3 ms·

I wonder why the medical industry doesn't do this, combining an insulin pump and a constant glucose monitor into a single system?

by listic 11y ago

tonylemesmer 11y ago
Liability. Clinical decisions are made by humans. Sad thing is, although the software controlling this would undoubtedly have lots of flaws and cause suffering and death, not implementing something also allows people to suffer and die.
- andrelaszlo 11y ago
  I'm sure this bias has a name? The idea that changing the outcomes for the better is actually worse because different people are affected. Or maybe because in one we are dying of a disease, and in the other one by software errors. Software errors should be avoidable, so they feel worse than disease somehow.
  - gambiting 11y ago
    Think about it this way. Imagine there's a hypothetical medical device X. It has been calculated, that due to operator errors, this machine on average kills 1/1000 patients. Operators are given more training,but the average does not change. Now. Another company makes an automated machine, which kills 1/10000 patients on average, because of software errors. Do you think anyone would ever allow the second machine to be sold, even though it would save 9 persons compared to the manually operated machine? Of course not. If it ever came to light that it killed anyone due to a software error, it would be gone faster from the market than you can spell "liability". Does not matter that in fact it's killing less people on average than any other type of machine - it's just that in our minds software bugs are avoidable so therefore they are not acceptable at all.
- _pmf_ 11y ago
  > Liability. Clinical decisions are made by humans. Pacemakers have a high risk, yet here we have an automated solution. I think liability alone cannot be the root cause.
deleted 11y ago
[deleted]
OopsCriticality 11y ago
The regulatory approval pathway for a combination drug/device platform, with a automatic clinical decision component, is a nightmare. Assume one did create the device, and got it to work across a wide patient population with varying diets, disease severity, treatment responsivity, etc., and then (somehow) got approval for it. Existing insulin pumps are already challenging to get reimbursed under insurance, and they have a more straightforward regulatory approval path with lower R&D costs. The super pump would need to be reimbursed for quite a bit more money to justify the increased R&D costs. That is going to be a very hard sell under quality of life improvement alone—clinical data showing an improved patient outcome or decreased long-term healthcare costs is what is needed. You're benchmarking against existing pumps with separate monitors, which sets a high bar.

I wonder why the medical industry doesn't do this, combining an insulin pump and a constant glucose monitor into a single system?

by listic 11y ago

I wonder why the medical industry doesn't do this, combining an insulin pump and a constant glucose monitor into a single system?

tonylemesmer 11y ago

Liability. Clinical decisions are made by humans. Sad thing is, although the software controlling this would undoubtedly have lots of flaws and cause suffering and death, not implementing something also allows people to suffer and die.

andrelaszlo 11y ago
I'm sure this bias has a name? The idea that changing the outcomes for the better is actually worse because different people are affected. Or maybe because in one we are dying of a disease, and in the other one by software errors. Software errors should be avoidable, so they feel worse than disease somehow.
- gambiting 11y ago
  Think about it this way. Imagine there's a hypothetical medical device X. It has been calculated, that due to operator errors, this machine on average kills 1/1000 patients. Operators are given more training,but the average does not change. Now. Another company makes an automated machine, which kills 1/10000 patients on average, because of software errors. Do you think anyone would ever allow the second machine to be sold, even though it would save 9 persons compared to the manually operated machine? Of course not. If it ever came to light that it killed anyone due to a software error, it would be gone faster from the market than you can spell "liability". Does not matter that in fact it's killing less people on average than any other type of machine - it's just that in our minds software bugs are avoidable so therefore they are not acceptable at all.
_pmf_ 11y ago
> Liability. Clinical decisions are made by humans. Pacemakers have a high risk, yet here we have an automated solution. I think liability alone cannot be the root cause.

deleted 11y ago

[deleted]

OopsCriticality 11y ago

The regulatory approval pathway for a combination drug/device platform, with a automatic clinical decision component, is a nightmare. Assume one did create the device, and got it to work across a wide patient population with varying diets, disease severity, treatment responsivity, etc., and then (somehow) got approval for it. Existing insulin pumps are already challenging to get reimbursed under insurance, and they have a more straightforward regulatory approval path with lower R&D costs. The super pump would need to be reimbursed for quite a bit more money to justify the increased R&D costs. That is going to be a very hard sell under quality of life improvement alone—clinical data showing an improved patient outcome or decreased long-term healthcare costs is what is needed. You're benchmarking against existing pumps with separate monitors, which sets a high bar.