15-Year-Old Maker Astronomically Improves Pancreatic Cancer Test
blog.makezine.com
blog.makezine.com
Unfortunately, this blog post and the one it claims as a source [1] are rather fluffy on details. Justin organized this information and presentation for the Intel Science and Engineering Fair (ISEF) [2]. More details about the process he discovered can be found on the ISEF 2012 profile page [3] and for those who don't want to follow the trail, I've reproduced it here:
"Pancreatic cancer is a devastating disease with a five-year survival rate of 5.5%. One reason for this is the lack of a rapid, sensitive, inexpensive screening method. A novel paper sensor is described that simply, rapidly and inexpensively screens for pancreatic cancer. Mia Paca cells overexpressing mesothelin, a biomarker for pancreatic cancer, were cultured; mesothelin was isolated, concentrated and quantified with ELISA. After optimization with the Western Blot assay, the antibody to human mesothelin was dispersed with single walled carbon nanotubes. This dispersion was used to dip-coat strips of filter paper, rendering the paper conductive. Optimal layering was determined using a scanning electron microscope. Cell media spiked with varying amounts of mesothelin was applied to the paper biosensor. Change in electrical potential was measured before and after application and a dose-response curve was constructed with an R2 value of 99.92%. In vivo tests on human blood serum obtained from healthy people and patients with chronic pancreatitis, PanIn, pancreatic cancer revealed the same trends.. The sensor’s limit of detection was found to be 0.156 ng/mL, satisfying the limit of 10 ng/mL, the level considered an overexpression of mesothelin consistent with pancreatic cancer. The sensor costs $3.00; 10 tests can be performed per strip. A test takes 5 minutes and is 168 times faster, 26,667 times less expensive, and 400 times more sensitive than ELISA, 25% to 50% more accurate than the CA10-9 test and is a sensitive, accurate, inexpensive, and rapid screening tool to detect mesothelin, a biomarker for pancreatic cancer."
[1] - http://www.fastcoexist.com/1680194/meet-the-15-year-old-who-...
[2] - http://www.societyforscience.org/isef/
[3] - http://apps.societyforscience.org/intelisef2012/project.cfm?...
http://www.pancan.org/section_research/strategic_research_pr...
Whether or not the test is a smashing success is not the only point of inspiration. I think the field of medicine is extremely prone to disruption by clever, process-focused laymen, whether they are 15 or 30-years of age. The field of medicine is filled with brilliant people, but it's also held back by institutional tradition and authority, i.e. "that's just the way things are done."
Frequent readers of HN are probably familiar with Atul Gawande's article on the checklist, in which hospitals who mandated that surgeons and nurses follow a simple list of steps (literally, as simple as "wash your hands") were able to reduce the rate of needless post-surgical infections to zero. http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_...
I believe Merck's first big drug came from reading a research paper that had apparently been overlooked. In a book I've been reading about how companies develop drugs, a veteran of the industry wrote about how a potential multi-billion dollar drug was almost shelved because the company's analysts had forgotten to remove dummy data from their test-analysis routines...and that this kind of thing happens all the time, apparently.
And of course, most people are pretty familiar with the calcified information-systems of their doctors' offices. Those things remain in place because that's how they've been done in the past, by many other brilliant people, so why re-examine them?*
(to be fair, medical information systems are also hindered by medical privacy laws governing the copying/distribution of patient data)
Edit: Just after I posted this, I came across this NYT article about a boy who went to the hospital after cutting his arm diving for a basketball and died from infection-related complications. The upshot:
> In a statement, the hospital said that emergency physicians and nurses would be “immediately notified of certain lab results suggestive of serious infection, such as elevated band counts.” Rory Staunton’s bands, or a type of white blood cell, were nearly five times as high as a normal level.
> The hospital has developed a new checklist to ensure that a doctor and nurse have conducted “a final review of all critical lab results and patient vital signs” before a patient leaves, Lisa Greiner, a spokeswoman, said in the statement.
http://www.nytimes.com/2012/07/19/nyregion/after-rory-staunt...
But isn't that really, as you said, "man bites dog" thinking? How many "clever, process-focused laymen" are there out there exactly? Do people really think that scientists involved in research with their training are at some kind of disadvantage in solving medical mysteries? That someone with no training whatsoever is just going to have some thought that others haven't explored in anything other than outlier situations?
