5 ms·

I’m sure doctors are looking forward to ultrasound scanners being common household devices, and getting 50 emails a day from panicked people convinced that thei

I’m sure doctors are looking forward to ultrasound scanners being common household devices, and getting 50 emails a day from panicked people convinced that their gallbladder is a tumor.

jazoom 9y ago
I'm looking forward to having an inexpensive portable USS to help find veins. I doubt consumers will pay for one of these, except maybe for pregnancy.
- JshWright 9y ago
  Yeah, this sort of thing is making quick inroads in prehospital care (this is far from the first portable ultrasound). Finding veins, FAST[1] scans, assessing the heart more directly during cardiac arrest, etc. [1]: https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma https://en.wikipedia.org/wiki/Focused_assessment_with_sonogr...
  - jazoom 9y ago
    We've been using portable USS machines for years but I suppose what I meant is one I can keep in my pocket and one that doesn't cost $150000.
    - JshWright 9y ago
      The GE Vscan has been around for years.
      - jazoom 9y ago
        That's interesting. I've not seen that before. Still seems to be far more expensive than what I'm thinking of, though. I'm looking forward to the day when every junior doctor can have one around their neck like every doctor has a stethoscope.
        JshWright 9y ago
        Why? What gap do you think it fills in the routine assessment? I'm all for expanding access to US, but I'm very wary of throwing gadgets for the sake of gadgets at doctors...
        jazoom 9y ago
        Patients who need an IVC and have brittle veins and peripheral oedema. It comes up a lot. I never said anything about routine assessment.
        JshWright 9y ago
        Sure, I would love a portable ultrasound in the back of my ambulance for that very reason. I still use my stethoscope _way_ more often than I start an IV where US would be handy.
        jazoom 9y ago
        I don't know why you keep putting words into my mouth. I never suggested it would replace a stethoscope.
        JshWright 9y ago
        You said every doctor should have one with them "like a stethoscope". I don't know where you got "replace" from... My point is that a stethoscope is an essential tool for assessing every patient. An ultrasound is a specialized tool for assessing a very small subset of patients.
        jazoom 9y ago
        I said "can". I don't know where you got "should" from.
QAPereo 9y ago
The benefits of portable units at a non-devastating price have more implications for democratization of quality of care than anything else. WebMD and Google have already let the other genie well and truly out of the bottle. Edit: By the way years ago I read an article which talked about the price of ultrasound devices, and the bottleneck was the price of the transducers. Obviously that’s changed, but when did that change? Does anyone here know?
- tachydyne 9y ago
  I work for a competitor to Butterfly, and the main difference between this device and other ultrasound transducers is the use of a CMUT array instead of the typical piezoelectric crystal. CMUT arrays are MEMS devices, made in a semiconductor fab using the same processes as other ICs. This makes them cheaper to produce than traditional arrays where the elements have to individually sliced and wired to the electronics. CMUT isn't new, it's been being worked on for 20 years, but it isn't used because it is much less sensitive than the piezoelectric arrays. Either Butterfly has made a breakthrough and are choosing growth over profit margins, or they are trying to make up for worse performance with a much cheaper price. We won't know which until their device is actually on sale.
  - QAPereo 9y ago
    Incredibly informative answer, thanks so much. One last thing, do you personally believe “breakthrough” or “discount” in this case?
    - tachydyne 9y ago
      20 years of CMUT being the next big thing in ultrasound has left me a sceptic, but I know some really smart people at Butterfly. I don't think they would bring a device to market that they didn't think was competitive. My guess is that it'll be okay, not the best imaging handheld device on the market but better than several of our competitors.
      - 9y ago
adenadel 9y ago
For now, this isn't a consumer device [0] 0. https://twitter.com/matthewherper/status/923897406776889344 https://twitter.com/matthewherper/status/923897406776889344
agumonkey 9y ago
This is a non issue IMO, it would probably self correct in a few months. Also you could still take advantage of that. The patient who made a few ultrasound videos along a period of time and still has pain worth seeing a doctor, can now spare the doctor some time by showing him a bit more data. Could be a data hell too I must admit, but somewhere somehow I'd hope people to learn a bit about biology and physics in the process and 1) know more 2) know when not to panic 3) know how to take care of their bodies
tehlike 9y ago
Thats technology. At some point you can see remote doctor sessions being a thing, and robotic doctors carrying out some basic surgeries.
mikenew 9y ago
I’m not saying that wouldn’t happen, but we need to get away from the idea that non-professionals shouldn’t have access to their own medical information. More education and empowerment is the answer, not less.
- mschuster91 9y ago
  > More education and empowerment is the answer, not less. The crux lies in determining the boundary between education and quackery. The resurgence of antivaxxers, homeopathy believers and friends doesn't exactly help the case for deregulation here.
  - staunch 9y ago
    Is there any evidence anti-vaccine and homeopathy movements are bigger than they were in the past? Google Trends suggests homeopathy is up a bit recently, but way down from its pre-internet peak. https://trends.google.com/trends/explore?date=all&q=homeopathy https://trends.google.com/trends/explore?date=all&q=homeopat...
    - mschuster91 9y ago
      > Is there any evidence anti-vaccine and homeopathy movements are bigger than they were in the past? I'm talking about Germany here as I can't really speak for the US, where from 2011 to 2013 prescriptions rose 3.8% and OTC sales went up 23% (https://de.wikipedia.org/wiki/Hom%C3%B6opathie#Bundesrepublik_Deutschland_ab_1990 https://de.wikipedia.org/wiki/Hom%C3%B6opathie#Bundesrepubli...). As for antivaxers, Europe as a whole has a huge measles problem which has risen in the last years (http://theconversation.com/whats-behind-the-sudden-rise-in-measles-deaths-in-europe-80909 http://theconversation.com/whats-behind-the-sudden-rise-in-m...).
  - averagewall 9y ago
    Are you saying proponents of quackery might misread somebody's home ultrasound or give misleading advice on how to read it? That doesn't sound any worse than what could happen with thermometers, stethoscopes, blood pressure meters, athlete wristbands, and inspecting the color of phlegm, poo, urine, skin, etc. Nobody would want to hide those things from people for their own safety.
samfisher83 9y ago
Maybe we can use machine learning to train a computer to identify these diseases. That would lot cheaper than a doctor and with enough data it could do a pretty good job.
- et2o 9y ago
  ultrasound is pretty much the worst imaging modality to do this in all of medical imaging.
jsight 9y ago
I'm not convinced that the subset that would do that with an ultrasound device is really any different from the subset that does this kind of thing already.
gotrecruit 9y ago
easy solution: charge per review of ultrasounds.
- err4nt 9y ago
  If I can go get a device, and somebody qualified to read the images I produce can also inform me how and where to take pictures - I'd pay for that kind of a service. Seems like a business model to me :)
  - giarc 9y ago
    Problem is that if you've ever had an ultrasound, it's not really something you can just tell someone how to do. They manipulate the transducer in real time, angling it just right, giving it just the right amount of pressure on the skin. Even if you did it in real time I can't imagine the frustration of a physician over the phone going "No move it to your right, now up, now back further, ok less pressure, now more pressure."
serf 9y ago
That'll be a nice worry for doctors to have in reaction to the spread of consumer-available precision imagery equipment. Right now I think it's more valid to worry about the patients who can't receive care due to whatever host of valid economic/social/cultural reasons prevent them from doing so -- and one of the best ways to help that struggle seems to be the creation of cheaper and more available diagnostics and therapies. I don't know about this specific device -- but any competition in the medical diagnostics market that may drive device price down seems to be a benefit.

