How a software engineer invented a breakthrough medical device • Hacker News Board

Re: How a software engineer invented a breakthrough medical device

#61

Post by ynniv » Fri, Sep 04, 2009, 10:09 PM UTC

marciovm123 wrote: post #9

This article is inspiring but it fails to mention that no studies have shown that the device actually works. The FDA approval process for medical devices is very different then from pharmaceuticals; to oversimplify, efficacy does not need to be demonstrated, only safety (i.e. the device is not toxic). Thus the fact that the device is FDA approved doesn't really mean much (although it sounds great). As with renewable…

Mechanically, or clinically? It seems likely that this will work mechanically. I don't think that he is claiming to have cured cancer, just improved the technique for delivering chemotherapy drugs to a certain kind of tumors.

Re: How a software engineer invented a breakthrough medical device

#62

Post by joe_the_user » Fri, Sep 04, 2009, 10:20 PM UTC

Novash wrote: post #15

marciovm123 wrote: post #9

This article is inspiring but it fails to mention that no studies have shown that the device actually works. The FDA approval process for medical devices is very different then from pharmaceuticals; to oversimplify, efficacy does not need to be demonstrated, only safety (i.e. the device is not toxic). Thus the fact that the device is FDA approved doesn't really mean much (although it sounds great). As with renewable…

You sound like the doctors on the article that says that "it wouldn't work anyway". I understand that you have a far greater background than I have and I respect that, but you must keep your mind open. Most of the great anchievements of mankind 'wouldn't work anyway' in the minds of the specialists of the age. And they were wrong. With all due respect, you, giving you background on the matter, can find any technical…

I have worked very, very briefly with medical devices...

The main thing to keep in mind is that biology is mind-bogglingly complex. More complex than our human, conscious minds can possible realize. This makes pills, devices and such much less reliable than one would imagine as an engineer inventing things, so the original poster has A point.

But... the very complexity of the biology field also means that the received ideas of experts about what is or isn't possible probably aren't right either. Probably, on the average, no one is right. So the experts could easily be wrong in telling you that a given approach will fail ... but it probably will fail anyway, just because most things fails.

However, it does seem like machines that rely on external tech might be easier than machines that rely on understanding biology - a machine which just finds and kills cancer cells seems more plausible than something tells the body itself to do something since the machine isn't depending the body to do anything.

Re: How a software engineer invented a breakthrough medical device

#63

Post by iag » Fri, Sep 04, 2009, 10:26 PM UTC

Nothing but utmost respect for this guy. I hope he succeeds

Re: How a software engineer invented a breakthrough medical device

#64

Post by joe_the_user » Fri, Sep 04, 2009, 10:30 PM UTC

by wrote: post #19

marciovm123 wrote: post #9

This article is inspiring but it fails to mention that no studies have shown that the device actually works. The FDA approval process for medical devices is very different then from pharmaceuticals; to oversimplify, efficacy does not need to be demonstrated, only safety (i.e. the device is not toxic). Thus the fact that the device is FDA approved doesn't really mean much (although it sounds great). As with renewable…

I have long felt that there is a massive and well funded lobby for curing things, but an impoverished prevention programme. There is no real financial incentive to prevent cancer etc, but lots of money and glory for curing people who have got cancer. This applies right across medicine. Similarly there is a massive and well funded lobby for power production and very little for power efficiency, which effectively achie…

I suspect that research isn't the problem...

Consider, if cancer prevention cost as much per person as cancer curing, it would be impossible to implement. So the prevention that makes any sense is cheap prevention.

Moreover, we know of many cheap preventative activities, especially exercise and healthy diet.

Unfortunately, it is hard to get people to engage in healthy activities. Indeed, it is easier to get someone to spend $100 on a bogus cancer prevention pill than it is get them to spend nothing at all and exercise regularly.

So I'm sure research efforts will continue on creating a pill to give people who live unhealthily the effects of a healthy lifestyle... but I'm more than skeptical

Re: How a software engineer invented a breakthrough medical device

#65

Post by tmoertel » Fri, Sep 04, 2009, 11:22 PM UTC

by wrote: post #19

marciovm123 wrote: post #9

This article is inspiring but it fails to mention that no studies have shown that the device actually works. The FDA approval process for medical devices is very different then from pharmaceuticals; to oversimplify, efficacy does not need to be demonstrated, only safety (i.e. the device is not toxic). Thus the fact that the device is FDA approved doesn't really mean much (although it sounds great). As with renewable…

I have long felt that there is a massive and well funded lobby for curing things, but an impoverished prevention programme. There is no real financial incentive to prevent cancer etc, but lots of money and glory for curing people who have got cancer. This applies right across medicine. Similarly there is a massive and well funded lobby for power production and very little for power efficiency, which effectively achie…

> There is no real financial incentive to prevent cancer etc, but lots of money and glory for curing people who have got cancer.

Prevention is much harder to sell than cures because the effect of prevention is hard for people to see. If you get cancer, are given a treatment, and you live, you assume that without the treatment you would have died (death being the "counter-factual" observation that corresponds to the factual observation of your not dying), and thus that the treatment effect was big and important. But if you take a preventative treatment and don't get cancer, you don't have an obvious counter-factual to which you can compare your present state of well-being. You don't have the opportunity to realize that without the preventative treatment you would have gotten cancer and died: that counter-factual history never had a chance to play out.