I mean if you take enough people of any age attempting enough things something is going to stick. This particular kid ignored his school work to work on this idea. How advisable is that in general? (We've seen that happen with people dropping out of Harvard as well who hit it big).
So the problem I have with this is the way the media portrays it which plays down what happens to the vast majority of people who either ignore their school work to pursue a passion (with a slim chance of success) or drop out of college and later wished they had finished.
Remembering Ron Kovic who was portrayed by Tom Cruise in "Born on the 4th of July". Wanted to go off and fight for his country like dad did based on all those romantic movies from WW2. Came back in a wheel chair.
I'll be brash and say "Yes"
Not because these particular researchers/experts are dumber than those in any other field. But this is a natural psychological state for anyone working within a specialized, intellectually demanding field: to not be aware of (or not want to care about) any other machinations that happen peripherally to what they're focused on.
So, I don't mean that a layperson can walk in and say, "Hey, I have a hunch if you combine this protein with this chemical and run this lab routine I developed on my own, you'll come up with the cure for cancer." But a layperson can notice that there may be an information gap between a researcher and a practitioner that results in groundbreaking work being ignored/not implemented correctly, and suggest a process that in itself is groundbreaking. Because a scientific breakthrough is not really useful if it's not actually used.
To refer to the "Checklist" again, there is nothing on that list that a high schooler could not have thought up him/herself. But do you think its implementation would've been accepted anywhere if someone who was not a doctor had pushed it? Even though a doctor did devise it, it faced considerable resistance.
So this is my wild speculation: The medicine field is especially susceptible to the detrimental effects of having blinders. Its practitioners are hard-working geniuses who have well-justified confidence in their processes and insights...but because of that confidence, may be unable to notice blind spots. Moreover, laypeople are unwilling to put in the effort to challenge medicine professionals, because doctors have traditionally such a reputation of being near-all-knowing, and so it's easy to sitback and say, "Who am I to question them? I didn't go to medical school for 8 years"
And this is how the implementation of a sensible checklist that includes steps as simple as "Wash your hands" can have a huge impact in modern medicine.
I don't disagree and it sounds like the proverbial urban legend about the kid who said "just let the air out of the tires" when the truck was stuck under the bridge.
I guess the question really is then how do you make an atmosphere where you can make people with blinders aware of other possible solutions in other disciplines or entertain wild thoughts from normals. (Not normals but I believe the success of Bell Labs stemmed from having all sorts of disciplines in close proxmity to each other to solve problems. But of course the "respect" factor was very important in that working.)
In terms of how to reduce the blinders in the practice of medicine in general...also, a tough question. Practitioners are resistant to change not only (or even perhaps mostly) because of intellectual elitism, but out of disincentives in the system. A formal implementation of a checklist that is as simple as "wash your hands" and "mark the limb to be operated upon with an 'X'" can be seen as a liability. Every ER surgeon has had some kind of experience when procedure is broken because of the pandaemonium involved in any given operation...it's not that they are too dumb to wash their hands, it's just an easy step to overlook when chaos breaks out. If a surgeon does forget to wash her hands and a patient suffers (either because of it or from an unrelated thing), that checklist is going to be seized on by the malpractice lawyer.
Malpractice is a very real, common thing in the medical industry...and so even common sense innovations with be held back out of well-intentioned concerns. This goes for electronic medical keeping and many other kinds of improvements that are still in limbo.
I think that stems from being a member of the "non it" group originally and finding acceptance among a group of people that appreciate and reinforce someone's willingness to share with others.
"that checklist is going to be seized on by the malpractice lawyer."
It's worse than that. My wife is a Physician. Not a week goes by when she tells me a hospital story where I think up something that a lawyer could use against them for something they don't do correctly or could have prevented.
An example, from just this morning:
The hospital that she works at has physicians that are on call to cover if there is an overload of patients. But they also have Physicians that will ask another to cover them if they can't make it in or have some other obligation. But there is no system in place to prevent the person who is "on call" from agreeing to help someone even though they are backup for the other situation. It's entirely up to the Physician to not do the wrong thing. And it happens since that is why I am telling this story and how the discussion came up.
