The Next Generation of Medical Tools May Be Home-brewed 70
An anonymous reader writes: In the Little Devices Lab at MIT, Jose Gomez-Marquez builds medical tools using a DIY mindset. He's designing cheap alternatives to existing hospital equipment to help spread high-quality medical care around the world. Gomez-Marquez is at the forefront of a large and often-unrecognized group of DIY medical tool builders. Together they are challenging the idea that staying healthy requires extraordinarily expensive, sophisticated equipment built by massive corporations. Harnessing this inventive energy, he argues, could improve the health of thousands of people around the world.
Fluffy the feel good piece (Score:2)
If coming up with a cheap nebulizer - which costs a hospital $2.50 for the plastic bits, is the best he can do, then this isn't going to get us far. Sure, the battery powered pump costs a couple of hundred dollars retail but anyone with more than a slotted head screwdriver for a brain is going to realize that it's an aquarium pump. This is hardly the earth shattering breakthrough that TFA insinuates it to be.
The other mentioned device, a better way to extract babies from the birth canal is certainly inte
Re: (Score:2)
The main reason hearing aids are expensive is twofold
i) They need to be individually calibrated to the user's hearing loss spectrum
This means skilled audiometric testing. Skilled labour costs money in any economy.
ii) The miniaturization
In 2 generations hearing aids have gone from a cumbersome box you carry around on a strap, to something that sits behind your ear, to something that sits in your ear.
The box type could be built very cheaply now. You could probably write a smartphone app that did a reasonable
Re: It's time to DIY a hearing aid (Score:2)
I would expect that you could also write an app that did the stereo hearing frequency response test (and I see a bunch are available). And you could combine the two apps.
Re: (Score:2)
Boy, the FUD on this one is going to be impressive.
Tell me, if its your baby who cannot get treatment with a nebulizer because multi-thousand dollar 'certified' equipment is not
affordable, when $50 of parts would do the job perfectly well, will you feel the same? Welcome to the lives of a good proportion
of the worlds population.
Of course that doesnt apply to YOU right? to fuck em.. let them watch their children die.
MIT should convert themselves to another business school and turn out more MBAs!
Re: (Score:2)
well how would you feel if you got something nasty because the doctor in the village was being creative with sharing needles?
the multi million dollare equipment isn't usually used to "keep healthy", it's used for getting healthy after getting something that would kill you.
Re: (Score:2)
Re: (Score:2)
If coming up with a cheap nebulizer - which costs a hospital $2.50 for the plastic bits, is the best he can do, then this isn't going to get us far. Sure, the battery powered pump costs a couple of hundred dollars retail but anyone with more than a slotted head screwdriver for a brain is going to realize that it's an aquarium pump. This is hardly the earth shattering breakthrough that TFA insinuates it to be.
It is obvious that you find it all too easy to sneer, but the big point he is making, as far as I can see, is that a serious lot can be achieved with relatively simply means, if you have the necessary insight and a bit of creativity. Nowadays too many people are blikered into thinking that we can only ever do anything at all with high technology; one of my favourite examples of the idiocy of this sort of viewpoint comes from the simple act of shaving. Not long ago people would use a straight razor - basical
Re: (Score:2)
The safety razor was a rather important invention (invented quite a while ago). Shaving with a straight razor requires skill, is more dangerous, and keeping that razor sharp requires more skill, time, and equipment. Safety razors took over pretty quickly because they're a lot more convenient. I don't know whether the modern multi bladed ones are better than single bladed ones, but I wouldn't call that "technology." It's just marketing.
Re: (Score:2)
I got fed up with the 4 and 5 blade contraptions as well, and went back 'old school' with a safety razor, soap, and boars-hair brush. Didn't go full old school with the straight razor - that does take too much time to keep sharp, and some time to get skilled with it. The safety razor though is great - blades are maybe 4 cents a piece - I can buy 'em in hundred packs.
Try it - you won't look back.