I’m sure doctors are looking forward to ultrasound scanners being common household devices, and getting 50 emails a day from panicked people convinced that their gallbladder is a tumor.

jazoom 9y ago

I'm looking forward to having an inexpensive portable USS to help find veins. I doubt consumers will pay for one of these, except maybe for pregnancy.

JshWright 9y ago
Yeah, this sort of thing is making quick inroads in prehospital care (this is far from the first portable ultrasound). Finding veins, FAST[1] scans, assessing the heart more directly during cardiac arrest, etc. [1]: https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma https://en.wikipedia.org/wiki/Focused_assessment_with_sonogr...
- jazoom 9y ago
  We've been using portable USS machines for years but I suppose what I meant is one I can keep in my pocket and one that doesn't cost $150000.
  - JshWright 9y ago
    The GE Vscan has been around for years.
    - jazoom 9y ago
      That's interesting. I've not seen that before. Still seems to be far more expensive than what I'm thinking of, though. I'm looking forward to the day when every junior doctor can have one around their neck like every doctor has a stethoscope.
      - JshWright 9y ago
        Why? What gap do you think it fills in the routine assessment? I'm all for expanding access to US, but I'm very wary of throwing gadgets for the sake of gadgets at doctors...
        jazoom 9y ago
        Patients who need an IVC and have brittle veins and peripheral oedema. It comes up a lot. I never said anything about routine assessment.
        JshWright 9y ago
        Sure, I would love a portable ultrasound in the back of my ambulance for that very reason. I still use my stethoscope _way_ more often than I start an IV where US would be handy.
        jazoom 9y ago
        I don't know why you keep putting words into my mouth. I never suggested it would replace a stethoscope.
        JshWright 9y ago
        You said every doctor should have one with them "like a stethoscope". I don't know where you got "replace" from... My point is that a stethoscope is an essential tool for assessing every patient. An ultrasound is a specialized tool for assessing a very small subset of patients.
        jazoom 9y ago
        I said "can". I don't know where you got "should" from.

