13 ms·

Cheap Smartphone Dongle Diagnoses HIV And Syphilis

102 points by joewee 12y ago

smoyer 12y ago
That reminds me of a parody of the lean start-up movement - a must-read in my opinion: http://theanorexicstartup.com/wp-content/the-anorexic-startup.pdf http://theanorexicstartup.com/wp-content/the-anorexic-startu...
swamp40 12y ago
No dongle jokes, please...
SwellJoe 12y ago
So, assuming the medical industry in the developed world gets out of the way (which I don't think is a foregone conclusion...it will take years, and possibly too many resources, to bring this to market in the US for a variety of good and bad reasons related to our regulatory environment), this is potentially one of the biggest revolutionary changes in healthcare in my lifetime. This makes detection of both viral and bacterial infections possible with very low-cost tools; the fact that it can detect both makes me believe that detecting practically any infectious disease (or at least any infectious disease that has identified biomarkers in blood, or other easily obtainable bodily fluid) is on the near horizon. One could buy this dongle, or one like it, and new diseases could be added via software upgrades (or by in-app purchases for the diseases you want to check for). This would potentially make doctors office visits obsolete for all but serious disease and chronic conditions. No need to go get checked for strep when you have a sore throat (of course, getting the antibiotics to treat it is another regulatory hurdle people in the US would face), lower need for cities and universities to provide STD testing, though treatment and education would still likely be within their perview. It allows better self-management of HIV, hepatitis, Lyme disease, and other chronic viral illnesses through more rapid and frequent testing. Even if this doesn't evolve to include other types of detection, I would still happily pay several hundred dollars for a re-usable STD testing tool. I like to get tested every 6 months, but the hassle and cost of going to the doctor or Planned Parenthood or online testing lab is high (free or low cost testing is available, but you trade much more hassle for the lower cost...among my friends who get tested at the city health center, they usually spend an hour or two waiting, which is not a cost I'm willing to pay to save a couple hundred bucks). If I could test for HIV for free before every new partner (and, hell, make it a practice to test with every partner), that'd be fantastic. Another article about this was posted a week or so ago to HN, but it didn't get any comments or many upvotes, which was disappointing, as this seems like entirely revolutionary technology, to me. And, it makes me want to go into medical tech because of how huge the potential is (but it would be an entirely new field for me, so my ability to be productive in it would take a while to develop).
- XorNot 12y ago
  You cannot possibly software update a device like this. The actual detection mechanics are chemical. The advance is in miniaturizing and automating tasks which used to take a laboratory and staff to do.
  - SwellJoe 12y ago
    Is it? I don't know the mechanics. How about genetic testing, is that also a chemical process that is unique for each marker? Seems like a genetic sequencing tool could be programmable once the DNA/RNA has been analyzed. The best HIV test available is an RNA test, which can provide results as early as six days after exposure. This is obviously not my area of expertise, so I don't know how realistic it would be to downsize such a thing. Also, how does this device perform a test for a viral infection and for a bacterial infection, if the tests are unique and chemical? Does it use a particular substance for each test, which has to be refilled per use? (Again, I have no idea how this stuff works.) I know that 23andme continues to produce new information about my genes as new studies are done to find genetic markers for various diseases and traits, which is pretty cool. If there were a device that detected viral and bacterial RNA/DNA, would that be software extensible?
    - nakkiel 12y ago
      Did you read the article? Quote from the article: "Blood from a patient is drawn through microscopic channels where it then meets chemicals that react with HIV and syphilis antibodies to produce a color change. This can then be picked up by a set of photocells in the dongle, and the results are then sent to an app on the attached smartphone or computer."
      - SwellJoe 12y ago
        Huh...I'd read the earlier article and didn't remember seeing that explanation. I didn't read this variant of the article, as I assumed the one I saw earlier was the more authoritative source, but, perhaps this is just a better article.
    - 12y ago
deleted 12y ago
[deleted]
- hamburglar 12y ago
  I think the idea is medical use in populations that don't have access to labs and other testing equipment, not as a date-screening device.
  - slackson 12y ago
    It would be useful for both purposes, wouldn't it?
    - stormbrew 12y ago
      Since they mention a false-negative in the article, it doesn't seem like it would be a good choice to rely exclusively on it. If it gave false negatives at a very low rate, though, a high rate of false positives wouldn't make it useless.
