Alphabet unit halts glucose-detecting contact lens project | Hacker News Reader

Alphabet unit halts glucose-detecting contact lens project

reuters.com

120 pointssonabinu95 comments

The actual blog post is much more informative: https://blog.verily.com/2018/11/update-on-our-smart-lens-pro...

Sounds like they couldn’t, with today’s technology, measure glucose levels to the accuracy required for medical devices. But will continue work on measuring other things with those lenses.

I don’t know why the negative tone of the article. Sounds like they tried something and demonstrated their specific solution didn’t work. Most research experiments generally don’t.

A lot of people in the scientific community had suggested for a while that glucose levels in eye fluid were not sufficiently correlated to blood glucose levels for glucose measured in tear fluid to be clinically useful. So even if you could detect glucose in eye fluid, it wouldn't help you manage disease. In the eyes of some this was an obvious limitation that the company brushed aside, and there was a fair amount of hype around it, so there were some ppl calling it vaporware

Although some of the core tech around engineering all the sensors, battery, Bluetooth etc into a contact lens is pretty cool. There are a lot of patents from the inventor, brian Otis (who wrote the blog post), if you want to take a look.

But based on the blog post it seems like they were having trouble measuring glucose in tear fluid, which is one step upstream from the aforementioned issue around lack of correlation btw eye and blood glucose. If you can't accurately measure the analyte it doesn't really matter if it's correlated w disease

"in the eyes of some..." - thought you could sneak that by HN? I see what you did.

You saw what they did there eh?

The technology is definately more than cool, hopefully some of that tech can be repurposed into something that can make it clinically.

Worth noting, tear glucose wouldn't need to be correlated in a linear fashion with BGL, as long as there was a way to derive BGL from tear glucose data.

I think the opposite is true. To achieve medical usage the correlation should be linear. If this is not the case, a small variation of glucose could lead to big jump in the reading, which would decrease the accuracy. In real life, most of the biological system or test exist in a buffered environment, which often show a range of linear relationship for substrates, and tests are often performed by adjusting into such linear range.

If a small variation in glucose led to a big jump in the reading, then the glucose calculation would end up with greater precision.

That is probably the catch. Tear glucose may not be all that well correlated with blood glucose.

The term "correlated" is often used as shorthand for having significant mutual information. The possibility of a nonlinear relationship is lost on very few.

Aside, spelling: it's definite, like finite/infinite. Think "the finite is more definite".

I had the idea of measuring the index of refraction in the aqueous humor using something like a multi-perspective speckle interferometry on the iris.

I think with all of these non-blood approaches is that only the blood matters, and the rate of change in the blood will always be much higher than anything else.

> Sounds like they couldn’t, with today’s technology, measure glucose levels to the accuracy required for medical devices.

There's a bit of spin there. Talking with friends working on it, glucose levels in tears simply can't be correlated with glucose levels in blood. A fundamental scientific issue, not an engineering one.

I was quite surprised when they tried that approach as such a correlation would be quite unexpected. Glucose measurement is an area of quite a lot of research, so their earlier announcements seemed premature at best.

I don't understand this -- we know there's pretty strong correlation between interstital fluid and blood sugar (which is how Dexcom and Lifestyle do their thing). If the correlation between blood sugar and tears isn't equivalent or better than that, what's the point?

Indeed there is no similar correlation. You are correct in "what's the point."

Indeed, most research projects generally don't.

In general, researchers don't report results of failures. How many academic papers reporting a negative would go through the review process...

So there's a bigger debate here. Negative results would also be useful for the broader community, but do not get published in most cases, because the processes may not scale to accomodate them (given most research experiments don't). What technical solutions can help here, and how would a solution become economically viable?

Pre-registration of experiments seems the best answer. Then you are motivated to add something to the registration, such as a negative results, rather than just looking lazy.

How do we know the failures aren’t due to incompetence. You can’t depend on a failure meaning impossible.

You can look at what they did , learn from it and draw your own conclusions.

That's true, but the same can be said for the reverse. How do you know that a research success is not really a failure. If anything, there is more incentive to forge successes than failures.

Indeed. If negative results can be published too and made useful for others, reduction in forged successes could be a side benefit.

Maybe because it was hyped up a lot, including on here.

The original announcement thread:

https://news.ycombinator.com/item?id=7073373

2016 update on Googlebet/Verily vaporware:

https://news.ycombinator.com/item?id=11845804

I didn't find the article's tone to be negative at all - it's dry and objective.

