I've been researching diagnostic medical equipment a lot recently, and it seems like the biggest barrier to homebrew medical diagnostic equipment is attitudinal. Discussion about building your own equipment are almost immediately sidetracked by FUD about how dangerous it is.
Proper medical devices have loads of safety features! They have isolated power supplies! They are tested in harsh environments! They fail in a predictable manner! There are regulations that need to be followed! New devices are still expensive because they are better!
Yes, electricity can kill you.
Yes, improper medical advice can kill you.
Yes, malfunctioning diagnostic equipment can lead to an incorrect diagnosis, which, yes, can kill you.
Yes, medical regulations exist and protect us from harm.
While a homebrew machine would not be able to compete with the latest and greatest, I'd hazard that even rudimentary diagnostic equipment could save thousands of lives a year in the developing world. These technologies are not new -- the medical ultrasound has been around for more than 60 years, and the EKG has been around for nearly 100. It seems insane that cost is still such a barrier for the machines used for medical diagnostics, when the price of other technologies has fallen so much in the same period of time.
I bought myself a Rigol DS1054Z, and I realized that I paid $400 for an oscilloscope that would have cost millions of dollars 30 years ago. I thought about the experiments I had done on neurons using the 50 year old oscilloscopes as part of my degree, and I realized that an ECG/EKG can be replicated pretty easily with an oscilloscope. It turns out, building an ECG is pretty trivial. It's not a 12-lead ECG, but it's also something I built out of parts I had on hand.
I don't see why other medical technology should be any different. Yes, unregulated medical technology is dangerous, but the risk doesn't seem to outweigh the potential benefit. If the parts to build these devices is cheaper and more accessible than they ever have been, and the equipment needed to build, test and calibrate the devices is cheaper and more accessible than ever, it seems like the devices themselves should be cheaper and more accessible than ever. I think there is a place for a $20k ultrasound, but when you live hours or days from an ultrasound, a cheaper option could save lives, even if the primary purpose is directing people to get a follow-up with the more capable machine.
I think one of the problems of "but this is just a small engineering project" is precision, reliability, quality-- whatever you want to call it.
There is interpretation that goes into reading an EKG, an xray, lab results. If there's any unreliability whatsoever, that will impact treatment and outcomes.
If there's any unreliability in your EKG readout, that's can be the different between diagnosing a minor heart attack versus chest pain.
The same goes for diagnosing a cancerous tumor from a benign one. There's already ambiguity and interpretation; if there's any imprecision in the measuring device, that's going to lead to bad outcomes-- both overtreatment and undertreatment.
Oh, definitely. I don't want to suggest the added inaccuracy is a trivial problem. It just seems like access to a diagnostic test with a lower resolution is better than no test at all.
In the abstract, I agree -- there are many situations where low res is better than none.
But given the amount of interpretation and reading (it truly is an art, not a science) that goes into reading an EKG and more importantly, a tumor x-ray, I think in this situation, low res is worse than none, because it's worthless (you can't tell anything from it) and it still cost you something.
If you do try to do a cancer diagnosis on a poor x-ray, you are basing cancer treatment on the flip of a coin.
no cancer? Well you might fill them up with expensive chemotherapy, which itself is carcinogenic. Actually has cancer? Well, you've just set them loose with an organic time bomb in their system.
Yeah, it's definitely an interesting question. I took two full years of biomedical ethics, and I think you could make a pretty strong claim for either side.
I personally think that performing a basic reading of an ultrasound or an ECG/EKG would be fairly simple with some training, but I also have a lot of experience reading raw data. I have a few friends who are Radiologists, and I'm going to have to ask them what they think. I'm really not sure what they'd think about all this, and I'm definitely open to the possibility that I'm massively overestimating my ability to interpret even "simple" diagnostic data.
I'd be interested to hear what you find out. I have a buddy who basically lost his police force job because of a mis-read EKG, which caused him to be taken off of his ADHD meds, which doctors wouldn't re-prescribe to him, because they thought he was an addict trying to score. He has a real case of ADHD. He wound up losing his job and his condo-- everything, basically.
From a quick look on eBay, you can pick up a vetinary ultrasound machine for between £800 and £2000. Are these materially different to medical ones, or is the cost difference down to certification?
At least in Germany, the ultrasound machines that most vets have are second-hand from (human) physicians and look older. I have yet to be at a doctor's office in Germany that didn't have an ultrasound, even general practitioners ("Hausarzt"). The concept of sending a patient off to an ultrasound technician for a routine scan seems baffling to German physicians.
Sources: asking the two vets I've brought birds to here, own visits to doctors
Simple and somewhat cheap ultrasound machine do exist. I'm not an expert about this market, but you can probably source some from China.
R&D and will be notably inferior with less capabilities than on high end systems, and you can probably also keep cost done if you skip some certifications.
Proper medical devices have loads of safety features! They have isolated power supplies! They are tested in harsh environments! They fail in a predictable manner! There are regulations that need to be followed! New devices are still expensive because they are better!
Yes, electricity can kill you.
Yes, improper medical advice can kill you.
Yes, malfunctioning diagnostic equipment can lead to an incorrect diagnosis, which, yes, can kill you.
Yes, medical regulations exist and protect us from harm.
While a homebrew machine would not be able to compete with the latest and greatest, I'd hazard that even rudimentary diagnostic equipment could save thousands of lives a year in the developing world. These technologies are not new -- the medical ultrasound has been around for more than 60 years, and the EKG has been around for nearly 100. It seems insane that cost is still such a barrier for the machines used for medical diagnostics, when the price of other technologies has fallen so much in the same period of time.
I bought myself a Rigol DS1054Z, and I realized that I paid $400 for an oscilloscope that would have cost millions of dollars 30 years ago. I thought about the experiments I had done on neurons using the 50 year old oscilloscopes as part of my degree, and I realized that an ECG/EKG can be replicated pretty easily with an oscilloscope. It turns out, building an ECG is pretty trivial. It's not a 12-lead ECG, but it's also something I built out of parts I had on hand.
I don't see why other medical technology should be any different. Yes, unregulated medical technology is dangerous, but the risk doesn't seem to outweigh the potential benefit. If the parts to build these devices is cheaper and more accessible than they ever have been, and the equipment needed to build, test and calibrate the devices is cheaper and more accessible than ever, it seems like the devices themselves should be cheaper and more accessible than ever. I think there is a place for a $20k ultrasound, but when you live hours or days from an ultrasound, a cheaper option could save lives, even if the primary purpose is directing people to get a follow-up with the more capable machine.