5 ms·

Full body scans for the people

29 points by sieste 2y ago

petercooper 2y ago
I get a significant medical every two years for various reasons. Some things are always worth measuring (weight, blood pressure, blood work) but conservatism is the status quo with proactive scanning beyond the essentials for good reason. Without the right preparation and counselling (or, at minimum, a systematic, logical approach to risk), people can get thrown by findings and struggle to weigh up the risks. Is that new cyst on your kidney a problem? Is that small brain aneurysm (with a very low risk of rupture) going to play on your mind? Might you opt for an operation with a higher mortality rate than simply ignoring it? Even worse: when that 'thing' they found isn't really a 'thing' at all but you got treatment for it anyway. This tech is great to have available and for motivated individuals to have the option to use, but as something to benefit the mass market, I suspect it'll take a lot of time to shift the needle, and not for technological reasons. I think things like a-fib and blood pressure detection on wearables is more likely to have an impact in the medium term.
- trackofalljades 2y ago
  This is just photography not radiation or magnetism, so some of those examples wouldn't come up...but I imagine skin cancer and some other preventative concerns might be addressed?
  - lm28469 2y ago
    > This is just photography not radiation or magnetism Ackchyually light is an _electromagnetic_ _radiation_ The question stays valid though, how many benign things would be treated, how many of these treatments would have net negative results, and at what cost for the already crumbling health system of most western nations
- admissionsguy 2y ago
  It seems obvious that one would do repeat measurements of the cyst and look for any changes, in particular rapid growth, rather than jump onto the operating table. Doing a procedure with higher risk than the asymptomatic condition itself probably should not be covered by insurance, but if someone wants to self-fund it, let them (same if they want to chop off their hand).
  - bluGill 2y ago
    That measurement may be an xray which means that repeated measurement has a chance of causing cancer! Xray isn't the only measurement we have that carries risk to the body if we do it - just one I expect everyone is aware of.
    - admissionsguy 2y ago
      Yeah but doing an MRI is strictly better than not doing an MRI. There is no way more information is bad unless some serious irrationality comes into play.
      - r2_pilot 2y ago
        More information can lead to unnecessary procedures(by way of insistence either of patient or doctor) which have their own complications.
      - itishappy 2y ago
        > There is no way more information is bad unless some serious irrationality comes into play. I have some bad news to deliver about humans...
      - thfuran 2y ago
        Doing an MRI isn't free, so it isn't strictly better than not doing one.
      - markus92 2y ago
        Gadolinium-based contrast (which you'll need for any scan worth their salt) is not completely risk free, so not entirely true. And claustrophobia is a bit more common than people think.
- cies 2y ago
  If people die before reproducing because they cannot weigh risks, that should result in a population that is better at weighing risk in the long run.
  - gipp 2y ago
    Cool, see you in a million years when that incredibly noisy effect converges
  - disattention 2y ago
    Strangely pro-eugenics take...
    - cies 2y ago
      Not at all. Hardcore against eugenics. Just in favour of people knowing what goes on inside their body (transparency) and against the narrative "its better for you not to know".
- boxed 2y ago
  These are all problems with doctors overreacting and oversharing. Collecting the information on a large scale to know what you are looking at next time seems like the sane approach.
  - michaelt 2y ago
    There's also a statistical problem. Let's say 1% of patients have X, and you've got a test for X which is 99% accurate. You screen 10,000 patients; 100 have X and you identify 99 of them. 9,900 don't have X, and you raise 99 false alarms. But if you expand screening to cover Y which 0.1% of patients suffer from, and your test for Y is equally accurate, you'll identify 10 patients with Y - and get 100 false alarms. So the rarer the thing you're screening for, the better your test needs to be - unless you want to be buried in false alarms. As I understand things, this is why we don't generally screen for prostate cancer in the under-50s.