Doesn't matter, what matters is that they published the story with a picture (a stupid picture, that there's no way it would work without alien technology) in hundreds of websites, generating buzz and a rise in their stock value due to investors goodwill.

This is why I dislike Google. If you read the news, you would think they have the future in their hands, but after 10 years of Android, many more of YouTube and Gmail, and only one thing works, only one thing brings them 90% of their revenue: advertising.

And boy do they sell advertising, but they also know how to advertise themselves...

Google is like a children whose parents give free access to chocolate (ad business money). Why would a child eat anything else besides chocolate? It's tasty, it's sweet, it's easy to eat. And it turns out that engineering something is not as easy as turning up ads on YouTube.

It's hard to create a multi-billion business like ads. It's not surprising they could not and probably will never be able to replicate that success. There's a handful of success like these in a century and it rarely comes twice from the same company. I agree with hype of their futurist stuff, they should tone it down if it's just for buzz.

It's hard now when Google have their market position. For Google it was easy to grab the low hanging fruit.

I wonder if former competitors like Altavista just never though of spying on their users and selling the info or if they assumed it would be illegal and didn't do it?

I was pretty surprised that gmail was successful. I didn't imagine that people wouldn't care that their email wasn't on their own computer. But, there you go.

Well, people had been using hosted email from their ISPs, AOL, Hotmail, etc. long before Gmail.

Gmail came out and offered an insane amount of storage, basically toppling the regime.

So surely Gmail wasn't the one that surprised you. That ship had long sailed before then.

Altavista had enough issues with trying to become a portal versus being a good search engine (plus being sold multiple times), which probably hobbled them more than anything else.

Yea I thought something similar - executives at the older companies feared jail time for doing some of those tactics so they stayed away. Of course there’s always lawyers to read the fine print, but still...

Ah come on, the truth is not at all that altavista didn't spy, or didn't do ads. It's that they (and exite, yahoo, infoseek, ...) completely overdid the spying and ads and Google instead massively optimized their backend.

And then a crisis came boom no more competitors.

Google was the least obtrusive of all of the search competitors, and the most useful. That was their great strength.

Man thinking about when this happened, it's now some 20 years ago. I'm old.

It is... if you don't have Google money, Google brand, Google costumer goodwil, Google P&R team, Google capability to attract talent, Google global outreach, Google datacenters, etc. If you ARE Google, and you have all of that? I think it's more difficult to explain why they failed.

Because they found a better solution through partnership with dexcom.

https://www.wareable.com/health-and-wellbeing/dexcom-g6-cgm-...

https://www.fiercebiotech.com/medical-devices/jpm-dexcom-dis...

Is it a transparent contact lens that you put in the eye?

So you don't like Google because all their revenue comes from advertising, but you're also angry that they're trying to branch out into things other than advertising?

I think what the parent is saying is that if you listen to the hype, you would perceive Google as bringing a lot of innovative tech into the world. But the reality is many of these hyped projects that provide this perception are quietly shut down, and at the end of the day after more than a decade Google is still just an ad machine. The parent is upset about the difference between what Google sells itself as doing versus what they actually do.

yeah, i understand what the parent is saying, and i think it's stupid. how are they supposed to diversify if they don't try? or are they supposed to do all their R&D in secret, just to avoid any perception that they might not be entirely evil?

yes, their PR people hype up their R&D efforts. But the point is that they're doing R&D, and why shouldn't they get a PR win out of that?

Well the point is it's been over a decade. They've done a lot of trying with little return.

The projects they're attempting take decades. Period. Loon, for example: Two years for a handful of prototypes, two years for LTE functionality and a "real" trial run, two more years for a mesh network so they aren't bottlenecked by satellites, another year for a large-scale real-world trial run (Puerto Rico), and now we're at the present day. Their job now is to demonstrate that they can keep a balloon fleet up long enough and at sufficiently low cost that it's safe to transition an entire country's economy over to the system. That's probably going to take another ten or fifteen years simply because that's how long it takes to show that your system is reliable enough to be core, critical infrastructure. And Loon is just an easy example. Waymo, Brain. Anything to do with healthcare. Etc. There's a reason these things are called "moonshots".

I thought loon was also considered a failure, although not shut down yet. It's an interesting idea on its own, but it's somewhat dated in that there are better technologies now that don't cost as much to run.

Last I heard it was declared economically viable and spun out. Wikipedia says Loon is currently contracted to provide internet service to a few particularly inaccessible chunks of Kenya, and its performance during the hurricanes last year is probably enough to guarantee its continued existence regardless.

Waymo doesn't count?

