Hacker News new | ask | show | jobs
by akg_67 4504 days ago
A few months ago, I had a BRAVO study done for acid reflux issue. Basically, a capsule with wireless transmitter is attached to esophagus wall. You carry around a bulky wireless receiver with antenna sticking out that records pH readings for 48 hours. You also record when you are lying down, eating and encounter acid reflux episodes on a piece of paper. After 48 hours, you need to take receiver and paper with recorded information back to the clinic so that they can retrieve the data from recorder.

Pain points:

1. A Bulky receiver that patient need to carry around or keep within couple of feet of your body. (inconvenience).

2. Patient need to remember to record on a paper when you are lying down and various other information.

3. Patient need to take the receiver back to clinic.

4. Clinic need to enter the information listed on paper and download data from receiver and upload to an analysis system.

5. If receiver is lost, patient is charged $3,000 to $5,000 and clinic need to buy another receiver.

In this age of smartphones with gyros and apps, I thought these pain points can be easily solved by creating a Smartphone App and turning smartphone into receiver from wireless capsule in esophagus. Smartphone can be attached to the chest to detect when a patient lies down. Patient can manually select options in apps for various information that need to be captured. After 48 hours, smartphone automatically sends captured information and data to a central server over internet.

Benefits:

1. Everyone has smartphone, no need for clinic to provide a bulky receiver that need to be returned to clinic after 48 hours and deal with lost receivers.

2. Patient doesn't need to go back to clinic just to return receiver and completed forms (Travel time and cost).

3. Clinic doesn't need to perform data entry and upload information to a system (Expensive medical labor).

Challenges:

1. Potentially limited market. But I am sure there are a few other similar medical monitoring procedures to which this solution could be extended (small market).

2. Potential FDA approval and clinical trials (expensive and long time to market). Depending on wireless protocol used between capsule and receiver, may need to redesign the capsule (much larger hurdle for a new startup instead of existing maker to modify).

3. Bringing together people with medical imaging domain knowledge and mobile OS App developers.

Why I am not pursuing this idea myself?

I thought about pursuing this idea for a short while as I spent couple of years consulting in medical imaging IT. But thought of putting together a qualified team and raising financing stopped me in the tracks. I prefer ideas that I can bootstrap (result of previous scars raising OPM). Most of my medical imaging contacts are on East coast of Canada and I am now on West coast of US so difficult to put together a good team with people I know. No experience with Mobile. Already involved with another idea in a totally different space.

Hopefully, sharing this idea helps someone else.

1 comments

Can you explain to me what the benefit of this study is supposed to be? (I think finding a way to eliminate the study would make more sense.)
The study measures the pH over 48 hour period near the entrance of stomach. This helps determine the frequency and strength of acid reflux into esophagus from stomach to assess the severity of gastroesophageal reflux disease (GERD). Typically, capsule is placed in esophagus during the endoscopy.

Based on my readings before the procedure, in my opinion, BRAVO capsule technique is currently the most advanced, accurate,and convenient method compared to previously used methods such as stents/catheter.

More info http://my.clevelandclinic.org/services/esophageal_ph_test/hi...

I am not sure what do you mean by eliminating the study. How else are you going to measure the pH to detect acid reflux in esophagus.

Thank you for replying. I am trying to understand what benefit there is to studying the frequency and strength. How is that information used? What good does it do you to know?

I am sorry if I sound obtuse. I am genuinely trying to understand this. I have a serious medical condition which causes extreme acidification. Reversing the acidity has reversed a lot of my symptoms. I did not need a fancy test to do that. So I am trying to understand ... why people do this sort of thing, I guess. It makes no sense to me but what I do makes no sense to other people. I don't know how to cross that communication gap right now. I am trying to figure it out.

The study helps figure out the severity and seriousness of the problem. There are wide range of treatments, from lifestyle changes to extended treatment with drugs, maintenance drugs and surgery. There is no one treatment that applies to everyone and study helps make a much better informed decision about treatment options. Too much acid reflux can result in lining deterioration, perforation or even cancer in esophagus. Based on study results, doctors can recommend the checkup frequency for esophagus too.

Hope this helps clarify why such studies are performed. I look at such studies as data-driven decision making.

Thank you for your patience. I am not sure it helps because I think what I do is data driven but it comes from another direction. I am not sure I understand any better or know what I need to be asking, really.