    - boxed 2y ago
      That's not a statistical problem, it's a problem of doctors not knowing statistics. My point is that you could do these scannings on a broad scale and not look at the result per patient. Don't give it to their doctor to look at by default as that is the problem. Use it for basic science FIRST.
    - thfuran 2y ago
      And sometimes the test itself can have rare adverse outcomes even ignoring the issues with false positives.
    - zo1 2y ago
      I may be off base. But it sounds like the accuracy rate of those tests is off if it's based on an assumption that you'll only test people who have risk factors. I would have thought that by now, being the year 2024, we've gotten better than just guessing and statistically inferring stuff. This is where the big disconnect is, and why so many are starting to distrust the medical field. We assume doctors can diagnose stuff and not just go around making educated guesses. No wonder it's a giant government-enforced cartel that restricts competition.
- Symmetry 2y ago
  This sort of thing does require a certain tolerance for ambiguity if you want to look at the raw results yourself rather than having a doctor do it for you.
sigmar 2y ago
>Neko Health, with its smaller price tag, doesn’t perform M.R.I.s or X-rays. Instead, it uses about 70 different sensors and a mix of proprietary and off-the-shelf technologies to non-invasively measure heart function and circulation, and to photograph every inch of a patient’s body. Feel like this should have been put way earlier in the article instead of repeatedly using the term "body scan" with no explanation for the entire first half of the piece. Not to say photos aren't useful, but I feel like many people think of mri/ct/x-rays when the word "scan" is used.
- logtempo 2y ago
  thanks, I could not find this one but I was almost sure it was only a 3D photoscan of the body since they mostly talk about moles and skin. The article is really hard to read if you don't care about storyselling...oops, storytelling.
- jvanderbot 2y ago
  I've got pretty high skin cancer risk, and this would be a godsend. Getting into a dermatologist is a pain, and when you move or change docs, you lose all the history.
throwme_123 2y ago
https://archive.is/vQVrn https://archive.is/vQVrn
riffraff 2y ago
I'd love to know more about what this is actually testing, or what tests it subsumes, it's not really clear to me from the article. I.e. I get a skin check every year (people take pictures instead of a machine, but its about the same), and it's about €50. Getting a bloodwork is free when asking my family doctor, or when donating blood. This is no MRI nor CT scan, so what _is_ it checking for $500? The article talks of circulation, does this replace some of those doppler vascular tests, perhaps?
- bluGill 2y ago
  There are a lot of options for tests. 15 years ago I found quest diagnostics price sheet online (it doesn't seem to be online anymore), at the time the lab cost to do your standard cholesterol measure (what most mean when they say blood work) was $1.10, but there was a long list of other things they could do, with the most expensive $18,000. (prices are from memory so probably wrong, but close enough for discussion)
- asah 2y ago
  do blood donations tests check your cholesterol etc ? or just infectious disease?
  - riffraff 2y ago
    depends on the organization/country, in Italy the largest organization managing this is AVIS[0] and they do both infections (every time) and cholesterol etc (once a year), and you get the results, it's a "plus" of being a donor. In Hungary presumably they do the disease checks but they don't tell you the results either, AFAIK. [0] https://www.avis.it/diventa-donatore/ https://www.avis.it/diventa-donatore/
- zamadatix 2y ago
  > This is no MRI nor CT scan, so what _is_ it checking for $500? The $500 goal mark is for Ezra, a full-body MRI scan. The Neko Health scan is listed as costing ~$230. As for bloodwork the cost may be covered to you as part of insurance/the visit but it's most certainly not free. and there is definitely variety in what tests "bloodwork" includes.
