[eighto]

It sounds like he's sold this system to several hospitals in the US though? According to the article anyway.

Does that not indicate that he might have something useful here? Even if he has a gamer nickname and is based in China.

[coolwulf]

I'm actually based in US.

To clarify, we have several research collaborations on-going in US clinics.

[yorwba]

Also according to the article, those hospitals run the software HIPAA-compliant in-house, whereas the free online service is intended for people who literally couldn't afford anything else.

[medimikka]

The resolution and planes in modalities that are useful for visual diagnostics (which, again, are outdated as hell) are so expensive, I don't think the little AI script drawing over suspected lesions (something a PET can do much better, including staging and grading) is the cost factor here.

But, hey, you do you. If you're comfortable subjecting yourself or your loved ones to this, by all means, do it. Without a decent sensitivity and specificity review, without an actual review in general, and without a corporation whose jugular I can cut if they screw up and murder my patient through a misdiagnosis, I'll stay away from someone's home grown shoe box medicine as far as I can. And I know all my serious colleagues will and are as well. It's not like that's the first person this week (or even today) trying to sell us one of those.

[yorwba]

From the article:

"Currently, many countries cannot operate Treatment Machines (radiation therapy machines) and CT scanners simultaneously due to insufficient power supply.

This might be hard to imagine for countries like China or the USA, but hospitals in these countries do not have hardware with sufficient computing power, nor do they have the funds to purchase AI service software. There's also a lack of understanding about AI technology, and even the performance of computers used by doctors can't be guaranteed."

By all means if you can afford it, sign an actual contract with the company developing this product; the free plan wasn't meant for you.

[medimikka]

> "Currently, many countries cannot operate Treatment Machines (radiation therapy machines) and CT scanners simultaneously due to insufficient power supply.

Yes, I know. I worked in Ghana. And, know what? Unless you're running a $5m/month Cyberknife or similar, you don't do those dual modality approaches. Most, literally all except five or six research hospitals in the US and EU, treatments still work (very well) with lead marker lines on patients. We image, we look at the image we stage, we localize, we take out a tape measure, we draw. It might sound archaic, but it works extremely well, especially in places like Ghana.

I'd seriously love to see "coolwolf"s experience in developing country cancer treatments. I mean, in developing countries we deal 95% with cervix, breast, liver and prostate. Neither are hard to image and localize/stage. In the case of higher stages, exploratory imaging is also done, but those lesions aren't of initially surgical or radioherapeutic concern. Those who are, can be localized by eye only. And that's the ones, that software outlines.

[coolwulf]

I am talking in terms of my experience Treating multiple brain Mets patients. They have lesions as small as 0.01cc which we treat using either GammaKnife or CyberKnife with zero margin for CTV. This accuracy won't be achieved easily with tape measurements AFAIK.

[medimikka]

It indicates, that he has sold a solution. It neither indicates that this solution is used[1], nor that those solutions are used for diagnostics.

And if Chinese single-individual solutions with gamer nicknames don't worry you, someone who frequents Hacker News and is probably not dumb, I understand many of the issues we have with medicine and medical communication much better. I'm sure you're confident that you, or a loved one, will be correctly diagnosed by this thing. I am not.

[1]: these hospitals are conglomerate hospitals who will buy things to try them out. I have dozens of bullshit solutions my bosses bought in storage. Why do you think you're getting raked over the coals for every small issue? Why do you think health care in the US is that expensive)

[eighto]

Thanks for your insights and sharing your expertise. I found it interesting to learn that these hospitals will purchase a solution just to test it out, possibly to then just shelve it. If that's what's happened here it seems quite dishonest of the author to imply that his software is being used there in actual clinical practice.

[coolwulf]

NeuralRad is being used during the clinic practice workflow at the moment. The platform currently is not FDA 510k cleared so we had to establish an IRB with the clinics which are building the platform into their clinical workflow.

[alwa]

You’re handling all the skepticism and hostility here with much more grace than I would be able to. I admire your tenacity and the scope of your effort-your hacker ethos, as it were.

I understand why the audience’s instinct is to judge you by the standards they’d judge a clinician or a formal medical device manufacturer, in that history of medical tech is littered with examples of well-meaning engineering efforts unintentionally causing harm.

As a counterbalance, though, I’d like to speak to the charitable interpretation: after all, how many times have I as a tech guy relied on practitioners in other fields to tell me what they could use, and whether what I built was helping them? It seems like you’re being judged on your skills as a practicing oncologist or full-scale US-market medical device manufacturer, when maybe a more fair frame might be that of a person who tries to help professionals whose work they admire by building tools they ask for.

I feel like just as it’s somebody else’s job to know how to doctor cancer, it will be somebody else’s job to prove that the tech is safe and appropriate to commercialize or popularize (what else is regulation for?).

From one person who likes making stuff to another person who makes stuff, though, I appreciate your good intentions, your creativity, and your follow through-and I admire your grace handling criticism here!

[hef19898]

Welly he is working at the point where clinicians and medical device manufacturers meet. Hence, those are the only standards to measure against.

If those standards are met, great, more power to NeuralRad. It just rubs some people wrong to market this in classic SV start-up fashion, using the latest, in this case AI, hype. It just rubs people in more serious industrues the wrong way sometimes. Which, by the way, is valid feedback for everyone on HN with a B2B start-up targeting clients in very mature and risk averse indistries.

[coolwulf]

Thank you!