Thanks, MTE

Peter Thiel likes to say that monopolies in general try to portray themselves as non-monopolies, as players in a broader field than just their lucrative specialty. This portrayal is supposed to reduce regulatory scrutiny.

Applying this to Google means that funding a broad swath of technology projects makes the company look like much more than the dominant online search ad company. It's a general technology company.

An alternative is that Google has a main revenue source, but they would like to diversify that.

You know, as long the attempts fail, there would be no way to tell the difference between both, which meshes pretty well with "but it's really hard" comment made before.

i'm not much of a thiel fan (e.g., poo-poos college, then sells book spouting business 101 concepts) but i agree with this.

it's the main reason why google became alphabet: not so much for true diversification (because there is no discernable diversification strategy in their portfolio), but as a legal maneuver, a regulatory shield, and a playground for the leadership.

Trying?

This is not trying.

This is effing up every other possible competitor.

If someone goes to a dumb VC asking for money for a product that is actually feasible, they will be turned down because they read on Forbes that google is making that miraculous device that is stupidly ridiculous in so many levels.... but hey! It's google! A Fortune 500 company and its on Forbes!

So, what, every research project and every startup should succeed? That's not how progress works.

This is a hilariously bad take... a) Have you heard of Waymo? There could not be a better example of a company with the future in their hands, due to a decade of investment and research in autonomous driving, about to launch a product many years ahead of its closest competitors. b) You say this is what you dislike about google, but is this not true for any of the big 4? Does Facebook or Amazon have anything that compares to their main cash cows?

> waymo

So how is your waymo car going?

Does it drive well?

Does it get good mpg?

Is it that secure?

Waymo is one of the worst offenders:

https://www.cnet.com/news/googles-sergey-brin-youll-ride-in-...

It was promised in 2012 to be completed in 2017... 2018 is ending and there is still no waymo anywhere besides on google's hands.

While Google has been promising that didn't deliver, not even close, others have been actually delivering self-driving cars to the hands of real costumers and don't get any credit.

As far as I know, waymo has the only public beta of an autonomous vehicle, and it's been running for over a year.

In other words, waymo has put sdcs nn the hands of a limited set of consumers, and right on schedule.

Or do you think that sergeys comments imply autonomous vehicles for public purchase, because that isn't implied and in many cases doesn't make sense.

Everyone and their dog has autonomous vehicles.

Meanwhile Google is trying to patent technology it's not theirs:

https://www.engadget.com/2018/10/02/waymo-self-driving-lidar...

You didn't actually address my specific comment: is anyone else publicly testing an SDC? Is waymo not doing that?

That's what you originally claimed.

Tesla isn't testing SDCs?

There's a difference between L2 and L4/5 autonomy. Tesla have not shown themselves to be capable of jumping to the harder side of that. Waymo, cruise, Uber and Lyft all are, but of the 4, waymo certainly appears to be the most advanced.

To be blunt, Tesla is doing glorified lane following, and everyone can do that. It's not going to turn left at the next traffic light anytime soon. The others will (or at least will try).

Yes, there is difference, but there is also a staggering difference between Google which doesn't have anything on the market, and Tesla that you can go out and buy one and drive it today.

I'm unclear what you mean by "on the market".

Waymo is currently having people pay for an AV rideshare service that can drive you around, and where the clients don't sit in the drivers seat. Whereas Tesla is apparently out here shipping a vehicle that (according to reddit anyway)[1] has hardcoded "do not brake here" zones on the map and almost crashes as a result.

Tesla's vehicles can't reliably drive on a freeway, much less on surface streets. Sure you can buy something, but its not an autonomous vehicle. Because as you rightly point out, you're still the one driving.

[1]:https://www.reddit.com/r/teslamotors/comments/9y6zpb/another...

Yeah, it's hard to believe that they intended to build this into a product considering they hadn't even done basic research to determine the correlation between tear glucose and blood glucose. It's going to be really hard for me to take any of their products seriously because of this.

WTF are you on about here? YouTube doesn't work? Gmail doesn't work? Search doesn't work? Android doesn't work? Maps doesn't work? This is just absolutely a ridiculous stance to take.

The person you are responding to clearly means "only one thing works to make money", as "works" in the context of a business and a discussion about stock price is not "it functions correctly" but "it brings on income".

But YouTube, gmail, etc. all drive people to advertising. That's like saying the words in the NYT don't "work".

You're argument doesn't make sense. YouTube, Android, and Google are 100% completely different businesses and are all wildly profitable.

What you seem to be confused about here is that you think a business model is the same as a business itself. This couldn't be further from the truth.