post_break 2y ago
Can we get colonoscopies for the people? Colon cancer is exploding and early treatment is key, but of course the insurance company thinks otherwise.
- binarymax 2y ago
  There are now mail-in colon cancer detection kits that some healthcare providers give you for free (well, fully paid by insurance at least) Far better than a colonoscopy. The company is called Cologuard. https://www.cologuard.com/ https://www.cologuard.com/
  - azinman2 2y ago
    It’s not better than a colonoscopy because polyps cannot be removed.
    - binarymax 2y ago
      I meant better in terms of patient comfort and accessibility. You are right it is not better for treatment. But if the test finds something, further action can be taken and treatment can be administered.
    - bsder 2y ago
      Nope. They did a comparison study between Europe (which does far fewer colonoscopies) and the US and there is no difference in mortality between the two while the US has a higher number of post operation complications. Like so many things lately, it's better to monitor with screening tests and only go in when you have symptoms. That having been said: it seems like the screening tests need to start to be given out to earlier ages, though.
- hollywood_court 2y ago
  I'm a 42 year old male and I had a colonoscopies perform in March. My GP was immediately concerned with my symptoms and referred me to a gastro doctor. The gastro doc shrugged everything off and didn't think I need a colonoscopy. So I went home and order two of the occult blood test. I used one test on Monday and the second on the following Friday. Both came back positive. So I called the gastro again and he finally scheduled me for the procedure. After the procedure he said everything was fine and he has no idea why the at home tests were positive. I don't know what to think now.
xyst 2y ago
https://archive.is/vQVrn https://archive.is/vQVrn
yellow_lead 2y ago
> Neko Health, with its smaller price tag, doesn’t perform M.R.I.s or X-rays. Instead, it uses about 70 different sensors and a mix of proprietary and off-the-shelf technologies to non-invasively measure heart function and circulation, and to photograph every inch of a patient’s body. It seems like the main use case is skin checks (i.e for cancerous moles).
chewmieser 2y ago
Unlocked (gift link): https://www.nytimes.com/2024/04/27/business/dealbook/daniel-ek-neko-health.html?unlocked_article_code=1.o00.KUWg.atjA_jDWP6Ah&smid=url-share https://www.nytimes.com/2024/04/27/business/dealbook/daniel-...
xyst 2y ago
I wish them good luck. It will be a massive uphill climb. Personally, I am in agreement that unnecessary scans can reveal what is otherwise benign findings to trained physicians. But to Joe Blow off the street, it can cause massive anxiety. Thus triggering a set of follow ups that may lead to expensive and unnecessarily risky operations. But I do also understand how a “clean” scan can alleviate any such anxiety in the future. Even just establishing a baseline of clean scans (MRI, CT, or even PET). Even if a benign finding is found. Can plan appropriately (ie, rescanning every X years) or if symptoms do arise intervention can proceed much faster rather than iterating through various sub-specialists and delaying care. In one case, there is something known as an “brain AVM”. Some say it’s genetic or just bad luck with genetics. But most won’t realize they have it until symptoms arise (ie, stroke like symptoms) or it’s discovered as an incidental finding (ie, patient comes into clinic with concussion).
- tiahura 2y ago
  As an ambulance chaser who looks at Joe Blow's imaging and reports everyday, my impression is that your concerns are overblown. I've had at least 100 reports with "probable spot noticed on lung/liver/kidney/spine, PT should followup." I've NEVER seen it result in unnecessary treatment. I've also had too many clients die from a cancer not found until it was too late.
tiahura 2y ago
MRIs are never going to be cheap, and CT scans will always involve considerable radiation. Therefore it seems like more resources should be directed at ultrasound. A little better resolution, and a little bit less cost, would go a long way towards democratizing imaging. It looks like google is doing some work in this area: https://health.google/caregivers/ultrasound/ https://health.google/caregivers/ultrasound/