Re: How a software engineer invented a breakthrough medical device

#66

Post by marciovm123 » Fri, Sep 04, 2009, 11:28 PM UTC

Novash wrote: post #43

marciovm123 wrote: post #23

Earlier quoted context omitted.

Very valid points. I'm not saying this kind of work shouldn't be pursued, I just wanted to point out that it is premature to think of this device as a "breakthrough". As I said before, I hope it works, and new approaches are in general a good thing. I just think the way they are reported is more for entertainment purposes then spreading true knowledge. Technically, the idea of killing a tumor w/ a localized toxin is…

Now I can see your point. Thanks for the reply. However, this treatment is not only about localized toxin. It has a two-fold approach of both blocking the blood path the tumor is feeding of and using a localized chemo treatment. Wouldn't this approach be more effective than the actual ways? I have another question. Since you claim that localized toxin causes the recurrence to be much more difficult to treat because t…

sure =). I'm an engineer and not an oncologist so don't quote me on this. The main msg is that treating cancer is really, really hard; as another commenter noted biology is incredibly complicated.

multi-pronged approaches do seem to work best; some variation of that already happens. Large tumors are surgically removed, anti-angiogenesis drugs work by blocking new blood vessels from growing, I mentioned some others. The problem is that even the most aggressive combinations of treatments haven't proved to actually work in practice, and death rates for most cancers have barely budged in the last 30 yrs. A reflection of this is that people will pay $50k+ for a drug that will increase life expectancy by a few weeks (or their insurance will, that's another topic).

People like me do train their entire lives to improve this, and we are working on many new possibilities, for example tracking circulating tumor cells and figuring out what DNA mutations they have to see if you can make a drug that is targeted towards deactivating whatever fraction of them actually lead to metastatic disease. Look up the National Cancer Institute's nanotechnology in cancer program to see more of this kind of stuff.

I don't know what the "unlocalized" side effects are and why things are done that way - I will say any kind of advance in treaments is incredibly difficult to achieve because you have to convince MDs and patients to go with something new when there is a tried and tested method, and it is their lives in the balance.

Re: How a software engineer invented a breakthrough medical device

#67

Post by anamax » Sat, Sep 05, 2009, 12:14 AM UTC

praptak wrote: post #52

anamax wrote: post #32

Earlier quoted context omitted.

> I think thorough testing and a long approval process is certainly in order. Huh? Suppose that it costs $1 and a quick test shows that it seems to help "a bit". Why not let folks skip a Coke for on the chance that the benefit is real while "thorough testing" goes on? Costs and benefits apply to testing as well as deployment.

"Suppose that it costs $1 and a quick test shows that it seems to help "a bit". Why not let folks skip a Coke for on the chance that the benefit is real while "thorough testing" goes on?" You missed the part about the worst case being death. What if using the device provides short term relief but makes 15 percent of patients die within half a year after its usage?

Nope.

I read the response that pointed out that the worst case here was slightly earlier death and realized that in many cases the worst case is exactly what I said it was, someone is out the cost of a Coke.

The fact that some medical "treatments" will kill you is not necessary useful when evaluating a different treatment.

It's important to evaluate things based on their actual costs and benefits, not the costs and benefits of other things.

Re: How a software engineer invented a breakthrough medical device

#68

Post by jodrellblank » Sat, Sep 05, 2009, 12:16 AM UTC

Novash wrote: post #53

nixme wrote: post #47

Earlier quoted context omitted.

Not to draw it out much further, but I don't think a majority of domain experts in a field would (or have in the past) completely discounted the possibility of an invention or achievement. It's usually journalists, pseudo-intellectuals, or self-proclaimed experts who make these types of claims. Are you saying that leading physicists and engineers in the mid-20th century didn't think space flight and satellites were a…

You're going too little backwards in time. Spaceflight was proposed in the begining of the 20th century. http://en.wikipedia.org/wiki/Robert_H._Goddard#A_Method_of_R... And yes, it was very criticized at the time but as you said, mainly by the media, as it seems. I doubt, however, that they did it without any backing. And I was wrong about satellites, it seems. I was pretty sure that the idea of using them as communi…

I don't believe that 'people' ('scientists') thought birds could not fly, or were lighter than air.

Re: How a software engineer invented a breakthrough medical device

#69

Post by mahmud » Sat, Sep 05, 2009, 12:34 AM UTC

Novash wrote: post #45

BigZaphod wrote: post #17

I found this gem in the comments on that page: I appreciate the kind comments. If you or a friend / family member could benefit from the catheter, please do not hesitate to contact us on our website at www.vasculardesigns.com No one will be turned away if they can not afford the catheter. Robert Goldman

Unfortunately, they arrived one month too late.

One month too late for whom? is there another product in the market, or is it too late for your own needs?

Re: How a software engineer invented a breakthrough medical device

#70

Post by Dove » Sat, Sep 05, 2009, 1:44 AM UTC

Seven years. Wow. That really makes me wonder how many folks die while treatments that might save them are still working their way through the FDA. And how many treatments don't exist at all -- just think, this thing could be on the third or fourth iteration by now!

I don't mind information, but that's just silly. People should be able to decide for themselves when to use experimental treatments, based on their own level of risk tolerence.