chris_va 12y ago
1) To be pedantic, it detects your immune response (not the microorganisms directly) 2) "14% false alarm rate" => That makes it basically useless.
- stormbrew 12y ago
  False negatives are very bad. False positives not so much. Worst case is you send someone to a better test to find out if it's true. This is what they aim for with home pregnancy test kits, afaik, for pretty good reasons.
  - Fomite 12y ago
    That very much depends on the disease in question. For these diseases, false negatives are bad. For diseases with intensive and dangerous treatments, false positives can be actively harmful to population health. This is commonly a problem in cancer screening.
    - cdcarter 12y ago
      Disease and plan. Almost every rapid HIV test out there is spoken about in "negative" or "maybe positive" terminology. If you get the two dots instead of one dot, you're referred to a physician who will administer a 4th gen test and probably a western bot, you aren't immediately started on ARVs.
  - ekianjo 12y ago
    > False positives not so much. Really. No psychological effect then, you assume ?
- SwellJoe 12y ago
  1. Which, makes it potentially of limited use for HIV testing in high risk populations, since it can take months for immune response to be detectable by this sort of test. Not useless, certainly, as it is actually comparable to what most people get when they go to the doctor to get tested for HIV (not in accuracy, as your second point mentions, but in how long one would have to wait after exposure to know if you're infected). But, for populations not at significant risk, it would be a very good in-between test. 2. Early HIV tests had quite high false positive rates, and an imperfect false negative rate. That improved dramatically over the span of a few years. This is a new research device. It is not expected to be perfect. My first version of anything is never perfect. Technology futures can be hard to predict, but history indicates the following are consistently true: It'll get smaller, faster, cheaper, more precise. Will getting smaller, faster, cheaper, and more precise make this device an effective diagnostic tool? I'd be willing to bet it will.
seesomesense 12y ago
False positive rate : 14% LOL !
shutupalready 12y ago
Was it really necessary to involve a smartphone at all? > color change [is] picked up by a set of photocells in the dongle, and the results are then sent to an app The logic to discriminate a color change could have been handled by a 75-cent microcontroller. Add a cheap display or a couple LEDs to show the test result, plus a cheap AA battery, and you have a self-contained gadget for less cost than creating the smartphone interface. Pregnancy tests and all sorts of sophisticated chemical test strips don't involve a smartphone. I'm thinking that the smartphone hookup is either: (1) a way to add future functionality like maintaining a database of the tests or uploading test results to somewhere (with all the privacy implications and risks of those), or (2) a marketing ruse since we all know that a smartphone app that does X is way cooler than a old-fashioned self-contained gadget that does X. An an example of how easily people fall for coolness of having a smartphone do something that doesn't actually need a smartphone, check out this comment to the original article: "I have been resisting the smartphone trend for years because they are expensive and there was no unique use for them: everything a smartphone did I ALREADY own a gadget for. This changes the game. Now I want a smartphone."
- Fomite 12y ago
  A couple thoughts: 1. The comment you're talking about is from, essentially, someone who doesn't know what they're talking about. This isn't really meaningfully a "game changer" in terms of "Should I buy an iPhone?" 2. Computers are already used to analyze many of these types of diagnostic tests. It may have been easier to port those systems to a smart phone than to develop a new, bespoke microcontroller. Expertise is a cost. 3. There are massive benefits to having this hooked up to a smart phone, and as you have mentioned, much of it goes to extra functionality. During the Ebola outbreak, case reports often had to be dealt with in paper forms processed by hand, which slowed both reporting and contact tracing. From a public health perspective, being able to link test results (deidentified or not) with a central repository at a ministry of health is a big deal. Imagine the use case of this not as one person and a smart phone testing themselves. Imagine it as one person and a smart phone testing 4 villages over the course of the week, in conjunction with actually getting people treatment.
  - 12y ago
DanBC 12y ago
This pages talks about the false positive rate of some existing tests: http://mobile.aidsmap.com/Accuracy/page/1323395 http://mobile.aidsmap.com/Accuracy/page/1323395
carlosgg 12y ago
They were featured on the Science Friday podcast: http://www.sciencefriday.com/segment/02/06/2015/honey-i-shrunk-the-lab-testing-for-stds-on-a-smartphone.html http://www.sciencefriday.com/segment/02/06/2015/honey-i-shru...