The one advantage modern razors have though is that you have to really really try hard to cut yourself. The saf
Re: (Score:2)
The example of the nebulizer was ridiculous. You can buy a full nebulizer for home use for under $25. [google.com] As others have stated here, the pump is just an aquarium pump. The bit that makes it a nebulizer is the little plastic parts that pump the air through the medicine. The "DIY inventor" didn't replace that bit, he just replaced the air pump.
Re: (Score:1)
Re: (Score:3, Funny)
I've had cancer and I've drank carrot juice - it's a close call which is worse.
Yes!! (Score:1)
This is something I could totally support.
Re: (Score:2)
On a Computer, Online, In the Cloud!
Synergy!
Ok, I'm all buzzworded out...
Re: (Score:2)
You both forgot "open."
He's partially right (Score:5, Informative)
Hi! Medical equipment designer here for several companies. He's partially right. It often doesn't take expensive equipment. Soap is a good example. And EMT's can do wonders with a 14ga needle.
However, to sell equipment in the USA and many other countries takes extraordinary amounts of validation testing. Lot's of documentation and proof. I won't even bother with the list, but check out CFR 21 for a taste. That extra work takes time and money. And that's where the first layer of expense comes from in our medical system.
If you're willing to dump the safety requirements corporations must follow, you can do things a lot cheaper.
Re: (Score:1)
Reminds me of the Zuckerburg Evaporation. "Everyone gets paid but Tyrone still can't read."
Re: (Score:2)
Re: (Score:2)
So if they can't see a doctor or get to a clinic, just what do you plan on putting in the little chamber? Tea? (actually might work with the xanthenes being bronchodilators). You just don't treat asthma by waving the nebulizer around.
Re: (Score:2)
The drug most often used, salbutamol [evidence.nhs.uk], is a dirt cheap generic, you can get get 20 x 2.5 mg nebuliser vials for around £2 ($3)
Re: (Score:2)
Incidentally, if there are any Yanks reading : the British National Formulary [evidence.nhs.uk] is an excellent reference for just how hard you're being shafted by your medical industry ; the prices listed are what the NHS pays for these drugs.
A 200-dose inhaler of that stuff costs £1.50 ($2.30) - I hear it's more like $100 in the states.
These are the prices you can get if you have a single-payer healthcare system negotiating on your behalf. Socialized medicine, the great evil!
Re: (Score:2)
Too true.
We don't have legislation capping drug prices AFAIK - our relatively cheap prices come from the power of having that single payer. If you have to choose between serving a market of 65 million people in one of the richest nations on Earth, and not serving that market, you're prepared to compromise a little on price.
It also helps that we have a blanket policy of using generic vs brand named drugs where possible, and we also have a body who's job it is to rate the effectiveness of treatments - we don'
Re: (Score:2)
Yeah. Good thing you guys talked yourselves out of public health care. Keep up the good work!
Re: (Score:2)
Re: (Score:2)
Many companies sell, either of their own volition or through government encouragement, to the third world for steep discounts already because there's less risk of being sued and for humanitarian reasons. It's naive to look at what a hospital in the US charges their customers (er, patients) and think that's what someone in the third world has to pay.
No, you are wrong.. (Score:5, Insightful)
Of course the party you either fail to appreciate, or dont want to mention is that the regulations are strongly supported by the incumbents.
It created a very artificially high gateway to entry for competitors, while the cost of maintaining it is well covered for the current manufacturers
who use it as a way to charge artificially high profit margins in the name of 'safety'. Many of the regulatory requirements have been actively
created BY the manufacturers..
This is of course how almost all of the medical industry operates, certainly not just the manufacturers.
The natural reaction to this is of course a black market in affordable 'medicine' for people who just cannot afford to take that ride. Unfortunately
the US has just taken the opposite tack by trying to 'spread the load' instead, continuing to fuel its insane medical inefficiencies, and to continue
to maximise profitability for medical related companies. What a surprise.
If you really think that top quality medicine costs that much, then I suggest you visit South Korea... Their private medical services are very high
grade, and cost much, much less. Their fault rates are also lower..
The fact is that a lot of diagnosis (and other) equipment is cheap to make these days, and is not directly a safety threat to patients. The medical
system however does not want large price drops in one area, as they are worried at all levels that it may tip the scales and their own gravy trains
may get tipped..