QAPereo 9y ago

The benefits of portable units at a non-devastating price have more implications for democratization of quality of care than anything else. WebMD and Google have already let the other genie well and truly out of the bottle. Edit: By the way years ago I read an article which talked about the price of ultrasound devices, and the bottleneck was the price of the transducers. Obviously that’s changed, but when did that change? Does anyone here know?

tachydyne 9y ago
I work for a competitor to Butterfly, and the main difference between this device and other ultrasound transducers is the use of a CMUT array instead of the typical piezoelectric crystal. CMUT arrays are MEMS devices, made in a semiconductor fab using the same processes as other ICs. This makes them cheaper to produce than traditional arrays where the elements have to individually sliced and wired to the electronics. CMUT isn't new, it's been being worked on for 20 years, but it isn't used because it is much less sensitive than the piezoelectric arrays. Either Butterfly has made a breakthrough and are choosing growth over profit margins, or they are trying to make up for worse performance with a much cheaper price. We won't know which until their device is actually on sale.
- QAPereo 9y ago
  Incredibly informative answer, thanks so much. One last thing, do you personally believe “breakthrough” or “discount” in this case?
  - tachydyne 9y ago
    20 years of CMUT being the next big thing in ultrasound has left me a sceptic, but I know some really smart people at Butterfly. I don't think they would bring a device to market that they didn't think was competitive. My guess is that it'll be okay, not the best imaging handheld device on the market but better than several of our competitors.
    - 9y ago

adenadel 9y ago

For now, this isn't a consumer device [0] 0. https://twitter.com/matthewherper/status/923897406776889344 https://twitter.com/matthewherper/status/923897406776889344

agumonkey 9y ago

This is a non issue IMO, it would probably self correct in a few months. Also you could still take advantage of that. The patient who made a few ultrasound videos along a period of time and still has pain worth seeing a doctor, can now spare the doctor some time by showing him a bit more data. Could be a data hell too I must admit, but somewhere somehow I'd hope people to learn a bit about biology and physics in the process and 1) know more 2) know when not to panic 3) know how to take care of their bodies

tehlike 9y ago

Thats technology. At some point you can see remote doctor sessions being a thing, and robotic doctors carrying out some basic surgeries.

mikenew 9y ago

I’m not saying that wouldn’t happen, but we need to get away from the idea that non-professionals shouldn’t have access to their own medical information. More education and empowerment is the answer, not less.

mschuster91 9y ago
> More education and empowerment is the answer, not less. The crux lies in determining the boundary between education and quackery. The resurgence of antivaxxers, homeopathy believers and friends doesn't exactly help the case for deregulation here.
- staunch 9y ago
  Is there any evidence anti-vaccine and homeopathy movements are bigger than they were in the past? Google Trends suggests homeopathy is up a bit recently, but way down from its pre-internet peak. https://trends.google.com/trends/explore?date=all&q=homeopathy https://trends.google.com/trends/explore?date=all&q=homeopat...
  - mschuster91 9y ago
    > Is there any evidence anti-vaccine and homeopathy movements are bigger than they were in the past? I'm talking about Germany here as I can't really speak for the US, where from 2011 to 2013 prescriptions rose 3.8% and OTC sales went up 23% (https://de.wikipedia.org/wiki/Hom%C3%B6opathie#Bundesrepublik_Deutschland_ab_1990 https://de.wikipedia.org/wiki/Hom%C3%B6opathie#Bundesrepubli...). As for antivaxers, Europe as a whole has a huge measles problem which has risen in the last years (http://theconversation.com/whats-behind-the-sudden-rise-in-measles-deaths-in-europe-80909 http://theconversation.com/whats-behind-the-sudden-rise-in-m...).
- averagewall 9y ago
  Are you saying proponents of quackery might misread somebody's home ultrasound or give misleading advice on how to read it? That doesn't sound any worse than what could happen with thermometers, stethoscopes, blood pressure meters, athlete wristbands, and inspecting the color of phlegm, poo, urine, skin, etc. Nobody would want to hide those things from people for their own safety.

samfisher83 9y ago

Maybe we can use machine learning to train a computer to identify these diseases. That would lot cheaper than a doctor and with enough data it could do a pretty good job.

et2o 9y ago
ultrasound is pretty much the worst imaging modality to do this in all of medical imaging.

jsight 9y ago

I'm not convinced that the subset that would do that with an ultrasound device is really any different from the subset that does this kind of thing already.

gotrecruit 9y ago

easy solution: charge per review of ultrasounds.

err4nt 9y ago
If I can go get a device, and somebody qualified to read the images I produce can also inform me how and where to take pictures - I'd pay for that kind of a service. Seems like a business model to me :)
- giarc 9y ago
  Problem is that if you've ever had an ultrasound, it's not really something you can just tell someone how to do. They manipulate the transducer in real time, angling it just right, giving it just the right amount of pressure on the skin. Even if you did it in real time I can't imagine the frustration of a physician over the phone going "No move it to your right, now up, now back further, ok less pressure, now more pressure."

serf 9y ago

That'll be a nice worry for doctors to have in reaction to the spread of consumer-available precision imagery equipment. Right now I think it's more valid to worry about the patients who can't receive care due to whatever host of valid economic/social/cultural reasons prevent them from doing so -- and one of the best ways to help that struggle seems to be the creation of cheaper and more available diagnostics and therapies. I don't know about this specific device -- but any competition in the medical diagnostics market that may drive device price down seems to be a benefit.