102 points by joewee 12y ago

That reminds me of a parody of the lean start-up movement - a must-read in my opinion: http://theanorexicstartup.com/wp-content/the-anorexic-startup.pdf http://theanorexicstartup.com/wp-content/the-anorexic-startu...

swamp40 12y ago

No dongle jokes, please...

SwellJoe 12y ago

So, assuming the medical industry in the developed world gets out of the way (which I don't think is a foregone conclusion...it will take years, and possibly too many resources, to bring this to market in the US for a variety of good and bad reasons related to our regulatory environment), this is potentially one of the biggest revolutionary changes in healthcare in my lifetime. This makes detection of both viral and bacterial infections possible with very low-cost tools; the fact that it can detect both makes me believe that detecting practically any infectious disease (or at least any infectious disease that has identified biomarkers in blood, or other easily obtainable bodily fluid) is on the near horizon. One could buy this dongle, or one like it, and new diseases could be added via software upgrades (or by in-app purchases for the diseases you want to check for). This would potentially make doctors office visits obsolete for all but serious disease and chronic conditions. No need to go get checked for strep when you have a sore throat (of course, getting the antibiotics to treat it is another regulatory hurdle people in the US would face), lower need for cities and universities to provide STD testing, though treatment and education would still likely be within their perview. It allows better self-management of HIV, hepatitis, Lyme disease, and other chronic viral illnesses through more rapid and frequent testing. Even if this doesn't evolve to include other types of detection, I would still happily pay several hundred dollars for a re-usable STD testing tool. I like to get tested every 6 months, but the hassle and cost of going to the doctor or Planned Parenthood or online testing lab is high (free or low cost testing is available, but you trade much more hassle for the lower cost...among my friends who get tested at the city health center, they usually spend an hour or two waiting, which is not a cost I'm willing to pay to save a couple hundred bucks). If I could test for HIV for free before every new partner (and, hell, make it a practice to test with every partner), that'd be fantastic. Another article about this was posted a week or so ago to HN, but it didn't get any comments or many upvotes, which was disappointing, as this seems like entirely revolutionary technology, to me. And, it makes me want to go into medical tech because of how huge the potential is (but it would be an entirely new field for me, so my ability to be productive in it would take a while to develop).

XorNot 12y ago
You cannot possibly software update a device like this. The actual detection mechanics are chemical. The advance is in miniaturizing and automating tasks which used to take a laboratory and staff to do.
- SwellJoe 12y ago
  Is it? I don't know the mechanics. How about genetic testing, is that also a chemical process that is unique for each marker? Seems like a genetic sequencing tool could be programmable once the DNA/RNA has been analyzed. The best HIV test available is an RNA test, which can provide results as early as six days after exposure. This is obviously not my area of expertise, so I don't know how realistic it would be to downsize such a thing. Also, how does this device perform a test for a viral infection and for a bacterial infection, if the tests are unique and chemical? Does it use a particular substance for each test, which has to be refilled per use? (Again, I have no idea how this stuff works.) I know that 23andme continues to produce new information about my genes as new studies are done to find genetic markers for various diseases and traits, which is pretty cool. If there were a device that detected viral and bacterial RNA/DNA, would that be software extensible?
  - nakkiel 12y ago
    Did you read the article? Quote from the article: "Blood from a patient is drawn through microscopic channels where it then meets chemicals that react with HIV and syphilis antibodies to produce a color change. This can then be picked up by a set of photocells in the dongle, and the results are then sent to an app on the attached smartphone or computer."
    - SwellJoe 12y ago
      Huh...I'd read the earlier article and didn't remember seeing that explanation. I didn't read this variant of the article, as I assumed the one I saw earlier was the more authoritative source, but, perhaps this is just a better article.
  - 12y ago

deleted 12y ago

[deleted]

hamburglar 12y ago
I think the idea is medical use in populations that don't have access to labs and other testing equipment, not as a date-screening device.
- slackson 12y ago
  It would be useful for both purposes, wouldn't it?
  - stormbrew 12y ago
    Since they mention a false-negative in the article, it doesn't seem like it would be a good choice to rely exclusively on it. If it gave false negatives at a very low rate, though, a high rate of false positives wouldn't make it useless.

