Araz

M.D. alumnus, researcher @karolinskainst/@KarolinskaUnsju (AI for antibiotic decisions). Resident GP. Co-Founder of @Medda_se (WIP, TBA). 31y. Husband & father.

[Araz @Araz_io]

@CanesDavid @DrPhiltill @jasonryanmd That is my point. We cannot gate keep information relating to US finding from patients if they are being generally full-body screened on a regular basis.

[Araz @Araz_io]

@DrPhiltill @CanesDavid @jasonryanmd Most patient want to see the complete results regardless of the physician’s assessment.

[Araz @Araz_io]

@DrPhiltill @CanesDavid @jasonryanmd Also this is not how human beings work, nor how our profession is ruled. We are humble consultants to the patient, if they want to know the results we are not gatekeepers of that knowledge.

But in fact is, today and tomorrow, we wont be able to tell them it’s benign.

[Araz @Araz_io]

@MusQed @byersblake Agreed, AI will definitely help over time but unlikely for this modality. The data still has to human-labeled, i doubt any radiologist would be able to label low resolution images to determine if it’s m/b lesions. Especially not on time series data.

[Araz @Araz_io]

@DrPhiltill @CanesDavid @jasonryanmd (5) US performance cannot outperform MRI resolution and reliability in almost all cases. And we know that the latter isn’t good enough to be used to in broad screening, even when including time series.

[Araz @Araz_io]

@DrPhiltill @CanesDavid @jasonryanmd (3) vital health related information cannot withheld from patients (thats the whole point of your argument btw)

(4) broad screening programs are known to cause harm even with complementary labs and scans.

[Araz @Araz_io]

@MusQed @byersblake No, not necessarily; benign and malicious lesions mostly grow at the same rate; additionally there are few to no way to differentiate between them on a scan without a confirming biopsy. Most people have several unrelated/harmless lesions at any time.

[Araz @Araz_io]

@DrPhiltill @CanesDavid @jasonryanmd That’s Davids point, we won’t. This argument is mute because we’ve already tried more accurate screening programs (eg. with MRIs) that have shown net harm. Regulators and professionals know this because it isn’t a new discussion, but one we have intensely debated for years.

[Araz @Araz_io]

@byersblake We already have annual private executive health screenings with MRIs - the consensus is that they clearly do more damage than good.

Health care related complications can kill people, and these investigations will require invasive procedures that we rather not perform.

[Araz @Araz_io]

@byersblake Time series wouldn’t make much difference. Both malign and benign lesions grow over time. Not all malign lesions will cause mortality/morbidity during you life time, the investigation will likely cause more damage than good.

[Jason Ryan @jasonryanmd]

Whole body scans in asymptomatic people won't save lives overall. They will mostly find benign incidentalomas that cause anxiety for otherwise healthy people. Many of us have benign growths that mimic cancer but are harmless. These will be discovered leading to unnecessary panic and additional testing that causes harm.

If you want to live a long healthy life, skip the scan and instead go the gym and eat a salad.

[Nick Mark MD @nickmmark]

I use ultrasound many times every single day in the ICU, but there’s a lot of unreasonable hype about this “whole body imaging” ultrasound. I’m very skeptical of the claims being made and I’ll explain why:

First some fundamental limitations of US:
Ultrasound doesn’t penetrate bone and doesn’t pass through air very well. This makes imaging the brain and lung parenchyma essentially impossible with US. Bowel gas also frequently makes it difficult to visualize abdominal structures like stomach, small bowel, colon. It can’t see into bone either which can limit its utility for musculoskeletal imaging. For this reason ultrasound isn’t really amenable to a “whole body scan.” It’s hard to see how this could replace other modalities (MRI, CT) if it can’t visualize so much of the body.

Ultrasound exams are often dynamic. If you’ve had one you may have been asked to roll or move to visualize certain structures. This requires a skilled operator. Immersing the patient in a tank for a 1 minute scan is a cute shortcut. It’s technically easier but it probably won’t be able get optimal images, further limiting interpretation. Also are they exchanging the water in the bath each time? Much of the time spend on imaging is actually cleaning the scanner between patients. Unclear how you can quickly disinfect a liquid scanner.

The theoretical resolution of ultrasound is very high, but that isn’t quite the same thing as being able to identify structures. There are lots of artifacts and limitations to ultrasound. For some organs (thyroid, kidney, liver) it’s great. For others it may be less so (pancreas, colon, stomach, etc). Hard to see this replacing existing methods, especially if the concern is cancer screening.

Ultrasound isn’t really one modality. There are a lot of different techniques (B mode, M mode, 3d modes, different types of Doppler, etc). Unclear how many of these this gizmo can do. Adding these capabilities may make the scan more capable but will also add to the scan time if it has to switch modes. There’s no free lunch. There’s always a tradeoff between scan quality and time.

AI is great at *certain* narrow medical image interpretation tasks. But there isn’t a massive training set of data for this “new” modality. I wouldn’t expect AI to be very good at reading these scans until they’ve accumulated millions. That means they are still paying human radiologists to interpret for the foreseeable future.

Everything in medicine is based on evidence. Proving that lung cancer screening saves lives took a decade. Where are the studies for this? So far just hype. More concretely, without evidence insurance won’t pay.

Finally, Who is this technique for? Yes it avoids ionizing radiation but so does MRI. Yes it’s quick, but so is a CT scan. The scan may be quick but the interpretation may be slow (It’s still dependent on human radiologists) and the machine may require time to clean. It can’t image lots of body parts so it’s hard to see how it replaces “whole body MRI scanners.” I’m sure there are tech/wellness bros who are excited but pay out of pocket for low quality wuick partial body scans but wider adoption depends on more than hype.

[Iman Radjavi @imanradjavi]

the stockholm ecosystem is about to explode 💥

[Araz @Araz_io]

@StephenFisherMD @beffjezos Nothing. They also conveniently fail to mention body fat artifacts, resolution, compulsory water immersion, human anatomical heterogeneity.

First impression is that it seems to be another silicone valley (un)health obsession trend, rather than anything medically useful.

[Araz @Araz_io]

Unless you want to find a lot unrelated crap, fear monger completely healthy people, this is a horrible idea.

Silicon valley techies need to recognize their own mortality and be at peace with it.

[The Verge @verge]

Midjourney Medical goes from generating ‘cat images’ to full-body ultrasound scans https://t.co/vBTW15aA5n

[Araz @Araz_io]

Also it reflects badly on your CV when you can barely make a years in a single position.

[Araz @Araz_io]

I’m on my 8th interview for a stealth startup. Is this normal?

[Araz @Araz_io]

Got offered a management position, when I was specifically applying for a technical/clinical position. They may have been a bit surprised when I declined the offer. Don’t take offers that don’t really interest you - even if they come with a hefty salary. It’s not worth it.

[Araz @Araz_io]

https://t.co/UFL7bEqBgC

[Araz @Araz_io]

Children who can use VPN workaround s are not the main target of ban. There are endless scientific evidence that social media engagement for children are DIRECTLY and INDIRECTLY harmful for their development and psychological wellbeing.

This should have been enforced long ago.

[Pavel Durov @durov]

Banning social media for teenagers only puts them in greater danger.

Teens are forced to switch to VPNs — and unlock far worse illegal content.

We’ve seen this before. When the Russian government banned Telegram, 95% of Russian teenagers kept using it. They just moved to VPNs.

[Araz @Araz_io]

Only people I see arguing against are social media enthusiasts and business owners - like Durov himself.

Most mainstream people agree with this ban.