Another woman (that I dated for many years not my wife) was a radiologist. She wouldn't even go on the record in reviewing another docs interpretation of a study. Didn't want to get on the chart lest get sued.
Otoh others in her group took malpractice as a necessary cost of doing business to churning out a top number of studies per day. It was expected that you would get sued and almost was a marker that you produced a lot of work.
The other thing that happened quite frequently that I personally experienced was the signing of study reports. If she didn't get her studies signed (electronically she did this from home so much for hipaa) someone else would sign them for her. They would just do "y" "y" "y" never reading and never catching errors in her dictation. Just approving so it could move to a final state. (You know the same way customer service people want to "close out" a support ticket).
This is what I don't like about your frame: this kid isn't actually a layman in the sense of layman vs specialist. He's probably a proto-doctor of some kind.
There certainly is a tension within academic fields between specialists and interdisciplinarians, but i would argue the layperson/specialist dichotomy, when it comes to contributions like this one, is a special case of the specialism/interdisciplinary dichotomy.
Medicine is a particularly interesting case, because there divisions are further fractured into basic research, applied research (say medical devices), and actual implementation of research findings, and between each of these are holes and pitfalls, where only a special few bridge the gaps, and help to transfer knowledge.
I would bet that this kid is, in actuality, the kind of person who makes up those bridges, as opposed to just someone who doesn't have the blinders a specialist has developed.
I had numerous "genius but not quite" moments around the time I started university: I'd come up with something that seemed fantastic, only to move on to the next chapter in the textbook to either find that the same method was invented 30 years ago by someone who didn't have the benefit of having all the pre-requisite knowledge lined up for them.
Or I might find researchers had spent years lining up by now well known problems with would-be spark of genius. I'm sure that's not a unique thing - once you have a certain foundation of knowledge, a lot of things suddenly become obvious to try.
As I learned more about my field, the "genius moments" became more and more rare: I knew better. For more and more things I can instantly give reasons why an approach is highly likely to fail. Far more options are closed off from the outset because I "know" they will be fruitless.
Most of the time this is sensible pruning of obviously meaningless avenues of research.
But sometimes, through chance and sheer volume of attempts or by coming at things from slightly different angles, someone will try a slight variation that has very different implications, or stumble upon flaws in the accepted "truth" because they don't "know better" than to try something that someone well versed in the field would immediately dismiss.
A great point. I didn't think of it from a role model point of view.
Since I'm sure that's not what you really think, would you mind explaining your position further?
To my surprise, it looks like this guy actually did a lot of the research on his own. At the very least, it appears the ideas was authentically his own, and then he enlisted the help of a lab to accomplish it.
[1] http://hackerne.ws/item?id=3329605
Edit: Because HN is killing old permalinks: http://hackerne.ws/item?id=3328995
Effectively, they become another pair of hands on a project that is well outside their intellectual input.
It looks like this guy synthesized his own idea rather than piggybacking off the work of another, partially completed project (which is usually the norm for ISEF winners)
(Yes, it failed to load for me under the .ws URL.)
Yep this test is gong nowhere.
I thin you're more likely right than me.
The idea of sets of super cheap markers which can are included all the time by default in blood tests is incredible.
Without more context, that claim is meaningless. Surely it cannot mean "this test gets the right answer 90% of the time when used on the general population". Nearly 99.99% of people do not have pancreatic cancer, so if I make a program that prints out the sentence "You don't have pancreatic cancer.", then my "test" would have a 99.99% accuracy rate against the general population.
I've often thought that such a unit would be a good idea for journalists and people in general; the language of reporting on and talking about a lot of scientific advances (medical in particular) is so damn imprecise about this stuff. Even if they report only one number, they could at least say which one it is. 90% could plausibly be either the precision or the recall here, or even F-measure or some other average of them, but as you point out, it's unlikely to be "accuracy" in the sense of (true positives + true negatives) / N, or it wouldn't be very impressive.
This just irks me about our (U.S.) education system. I understand doing classwork is important. Yet here you have a young student taking interest in science and engineering and gets in trouble for it? That doesn't make sense to me at all. The work he's doing should be more than enough credit for his classwork. Take him aside from the class and foster this work and passion. He'll learn more science from this one project than doing 10x the amount of classwork in any syllabus. I see no reason why his science grade could be reflected on this work.