chris_va 12y ago

1) To be pedantic, it detects your immune response (not the microorganisms directly) 2) "14% false alarm rate" => That makes it basically useless.

stormbrew 12y ago
False negatives are very bad. False positives not so much. Worst case is you send someone to a better test to find out if it's true. This is what they aim for with home pregnancy test kits, afaik, for pretty good reasons.
- Fomite 12y ago
  That very much depends on the disease in question. For these diseases, false negatives are bad. For diseases with intensive and dangerous treatments, false positives can be actively harmful to population health. This is commonly a problem in cancer screening.
  - cdcarter 12y ago
    Disease and plan. Almost every rapid HIV test out there is spoken about in "negative" or "maybe positive" terminology. If you get the two dots instead of one dot, you're referred to a physician who will administer a 4th gen test and probably a western bot, you aren't immediately started on ARVs.
- ekianjo 12y ago
  > False positives not so much. Really. No psychological effect then, you assume ?
SwellJoe 12y ago
1. Which, makes it potentially of limited use for HIV testing in high risk populations, since it can take months for immune response to be detectable by this sort of test. Not useless, certainly, as it is actually comparable to what most people get when they go to the doctor to get tested for HIV (not in accuracy, as your second point mentions, but in how long one would have to wait after exposure to know if you're infected). But, for populations not at significant risk, it would be a very good in-between test. 2. Early HIV tests had quite high false positive rates, and an imperfect false negative rate. That improved dramatically over the span of a few years. This is a new research device. It is not expected to be perfect. My first version of anything is never perfect. Technology futures can be hard to predict, but history indicates the following are consistently true: It'll get smaller, faster, cheaper, more precise. Will getting smaller, faster, cheaper, and more precise make this device an effective diagnostic tool? I'd be willing to bet it will.

seesomesense 12y ago

False positive rate : 14% LOL !

shutupalready 12y ago

Was it really necessary to involve a smartphone at all? > color change [is] picked up by a set of photocells in the dongle, and the results are then sent to an app The logic to discriminate a color change could have been handled by a 75-cent microcontroller. Add a cheap display or a couple LEDs to show the test result, plus a cheap AA battery, and you have a self-contained gadget for less cost than creating the smartphone interface. Pregnancy tests and all sorts of sophisticated chemical test strips don't involve a smartphone. I'm thinking that the smartphone hookup is either: (1) a way to add future functionality like maintaining a database of the tests or uploading test results to somewhere (with all the privacy implications and risks of those), or (2) a marketing ruse since we all know that a smartphone app that does X is way cooler than a old-fashioned self-contained gadget that does X. An an example of how easily people fall for coolness of having a smartphone do something that doesn't actually need a smartphone, check out this comment to the original article: "I have been resisting the smartphone trend for years because they are expensive and there was no unique use for them: everything a smartphone did I ALREADY own a gadget for. This changes the game. Now I want a smartphone."

Fomite 12y ago
A couple thoughts: 1. The comment you're talking about is from, essentially, someone who doesn't know what they're talking about. This isn't really meaningfully a "game changer" in terms of "Should I buy an iPhone?" 2. Computers are already used to analyze many of these types of diagnostic tests. It may have been easier to port those systems to a smart phone than to develop a new, bespoke microcontroller. Expertise is a cost. 3. There are massive benefits to having this hooked up to a smart phone, and as you have mentioned, much of it goes to extra functionality. During the Ebola outbreak, case reports often had to be dealt with in paper forms processed by hand, which slowed both reporting and contact tracing. From a public health perspective, being able to link test results (deidentified or not) with a central repository at a ministry of health is a big deal. Imagine the use case of this not as one person and a smart phone testing themselves. Imagine it as one person and a smart phone testing 4 villages over the course of the week, in conjunction with actually getting people treatment.
- 12y ago

DanBC 12y ago

This pages talks about the false positive rate of some existing tests: http://mobile.aidsmap.com/Accuracy/page/1323395 http://mobile.aidsmap.com/Accuracy/page/1323395

carlosgg 12y ago

They were featured on the Science Friday podcast: http://www.sciencefriday.com/segment/02/06/2015/honey-i-shrunk-the-lab-testing-for-stds-on-a-smartphone.html http://www.sciencefriday.com/segment/02/06/2015/honey-i-shru...