Profitable because people pay for those services?

No, nobody is paying for YouTube red, nobody is buying "Android", they are profitable because they put ads in people screens. Nothing more, nothing less.

Again, you're failing to understand the point. There is a difference between a business model and the business itself. There are many different ways to monetize a product/service besides direct sales.

Good on Alphabet for 1) releasing their findings and 2) not continuing the experiment for publicity purposes.

I'm wondering though, even if this were a success, how many people would it help? How big is the intersection of people who use contact lens (i.e. can afford them and don't find them annoying) & have diabetes?

In the US, there are 45 million people who wear contacts [0] and 30 million with diabetes [1]. Naively assuming independence, that means potentially 4 million people would benefit from this. Seems like small potatoes to Alphabet, even if they could capture 50% of the market.

0: https://www.cdc.gov/contactlenses/fast-facts.html 1: https://www.cdc.gov/media/releases/2017/p0718-diabetes-repor...

I suspect the number would be quite a bit larger. You have to consider how many with diabetes would be willing to wear contact lenses, and if you consider what the tradeoffs involved are, I think you'd find it's a rather large proportion.

Managing blood sugar how we do it now is a far larger bother than wearing contact lenses. I would guess that most diabetics who could afford them and did not have some physical aversion would use the lens monitors.

The alternative is primarily: draw blood from your finger every time you want to know where your blood sugar is. (There are other 'continuous' glucose monitors, but you have to keep a needle in you all day, and my understanding is they are inaccurate enough that you still often need to check sugar by drawing blood.)

> The alternative is primarily: draw blood from your finger every time you want to know where your blood sugar is. (There are other 'continuous' glucose monitors, but you have to keep a needle in you all day, and my understanding is they are inaccurate enough that you still often need to check sugar by drawing blood.)

I have been using Freestyle Libre for the last two years and only picked my fingers a handful of times in that period. It’s very accurate for me, perhaps a few (10-ish) minutes delay at most compared to fingers and toes, on par with measuring in the arm. And it’s a small fibre, not a needle that’s in the arm for two weeks at a time, doesn’t hurt at all.

The development in diabetes treatment have been tremendous the last years, which might be another reason as of why Alphabet is discontinuing this project.

Hmm, maybe time for me to look into CGMs again :) Any recommendation for how to go about getting the Freestyle Libre? I don't have insurance, so I'm guessing it's gonna be prohibitively expensive...

I'd have to double check, but my recollection the last I looked into the Freestyle Libre monitor was that the Reader cost about $150, and the monitors (the things that attach to your arm) cost somewhere around $100 to $150 a month. Not cheap, but significantly less expensive than the older style monitors, and reports are that the Freestyle Libre is much less uncomfortable then the old style monitors.

There're other contact-lense type efforts underway, listed in another article on the OP subject [1]. It's still a question whether a tiny layer of tear could yield a stable gluco measure.

[1]: https://www.mobihealthnews.com/content/alphabets-verily-shel...

It’s not really a needle but a cannula but close enough.

I don’t like being tethered between my sensor and a device. If I could be wireless I’d be more interested but the current devices are not there yet.

I’d rather see work toward the digital pancreas improve. Maybe in 5 years, but I’ve been saying that for 20 years.

Freestyle Libre doesn't require drawing blood. It isn't a CGM though because it won't alert you when the blood sugar level is not in the normal range.

> Good on Alphabet for ... 2) not continuing the experiment for publicity purposes.

They announced that they were starting their project for publicity purposes! Typically scientists announce their results, not getting a grant.

> Verily cited insufficient consistency in the correlation between tear glucose and blood glucose

For a research project, they should have measured that in week one, and canned the project just 3 weeks in after a bunch of test results on swabs from peoples eyes couldn't be closely correlated with blood glucose after controlling for temperature and humidity in an excel spreadsheet.

How did it take years for them to figure this out? Smells of bad management to me - the engineers saying 'It's so nearly working!!' for years just to keep their jobs, and management believing them.

> How did it take years for them to figure this out?

They thought they could beat it by measuring over long periods of time. This didn’t work. Medical research and scientific envelope-pushing is hard. This was a risky project that failed; everyone walks away with superior knowledge and nobody was harmed.

But Google isn't a startup. They have stocks in the stock market.

What's the cumulative effect of this type of project management on their stock ? is it possible it's positive ?

Wow. I knew that HN commentators were over their head, but this is probably the most outrageous one I've seen.

I sure hope none of the companies, startups included, dont give up after a week (or three) of testing on the projects they are working on.