Here is a wonderful 11 minute talk by Ken Robinson http://www.youtube.com/watch?v=zDZFcDGpL4U
Plus there are some benefits of a syllabus, such as making sure that fundamental knowledge is taught. If you (as a student) missed algebra because you were doing your investigation into fractals, you're going to find calculus much more difficult than you would otherwise.
199 rejections, and the Professor that decided to let a 15 year old try a wild idea is at ... Johns Hopkins.
America may be doing a lot of things foolishly, but mentoring great talent for the future seems taken care of
I like the quote but I think people throw it around far too loosely. It seems to be an impossibility or else every company founded by A class people (assumption: there must be at least SOME such companies) would only ever consist of A class people, but that clearly isn't the case. For sake of argument let's assume Google, Facebook and Microsoft (and likely many, many others) were all founded by A class people. Do these companies consist solely of A class people? If not someone, somewhere, must have hired a non A class person, thus the hirer themseves couldn't have been A class by the original statement. You can apply the recursive argument here eventually terminating in the founders :)
EDIT: Add Apple to the list of companies with (obvious) A class level founding teams. Funny oversight on my part since the quote is from Steve Jobs himself :)
I have a MD and a background in biochemistry, and can say most people I've met in the field of oncology don't nearly have the creativeness and audacity of this kid's idea. Essentially he's using the carbon nanotube materials, sending an electric current through it, and detecting minute voltage changes that occur when cancer proteins bind to the antibodies laced over the nanotubes.
The cost of using nanotubes to detect cancer, however, may be quite prohibitive. Think 500-1000 dollars per test. On a population screening level, I don't think most governments or insurance companies would go for it.
Besides, finding it earlier == longer treatment periods == more money spent on medicine right? What's the smiley face for disappointment?
1) Not interested. Why? Doesn't make us money.
2) Supressing. Why? Because this keeps us from making money.
Interesting read about a great invention wasted.
http://www.guardian.co.uk/society/2006/jun/17/health.medicin...
I don't think you understand economics. If Company A could sell this test for less than the tests available by Companies B and C, Company A will get more sales. If the product is much cheaper to manufacture, then they get better margins too.
Any company in the world would jump at a chance for higher volumes at higher margins.
I also think it's inspirational b/c it points up the importance of synthetic scientific research done by folks who are so to speak 'out of the fold'. We need institutional science, clearly, but we also need people who can take a step back and look at the big picture and see how things fit together.
Why would this tire you out, though?
-Not enough physical space in lab - most wet labs are crowded with 2-3 people per bench
-No one with enough time to supervise a high school student bumbling around the lab. You basically need a grad student or post-doc babysitting new people (HS student or new grad, doesn't matter) since they don't know where anything is or how to do anything
-Not enough money. Funding has to come from somewhere, and if they don't have money to throw at this particular project they won't.
-Not the focus of the lab. I would hazard a guess that the HS student emailed anyone that was remotely involved in pancreatic cancer or material science. Realistically, there are probably a handful of labs that do this sort of research and the kid just didn't know which ones to email...so he emailed everyone.
-Other. Maybe the professor is teaching? On sabbatical? Already has ten undergrads?
http://www.pancan.org/section_research/strategic_research_pr...
Essentially, this seems pretty damn early as far as results go. There will probably be a few years before we know it actually works or not.
There are two aspects to the reported work. The first is the use of carbon nanotube biosensors incorporating antibodies. Google shows they've been around for a while and are reportedly more sensitive than previous methods. The second is using the levels of mesothelin to diagnose pancreatic cancer, this is less widely established, but was also recently reported by a different lab (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna...).
Putting the two together seems to be the work of Jack Andraka.
I see them all the time - and I hate them because I cynically predict that what ever it is that they are about to tell me is going to be either trivial, false or hyped.
I don't blame the kids - I guess it's just to get the clicks/attention for the news organisations.
If your age is being touted as the reason we should care about what you have done - then the thing that follows is probably bullshit, trivial or hyped.
Have you ever heard "34"-year-old tech CEO launches new multi billion dollar product line?
No. You read "Google launches Project Glass".