Re: (Score:2)
Have you tried to meet with the FDA and get a medical device approval started? It's not hard. It's free to meet with the FDA and there is a ton of grant funding out there for exactly the kinds of clinical trials required here. The barrier of entry argument is an illusion if you actually know what you're doing. The FDA isn't going to do your study design for you, and the NIH isn't going to give money for a poorly defined set of experiments. In my experience, very few people even try to do this. That's j
Quick question (Score:4, Interesting)
Aircraft instrument designer here, I've got a quick question for you.
Avionics certification require a lot of paperwork and documentation as well (DO-178B [wikipedia.org]), but my impression is that it's mostly "paperwork for the sake of paperwork".
The FAA makes a big deal about things which have no impact on safety, make a big deal about things that have little impact on safety (coverage analysis), and leave the device testing completely in the hands of the manufacturer.
In short, if you have a process and paper trail, you can get certification. The aircraft manufacturer is the one that actually requires safe design practices, and this is lateral to the certification process.
Is it the same in the medical world? Are the requirements mostly about paper trails and accountability, or are there some actual safety regs there? What proportion is about safety?
For example, we hear all the time how medical devices have no security, that they can be easily hacked, pacemakers can be reset in the wild by a hacker, and so on. Is device security not part of the regs?
(I complained about the lack of common-sense safety regs in the FAA, and was told that it's bureaucratic safety, not human safety. The FAA people want deniability of blame, so they worry about procedure and regulation rather than actual safety.)
I wonder how much of the effort actually goes into making a safe device. The FAA system is still stuck with 1970's guidelines for software safety, for instance, and has never updated with modern theory. (I could give you a list...)
So... how much of the medical certification process actually keeps us safe?
Re: (Score:1)
Well, we can complain about the FAA all we want, but I can't remember the last last time there was a serious airline wreck in the States. As for medical tools, it's too bad the Snap On truck doesn't have any.
Re:Quick question (Score:4, Insightful)
Well, we can complain about the FAA all we want, but I can't remember the last last time there was a serious airline wreck in the States.
I think that's a false association. You might just as well say "well, my anti-tiger rock seems to be working".
I've already noted that it's the aircraft manufacturers who ensure safety, at great expense and effort in addition to the certification process.
Considering the expense of certification and that it's largely needless, don't you think the expense and effort should be directed towards a more useful goal? At the least, don't you think the regs should be changed to encourage safety?
And from a completely economic perspective, since the cost of compliance is so high, are useful solutions which would make us safer being ignored because the price of entry is so high? (For the longest time there were no updated Cessna designs because they couldn't afford the certifications. The older designs went for *decades* without modern updated electronics.)
I complain about the FAA because their system is worthless. You support them because their pointless system hasn't caused an accident.
Your anti-tiger rock could be put to better use.
Re: (Score:1)
You support them because their pointless system hasn't caused an accident.
Their 'pointless' system has prevented many accidents. You, as a direct beneficiary, don't know what you are babbling about. Their 'pointless' system has made flying safer than going upstairs to take a piss.
Re: (Score:1)
Is it the same in the medical world? Are the requirements mostly about paper trails and accountability, or are there some actual safety regs there? What proportion is about safety?
Yes, it is the same. The be all and end all is that you can point at a pile of documentation and you are all good. The actual regs are very light on details, and device security is simply not a consideration in most instances. When tasked as part of a team creating a new medical device I was extremely disappointed to discover that all that was necessary was to produce lots of documents that referenced at each other, ultimately pointing to a competitors device already on the market and saying "our is like th
Re: (Score:2)
Re: (Score:2)
This paperwork for aircraft instruments is not just for the sake of paperwork. There is a huge market for counterfeit aircraft parts.
Re: (Score:2)
Ah, I see. Thank you for the explanation.
I agree with you, for safety critical parts it is definitely important. Shoddy construction has often enough led to bad accidents.
Re: (Score:1)
Re: (Score:2)
The medical industry has both. There's a lot of paperwork for accountability and traceability, but most of the expense, at least for new things, is directly related to safety and efficacy. It's relatively easy to test whether airplanes fly or not, and you can test safety and reliability without exposing airliners worth of people to danger. You can't do that with drugs and medical devices - you have to test them for efficacy on lots of actual people.