These types of people confuse the ease of pooping on something with the viability and worthwhileness of that thing.

I see this in a positive light. They tested, it didn't work as well as they expected and hence they're abandoning it.

Sounds like what Theranos should have done

Theranos should be a case study of how not to, for a long time to come in tech firms - especially, those dealing with real-life humans in the healthcare arena.

Even more, Theranos should be a case study for investors. People in the industry were calling out Theranos' nonsense for many years before the whole thing finally collapsed.

I'd really like to know if investors were just oblivious or if they genuinely believed that Holmes could fake it until she made it.

People in the industry were calling out Theranos' nonsense for many years

People in the industry enabled Theranos. You don’t make deals with Walgreens and Safeway without people in the industry backing you.

Of course, there were fair number of doubters. But when the likes of Mayo Clinic lend their name to anything from Theranos, it’s safe to say an important part of the industry backed it.

Given most of them have f.you money and no interest in thinking about those pesky details like physics and chemistry (hello ubeam) I doubt they will worry about this for more than 5 minutes.

Eh, they were shorts, pushing their negative spin. /s

I think the media and social justice movement also played a role. I distinctly remember people with very relevant credentials stating that it was impossible to obtain accurate clinical result from such tiny amounts of blood.

The mainstream media and social media mobs (even here to some degree), immediately chided them as sexist basement-dwelling neckbeards, envious that this young female Steve Jobs of science was showing that the evil patriarchy no longer had power to keep women out of STEM. Of course, not a single apology or retraction was ever issued.

I don't remember any of the white knighting you're talking about. Do you have an actual reference to these kinds of attacks being made, on here or in a major news publication?

They should have abandoned much earlier. A few weeks into that project they should have been getting their first results from swabs of tears back from the lab. Thats the point at which they could see that glucose levels would be low, hard to measure, and with low correlation to blood glucose.

>Our clinical work on the glucose-sensing lens demonstrated that there was insufficient consistency in our measurements of the correlation between tear glucose and blood glucose concentrations to support the requirements of a medical device. In part, this was associated with the challenges of obtaining reliable tear glucose readings in the complex on-eye environment. For example, we found that interference from biomolecules in tears resulted in challenges in obtaining accurate glucose readings from the small quantities of glucose in the tear film. In addition, our clinical studies have demonstrated challenges in achieving the steady state conditions necessary for reliable tear glucose readings.

Why wasn't this clinical work done prior to any work on "smart lenses"? This is like Theranos trying to build all this equipment to support fingerprick blood tests only to find out that venous blood is superior for a lot of things that you want to measure.

It seems that it may work somehow in controlled environment but hit hard rocks when applied to more real patients. It never reached the stage of mass deployment, which is different from Thernos.

Well, medical research is always difficult.

With DiaMonTech (www.diamontech.com) we are also working on a non-invasive blood sugar monitor. Google lens was always a discussion with the interested parties (e.g. investors). Our take was that it is hard to detect the small concentration of glucose in tear fluids but even if you manage to do that, the real problem would be that there is always a delay (between 30 and 100 minutes) until changes in the blood sugar level are seen in tear fluid. So for people with fast changing blood sugar levels (i.e. diabetics) the needed information comes too late.

Honestly I think it wasn't a great tech idea/application in the first place. A lower profile Dexcom [0] would be the better option. My boyfriend has one of these and he can leave it on for 10 days. I take my contacts out at night and normally if I don't leave the house I just use glasses (so does he). His dexcom can monitor 24/7 where as contacts don't work that way. Also before you say "they have contacts you can sleep in and leave in your eyes for a month" I know, but some people's eyes are more prone to infection or have other issues that don't allow for this.

[1] http://www.annualreports.com/HostedData/CompanyHeader/header...

> In a blog update, Verily cited here insufficient consistency in the correlation between tear glucose and blood glucose concentrations to support the requirements of a medical device.

Continuing the extremely long and varied history of failures in non-invasive glucose testing, especially those attempting to measure proxies rather than the blood itself: See John Smith's _The Pursuit of Noninvasive Glucose Blood Tests: "Hunting the Deceitful Turkey"_ http://www.mendosa.com/noninvasive_glucose.pdf

while glucose-detecting lens are cooler and would be very convenient, there seems to be breath analyzing devices development which does show very good promise - i.e. the acetone in breath seems to be an established correlate and the work seems mostly about building convenient device (for people who don't already have a dog performing such a service :) and for that work the product development power of Google money i think would help very much.

Was rapid evaluation team getting neck massages for positive rapid evaluations?

Reply on news.ycombinator.com