Full body scans for the people(nytimes.com)
nytimes.com
Full body scans for the people
https://www.nytimes.com/2024/04/27/business/dealbook/daniel-ek-neko-health.html
10 comments
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.
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.
The article is really hard to read if you don't care about storyselling...oops, storytelling.
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.
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.
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.
Collecting the information on a large scale to know what you are looking at next time seems like the sane approach.
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.
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.
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.
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.
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.
And sometimes the test itself can have rare adverse outcomes even ignoring the issues with false positives.
Nope. The problem is that there are four quadrants in statistics, not two.
There are "found it and you have it", "found it and you don't have it", "didn't find it and you have it" and "didn't find it and you don't have it". Optimizing one of those quadrants deoptimizes the others. If you aren't looking for something specific because your Bayesian probability got bumped by other symptoms, you're going to pop the green jellybean. https://xkcd.com/882/
As someone who has been going through a lot of CT scans recently, I can tell you that they find a lot of inconsequential things. I can imagine that MRIs find even more. My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. My response: "The CT scan results are basically saying "Sucks to get old, brah." There's only one alternative, and it's not very preferable. Now, let's get the thing we're monitoring fixed."
There are "found it and you have it", "found it and you don't have it", "didn't find it and you have it" and "didn't find it and you don't have it". Optimizing one of those quadrants deoptimizes the others. If you aren't looking for something specific because your Bayesian probability got bumped by other symptoms, you're going to pop the green jellybean. https://xkcd.com/882/
As someone who has been going through a lot of CT scans recently, I can tell you that they find a lot of inconsequential things. I can imagine that MRIs find even more. My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down. My response: "The CT scan results are basically saying "Sucks to get old, brah." There's only one alternative, and it's not very preferable. Now, let's get the thing we're monitoring fixed."
> My doctors have been what seems to be unduly impressed with my ability to just shrug the reports off except for the specific thing that I need to get fixed. Apparently, most people freak out and they have to spend a lot of time talking them down.
Why would the doctor even tell the patient that irrelevant stuff then? Seems like malpractice.
Why would the doctor even tell the patient that irrelevant stuff then? Seems like malpractice.
As an ambulance chaser who reads imaging reports everyday, I can confirm: if you're over 30, you've got at least one cyst somewhere in your body.
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).
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).
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.
And then, even if the measurement was entirely neutral and risk-free to the body, there's still the question whether one can afford the cost (time, and possibly also money) of monitoring the abnormality.
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.
More information can lead to unnecessary procedures(by way of insistence either of patient or doctor) which have their own complications.
> There is no way more information is bad unless some serious irrationality comes into play.
I have some bad news to deliver about humans...
I have some bad news to deliver about humans...
Doing an MRI isn't free, so it isn't strictly better than not doing one.
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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?
> 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
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
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.
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.
Cool, see you in a million years when that incredibly noisy effect converges
Strangely pro-eugenics take...
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".
Just in favour of people knowing what goes on inside their body (transparency) and against the narrative "its better for you not to know".
Can we get colonoscopies for the people? Colon cancer is exploding and early treatment is key, but of course the insurance company thinks otherwise.
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.
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.
Lots of companies/industries pray on hypochondriacs, the "vitamin" industry for example. I wouldn't be surprise if they sell shady tests (high false positives/negatives) at a premium for people who "want to be sure". I've seen the same for STDs
I recently learned from a friend in the industry, that when companies run "clinical" trials for their products, they almost never use a control in the study. It's pretty much just "Use this product that is specially formulated to do this, and report back if it made a change".
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/
Far better than a colonoscopy. The company is called Cologuard. https://www.cologuard.com/
It’s not better than a colonoscopy because polyps cannot be removed.
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.
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.
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.
What prevents you from getting one ?
Insurance.
What do you think will happen to your insurance payment when every 25+ is given a """free""" colonoscopy every year ?
You don't need one every year.
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?
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?
> 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.
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.
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)
do blood donations tests check your cholesterol etc ? or just infectious disease?
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/
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/
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https://www.nytimes.com/2024/04/27/business/dealbook/daniel-...
https://www.nytimes.com/2024/04/27/business/dealbook/daniel-...
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/
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/
> 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).
It seems like the main use case is skin checks (i.e for cancerous moles).
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).
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).
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.
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.
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.