29 points by sieste 2y ago

I get a significant medical every two years for various reasons. Some things are always worth measuring (weight, blood pressure, blood work) but conservatism is the status quo with proactive scanning beyond the essentials for good reason. Without the right preparation and counselling (or, at minimum, a systematic, logical approach to risk), people can get thrown by findings and struggle to weigh up the risks. Is that new cyst on your kidney a problem? Is that small brain aneurysm (with a very low risk of rupture) going to play on your mind? Might you opt for an operation with a higher mortality rate than simply ignoring it? Even worse: when that 'thing' they found isn't really a 'thing' at all but you got treatment for it anyway. This tech is great to have available and for motivated individuals to have the option to use, but as something to benefit the mass market, I suspect it'll take a lot of time to shift the needle, and not for technological reasons. I think things like a-fib and blood pressure detection on wearables is more likely to have an impact in the medium term.

trackofalljades 2y ago
This is just photography not radiation or magnetism, so some of those examples wouldn't come up...but I imagine skin cancer and some other preventative concerns might be addressed?
- lm28469 2y ago
  > This is just photography not radiation or magnetism Ackchyually light is an _electromagnetic_ _radiation_ The question stays valid though, how many benign things would be treated, how many of these treatments would have net negative results, and at what cost for the already crumbling health system of most western nations
admissionsguy 2y ago
It seems obvious that one would do repeat measurements of the cyst and look for any changes, in particular rapid growth, rather than jump onto the operating table. Doing a procedure with higher risk than the asymptomatic condition itself probably should not be covered by insurance, but if someone wants to self-fund it, let them (same if they want to chop off their hand).
- bluGill 2y ago
  That measurement may be an xray which means that repeated measurement has a chance of causing cancer! Xray isn't the only measurement we have that carries risk to the body if we do it - just one I expect everyone is aware of.
  - admissionsguy 2y ago
    Yeah but doing an MRI is strictly better than not doing an MRI. There is no way more information is bad unless some serious irrationality comes into play.
    - r2_pilot 2y ago
      More information can lead to unnecessary procedures(by way of insistence either of patient or doctor) which have their own complications.
    - itishappy 2y ago
      > There is no way more information is bad unless some serious irrationality comes into play. I have some bad news to deliver about humans...
    - thfuran 2y ago
      Doing an MRI isn't free, so it isn't strictly better than not doing one.
    - markus92 2y ago
      Gadolinium-based contrast (which you'll need for any scan worth their salt) is not completely risk free, so not entirely true. And claustrophobia is a bit more common than people think.
cies 2y ago
If people die before reproducing because they cannot weigh risks, that should result in a population that is better at weighing risk in the long run.
- gipp 2y ago
  Cool, see you in a million years when that incredibly noisy effect converges
- disattention 2y ago
  Strangely pro-eugenics take...
  - cies 2y ago
    Not at all. Hardcore against eugenics. Just in favour of people knowing what goes on inside their body (transparency) and against the narrative "its better for you not to know".
boxed 2y ago
These are all problems with doctors overreacting and oversharing. Collecting the information on a large scale to know what you are looking at next time seems like the sane approach.
- michaelt 2y ago
  There's also a statistical problem. Let's say 1% of patients have X, and you've got a test for X which is 99% accurate. You screen 10,000 patients; 100 have X and you identify 99 of them. 9,900 don't have X, and you raise 99 false alarms. But if you expand screening to cover Y which 0.1% of patients suffer from, and your test for Y is equally accurate, you'll identify 10 patients with Y - and get 100 false alarms. So the rarer the thing you're screening for, the better your test needs to be - unless you want to be buried in false alarms. As I understand things, this is why we don't generally screen for prostate cancer in the under-50s.
  - boxed 2y ago
    That's not a statistical problem, it's a problem of doctors not knowing statistics. My point is that you could do these scannings on a broad scale and not look at the result per patient. Don't give it to their doctor to look at by default as that is the problem. Use it for basic science FIRST.
  - thfuran 2y ago
    And sometimes the test itself can have rare adverse outcomes even ignoring the issues with false positives.
  - zo1 2y ago
    I may be off base. But it sounds like the accuracy rate of those tests is off if it's based on an assumption that you'll only test people who have risk factors. I would have thought that by now, being the year 2024, we've gotten better than just guessing and statistically inferring stuff. This is where the big disconnect is, and why so many are starting to distrust the medical field. We assume doctors can diagnose stuff and not just go around making educated guesses. No wonder it's a giant government-enforced cartel that restricts competition.
Symmetry 2y ago
This sort of thing does require a certain tolerance for ambiguity if you want to look at the raw results yourself rather than having a doctor do it for you.

sigmar 2y ago

>Neko Health, with its smaller price tag, doesn’t perform M.R.I.s or X-rays. Instead, it uses about 70 different sensors and a mix of proprietary and off-the-shelf technologies to non-invasively measure heart function and circulation, and to photograph every inch of a patient’s body. Feel like this should have been put way earlier in the article instead of repeatedly using the term "body scan" with no explanation for the entire first half of the piece. Not to say photos aren't useful, but I feel like many people think of mri/ct/x-rays when the word "scan" is used.

logtempo 2y ago
thanks, I could not find this one but I was almost sure it was only a 3D photoscan of the body since they mostly talk about moles and skin. The article is really hard to read if you don't care about storyselling...oops, storytelling.
jvanderbot 2y ago
I've got pretty high skin cancer risk, and this would be a godsend. Getting into a dermatologist is a pain, and when you move or change docs, you lose all the history.

throwme_123 2y ago

https://archive.is/vQVrn https://archive.is/vQVrn

riffraff 2y ago

I'd love to know more about what this is actually testing, or what tests it subsumes, it's not really clear to me from the article. I.e. I get a skin check every year (people take pictures instead of a machine, but its about the same), and it's about €50. Getting a bloodwork is free when asking my family doctor, or when donating blood. This is no MRI nor CT scan, so what _is_ it checking for $500? The article talks of circulation, does this replace some of those doppler vascular tests, perhaps?

