handheld device and requires a shroud lends credence to that idea.

Re:

[fuego451 (958976)]

You really have to wonder what the FDA's motivation is for not allowing at least experimental use of this device in emergency settings, along with other accepted practices, to measure its effectiveness. Is there a genuine concern for the patients safety? The device certainly seems harmless enough.

Ever the cynic, I would guess that the device and the procedure are relatively inexpensive and all parties involved are working out how best to monetize (god I hate that word).

Re:

[camperdave (969942)]

The device certainly seems harmless enough.

I don't know... If they can shine IR through a skull, bounce it off of a blood clot, and back through the skull, it's got to be fairly "bright". That's something like 2cm worth of bone that the light is shining through, and it's not like human skulls are made of crystal.

Doctor who?

[thorgil (455385)]

In other news...

Doctor Who spotted in India! /T

I wonder

[Disharmony2012 (998431)]

If this thing will be common I HATE MRIs but, I've been having massive headaches during and after sex. and yes I will wait, because I know the MRI tubes read my mind everytime go into one, and they won't let you bring a tin foil hat.

Re:I wonder

[j79zlr (930600)]

I've been having massive headaches during and after sex.

Its called guilt, you shouldn't masturbate that many times a day.

Re:

[linguizic (806996)]

Ah yes, the instinctive reaction by nerds that posting on /. and getting laid are mutually exlcusive.

Damn straight!! I'm getting laid right no-o-oh, oh oooh yeah!

Re:

[Ihlosi (895663)]

Especially not in an MRI machine.

I heard people with claustrophilia get kicks out of that.

A marvelous invention!

[Cathoderoytube (1088737)]

I have to say as a blood clot sufferer this invention sounds great. For those of you who don't know the previous means for checking for blood clots was to drain out all the patients blood and let it settle, then the doctors would count the blood clots floating on the surface. On one occasion my doctor accidently dropped his pen in the vat, then he tried to fish it out. I went completely spare and told him if he expected to put that blood back in me after he'd been sloshing around in it he had another thing coming.

The Slashdot blood test

[by Anonymous Coward]

for your insensitive clots.

How it works

[c_fel (927677)]

Hemoglobin has a different absorption spectrum when it's oxygenated (oxyhemoglobin) or not (desoxyhemoglobin). An interesting characteristic of this spectrum is observed in the near-infrared part or light (700-850nm): http://omlc.ogi.edu/spectra/hemoglobin/index.html [ogi.edu]

In the infrared part, oxyhemoglobin absorbs less light than desoxyhemoglobin ; it's the contrary in the red part. So if we shoot these near-infrared wavelengths (and some more, to get a good idea of the absorption spectrum) in the head and detect it somewhere else (around 5-6cm from the source), we can get information on the concentration and oxygen level of the hemoglobin in the middle of the emitter and the detector. If the hemoglobin is more present than somewhere else in the head, and it's less oxygenated than usually, we get a good idea that there's something wrong there.

Other advantages : infrared light is non-ionizing, so it's absolutely no dangerous to use that kind of instrument continuously on a person until we are sure there's no problem.

It's brilliant and I'm glad to see that kind of instrument emerging.

Re:

[nanosquid (1074949)]

infrared light is non-ionizing, so it's absolutely no dangerous to use that kind of instrument continuously on a person

A kitchen broiler is also non-ionizing radiation, but I suspect using it "continuously" on someone's brain is not such a good idea.

Re:

[clickclickdrone (964164)]

I suspect if your brain is filling up with blood and the nearest CT scanner is either next town or at the end of a 2 hour waiting list then you'll be pretty damned glad to have a hand held diagnostic that can be used in seconds, even if there was a small risk either from it's method of operation or success rates.
Everyone here seems to be looking at the products value in terms of the US medical industry which is a very different thing to the rest of the world. The US model is incredibly expensive but also h

Re:

[Ihlosi (895663)]

I suspect if your brain is filling up with blood and the nearest CT scanner is either next town or at the end of a 2 hour waiting list then you'll be pretty damned glad to have a hand held diagnostic that can be used in seconds

The problem is - you'll still need to find an available OR with the corresponding OR team and a neurosurgeon. They're usually where the nearest CT scanner is and have similar waiting lists.

Re:

[clickclickdrone (964164)]

The problem is - you'll still need to find an available OR with the corresponding OR team and a neurosurgeon

No, your missing the point - stop thinking US medicine practicies and facilities. I watched the BBC news item about this. A guy came in after a bike crash. At the side of the bed they scanned him, found a clot gave him a local, drilled a hole in his head and drained it - jobe done.
They interviewed the poor sap just hours later 'How do you feel?' (shellshocked and quiet voice) 'Better'.

Re:

[Ihlosi (895663)]

At the side of the bed they scanned him, found a clot gave him a local, drilled a hole in his head and drained it - jobe done.

Ouch.

The device probably doesn't tell you whether the bleeding is epidural or subdural. If it's the former, you _might_ be able to get away with the simple procedure you describe, but if it's the latter, you better get the neurosurgeon, and fast.

Re:

[clickclickdrone (964164)]

>epidural or subdural
Have to admit ignorence and not know the difference but if it helps, they drilled 3 holes, took out a triangular section of bone and flushed the area with a clear solution (saline?).

Re:

[nbritton (823086)]

It's brilliant.

Luminously intelligent, or radiantly bright?

Cheap?!

[quarrel (194077)]

Oi!

Who are you to call my blood clots cheap?!

False alarms?

[edsyc (1088833)]

Obviously a great development, but I wondered what the false alarm rate was. The device can detect 98% of blood clots, but how often does it say there is a blood clot when there actually isn't? False alarms could lead to costly, unnecessary surgeries that insurance (at least, insurance in the US) may not cover.

Could you scan a whole head?

[jamesh (87723)]

Could you scan a whole head with a sufficiently bright torch in your mouth? Maybe you'd need that transparent skin mod from a while back too... It's be kind of strange having your eyeballs illuminated from the back :)

I wonder if the same tech could also be used to detect DVT too? They could build it into the X-Ray machine at airports so that on the way in and out and a bell would ring if it found a blood clot in your legs (it would make sense to detect them on the way in too!)

Doctor Who?

[phozz bare (720522)]

Couldn't he have just used his Sonic Screwdriver instead?

Thanks, I'll be here all week.