The regulatory agencies have a lot of catching up to do
Medical devices are not going to be routinely HB (Score:2, Insightful)
A lot of tools in medicine are initially built as one offs, effectively home built. However, when dealing with medicine the controls are simply not good enough. When we build and test a medical device, it takes rigorous testing to know how it will interact with patients and other devices/ medicines. Home built devices simply are not consistent enough to be able to keep things within allowable guidelines. It is bad enough that unrelated symptoms get reported under current practices, but homebuilt would make
that sort of works (Score:1)
When someone's computer breaks, they bring it in to my shop with a list of symptoms, error codes, etc and then I fix it. That
Re: (Score:2)
When I go on WebMD or wikipedia, I always apparently have a rare jungle disease or cancer based on my symptoms
Well, yeah, a huge number of illnesses include symptoms like elevated temperature, sore throat, muscle aches, fatigue, etc, since that's how the body reacts to nearly anything that goes wrong internally. I'm hopeful that expert medical diagnostic systems will eventually be able to improve on patient diagnosis.
Re: (Score:1)
What amuses me is that most medical conditions and illnesses that laymen are told that they have are just Latin language translations of the symptoms. Once you understand that, when a doctor pronounces that somebody has a particular 'illness' you just say 'duh, yeah, tell me more than the symptoms.'
Re: (Score:2, Insightful)
Too bad that MRIs don't cost $10 million. More like $1 million. That is a lot but they are very, very complex devices.
And yes, people care. And yes, there is graft, greed, avarice, blackjack and hookers but it's a pretty complicated problem. So complicated that even the vaunted European social democracies (the ones with the 'free' healthcare' are scratching their heads trying to figure out how to afford everything.
Blow into a paper bag for a while and quit hyperventilating.
Re: (Score:2)
even the vaunted European social democracies (the ones with the 'free' healthcare' are scratching their heads trying to figure out how to afford everything
As a citizen of the democracy with the "best healthcare system in the world [commonwealthfund.org]", (the UK NHS) we already worked out how to afford everything - have a single-payer system that can negotiate a sensible price, and don't waste money on all that insurance bureaucracy.
We spend less than half what the USA does, and get better outcomes.
The problem is that the medical-industrial complex has worked out that obviously, people are willing to spend a lot more, and have contrived with our politicians to try and destroy the
As long as we're not talking firmware (Score:1)
I'd hate for the crapfest that is forked software patches to intersect with modern medicine.
"Quick! Install the patch for OpenSSL before your pacemaker crashes and YOU DIE."
"Nah, you need version V1.2.003, Barney patched it last night."
"It doesn't work on HealthSmart devices, for that you need the unapproved fork from SuplexNet, there's a binary from three months ago that might be compatible with your web frontend but it might break the audio. There's a few issues there. Don't mind the corruption on the gra
made at MIT means it's not cheap (Score:1)
When your facilities and equipment are free, your materials and labor are heavily subsidized, and you don't factor in legal or accounting overhead, it's really easy make cheap stuff!
How expensive would it be to attract the talent an MIT lab attracts for free? How much would it cost to build similar facilities, hire the same quality of administrative staff, hire equivalent IP lawyers, have the same legal and insurance freedom to operate, have the same quality accounting tools...
If it's at MIT (or some place
Re: (Score:1)
Staying Healthy (Score:2)
"staying healthy requires extraordinarily expensive, sophisticated equipment"
Not all the time, but for the most part 'staying healthy' requires eating sensibly and exercising.
And, yes, that can be 'home-brewed'.
Obsidian Scalpels (Score:2)
Someone I know had to go in for basic hernia surgery. However this person was an avid flint knapper. He asked his surgeon if he could furnish obsidian blades for his scalpels since obsidian, when fractured properly, creates a edge just a few atoms thick, far thinner than the sharpest steel blade. The result is a perfect cut that leaves very little scar tissue, and no perceivable scar.
I don't know why there isn't a bigger obsidian scalpel industry.