bluGill 2y ago
There are a lot of options for tests. 15 years ago I found quest diagnostics price sheet online (it doesn't seem to be online anymore), at the time the lab cost to do your standard cholesterol measure (what most mean when they say blood work) was $1.10, but there was a long list of other things they could do, with the most expensive $18,000. (prices are from memory so probably wrong, but close enough for discussion)
asah 2y ago
do blood donations tests check your cholesterol etc ? or just infectious disease?
- riffraff 2y ago
  depends on the organization/country, in Italy the largest organization managing this is AVIS[0] and they do both infections (every time) and cholesterol etc (once a year), and you get the results, it's a "plus" of being a donor. In Hungary presumably they do the disease checks but they don't tell you the results either, AFAIK. [0] https://www.avis.it/diventa-donatore/ https://www.avis.it/diventa-donatore/
zamadatix 2y ago
> This is no MRI nor CT scan, so what _is_ it checking for $500? The $500 goal mark is for Ezra, a full-body MRI scan. The Neko Health scan is listed as costing ~$230. As for bloodwork the cost may be covered to you as part of insurance/the visit but it's most certainly not free. and there is definitely variety in what tests "bloodwork" includes.

post_break 2y ago

Can we get colonoscopies for the people? Colon cancer is exploding and early treatment is key, but of course the insurance company thinks otherwise.

binarymax 2y ago
There are now mail-in colon cancer detection kits that some healthcare providers give you for free (well, fully paid by insurance at least) Far better than a colonoscopy. The company is called Cologuard. https://www.cologuard.com/ https://www.cologuard.com/
- azinman2 2y ago
  It’s not better than a colonoscopy because polyps cannot be removed.
  - binarymax 2y ago
    I meant better in terms of patient comfort and accessibility. You are right it is not better for treatment. But if the test finds something, further action can be taken and treatment can be administered.
  - bsder 2y ago
    Nope. They did a comparison study between Europe (which does far fewer colonoscopies) and the US and there is no difference in mortality between the two while the US has a higher number of post operation complications. Like so many things lately, it's better to monitor with screening tests and only go in when you have symptoms. That having been said: it seems like the screening tests need to start to be given out to earlier ages, though.
hollywood_court 2y ago
I'm a 42 year old male and I had a colonoscopies perform in March. My GP was immediately concerned with my symptoms and referred me to a gastro doctor. The gastro doc shrugged everything off and didn't think I need a colonoscopy. So I went home and order two of the occult blood test. I used one test on Monday and the second on the following Friday. Both came back positive. So I called the gastro again and he finally scheduled me for the procedure. After the procedure he said everything was fine and he has no idea why the at home tests were positive. I don't know what to think now.

xyst 2y ago

https://archive.is/vQVrn https://archive.is/vQVrn

yellow_lead 2y ago

chewmieser 2y ago

Unlocked (gift link): https://www.nytimes.com/2024/04/27/business/dealbook/daniel-ek-neko-health.html?unlocked_article_code=1.o00.KUWg.atjA_jDWP6Ah&smid=url-share https://www.nytimes.com/2024/04/27/business/dealbook/daniel-...

xyst 2y ago

I wish them good luck. It will be a massive uphill climb. Personally, I am in agreement that unnecessary scans can reveal what is otherwise benign findings to trained physicians. But to Joe Blow off the street, it can cause massive anxiety. Thus triggering a set of follow ups that may lead to expensive and unnecessarily risky operations. But I do also understand how a “clean” scan can alleviate any such anxiety in the future. Even just establishing a baseline of clean scans (MRI, CT, or even PET). Even if a benign finding is found. Can plan appropriately (ie, rescanning every X years) or if symptoms do arise intervention can proceed much faster rather than iterating through various sub-specialists and delaying care. In one case, there is something known as an “brain AVM”. Some say it’s genetic or just bad luck with genetics. But most won’t realize they have it until symptoms arise (ie, stroke like symptoms) or it’s discovered as an incidental finding (ie, patient comes into clinic with concussion).

tiahura 2y ago
As an ambulance chaser who looks at Joe Blow's imaging and reports everyday, my impression is that your concerns are overblown. I've had at least 100 reports with "probable spot noticed on lung/liver/kidney/spine, PT should followup." I've NEVER seen it result in unnecessary treatment. I've also had too many clients die from a cancer not found until it was too late.

tiahura 2y ago

MRIs are never going to be cheap, and CT scans will always involve considerable radiation. Therefore it seems like more resources should be directed at ultrasound. A little better resolution, and a little bit less cost, would go a long way towards democratizing imaging. It looks like google is doing some work in this area: https://health.google/caregivers/ultrasound/ https://health.google/caregivers/ultrasound/