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Comment by verandaguy | Hacker News Reader

I'm sorry, a billion full-body scans a month?

For what possible reasons? Are people going to be doing these things recreationally? Cause otherwise you're talking about scanning the entire world's population, including the very young, the very old, the mobility-impaired, and those without easy access to US-based facilities (i.e.... people who are part of the small fraction of the global population who do not live in the US), twice over, every 18 months.

What possible use could there be for doing this?

I recognize that the presser says the scanners will be deployed "around the world," but let's be real, this will probably be 80% US.

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"What possible use could there be for doing this?"

I've encountered this attitude before, and I always find it perplexing that there are people who are annoyed by, even hostile to, the idea of frequent health telemetry.

What possible use? How about giving people greater visibility inside their own bodies without having to navigate the labyrinth of the healthcare machine and without having to justify themselves to actuaries?

A counter point: a fixation on medical diagnoses can be counterproductive to living a good, happy, and healthy life. My implication is that data will lead to self-diagnosis, when maybe it’s not necessary.

There’s a reason most people don’t get medical scans every checkup, they’re simply not necessary for the majority of (healthy) people.

In Japan, the government gives everyone a battery of full body tests at least once per year. I guess you know better than Japan, right?

The whole argument that "you'll worry yourself sick" is such patronizing trash. It's obviously programming that came from the insurance industry, and you lapped it right up.

There's a world of difference between the health checkups we get in Japan, and something like a full-body MRI/CT.

You're not arguing in good faith when you equate those.

Are you joking? 人間ドック is absolutely more than a "health checkup". Maybe do some reading: https://medical.kameda.com/general/en/ningendock/what/

> The Ningen Dock is a comprehensive health checkup system that includes a battery of tests, including blood tests, chest X-rays, and ultrasound scans, among others as well as advanced diagnostic tests as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) or Endoscopy. These tests can help detect potential health problems early before they become more serious or difficult to treat.

That is not the same as the annual mandatory health check.

Maybe your employer pays for you to get a more comprehensive checkup by default and you're unaware of this?

But the ones vast majority of population here gets do not include MRI or CT or Endoscopy.

And, _even then_; specific checkups when you're looking for _specific things_ are still very different things than a full-body MRIs.

I think there’s actually a difference between getting a battery of tests from a set of doctors (overseen by the government) tailored to your risk factors and a company trying to sell a fully body scan which they think you should casually get all the time.

I don't think there's much difference? The technicians that perform the tests are not doctors. You usually see a doc for 5 mins at the end, to discuss any anomalies. Even then, they're just going to refer you to see your GP or a specialist. At the end of the day, the ningendoku is just information that your doctors can access. I'd much prefer a high-resolution full body scan.

Either way, the patient should make the choice about whether they want that info, not an insurance company or a know-it-all armed with a dubious study concluding that asymptomatic conditions are better left undiscovered.

I have thought about your position more and I realize I basically agree. More data isn’t strictly good, but in the right hands it is useful, and that choice should be left to individuals.

Also, it makes sense to me that, as technology improves and becomes cheaper, we should utilize it more. It may take time to come up with the proper process to maximize usefulness and reduce false positives, but it’s the path of progress.

I hope that in the future, humans consider it barbaric that we weren’t aware of things like cancer and tumors at the earliest stages, even if in many cases there’s no treatment necessary.

because it has negative effects. Over scanning leads to, in particular with the economic incentives of the healthcare system at large not to mention a company like this, over-treatment. It's one of the reasons countries have scaled back mammograms because women have been forced into surgery and treatment with no meaningful improvement in outcomes. Prostate cancer being another one.

My wife's a cardiologist and hypochondriacs with smartwatches have become a frequent occurrence because healthy young people despite regular check ups have convinced themselves their watch telling them their pulse got high that one time must mean they're dying and they'll show up not one but five times.

The same is happening with so called "sleep optimizations" which themselves can produce insomnia as people start to self-monitor and enact sleep efforts.

Rather than dealing with the issue—hypochondriacs or whatever—you prefer to remove the option for the non-hypochondriacs?

The fact that doctors like your wife think that people who are concerned about their health and want more information is a problem tells me everything I need to know about your (and her) worldview. You've dressed it up as being pragmatic, but the reality is that you're arguing for censorship and against freedom of information.

>that people who are concerned about their health and want more information is a problem

It is a problem because there's evidence based standards for when examinations are indicated and prolong or improve a person's life. You being extremely concerned doesn't move that needle and subjecting you to tests simply because you're anxious is blatantly unethical and harmful to your psychological wellbeing.

And nope this isn't censorship, it's being mathematically literate and understanding how data production works. Here's an actual real world example. There are aids tests that are 99% accurate. About 30 in 1000 people in the US have AIDS. 99/1 is great odds, let's test everyone, data doesn't hurt right? Except as it turns out if you test a thousand people randomly you'll have 10 false positives and 3 people with AIDS, Bayes in action.

So if you sent every American through body scanners, which are less reliable than that test btw, you'd have quite literally millions of people in follow up procedures for diseases they do not have with their mental health ruined and the system ground to a halt, because producing information is not always the right thing to do.

That's definitely an important point to consider, in fact something I think everyone in these conversations should be cognizant of, and also why it makes me believe the actual conversation should move to whether the device improves false positives/negatives rates or not (or at least has a chance to), which then might warrant wider access/use.

A better question is if people are going high-res, why not go high-res with tests whose accuracy is known, and for which there are useful, data-driven treatments?

Instead of casting a net of unknown quality every month, comparing against a null dataset (there does not exist a large dataset of these scans with outcomes for given markers).

Why not advocate cheap, easy blood/urine tests with higher frequency? Those tests do have large reference datasets with outcomes. And they have prescriptive value: there is likely more benefit to catching hypertension or diabetes earlier in more people.

True, though those things don't have to be mutually exclusive.

Something doesn't add up. The entire Japanese healthcare system is built around the idea that preventative testing for asymptomatic conditions is effective. You can read all about it, if you want.

Personally, I think you've swallowed some kind of health insurance industry black pill, whether you know it or not.

>You can read all about it, if you want.

I don't need to, I've lived in Japan and done the Ippan Kenshin which is the once a year health checkup. It consists of getting your weight, height blood pressure measured, an eye test, urine tests for diabetes and a blood test for cholesterol. That's very reasonable.

The one thing some doctors still tend to do is a chest-xray, which is not reasonable. They do it because tuberculosis was widespread in post-war Japan and they just kept doing it, but it has no positive impact on mortality rates.

I don't read the parent comment to take issue with the use case per se but the billion scans per month figure.

Surely, whatever this is giving you, getting a scan once a month must be plenty. They need a billion people to get a scan every month.

Because false positives have a tremendous emotional (and, depending on your healthcare system, also monetary) cost to patients.

Theoretically if this was possible (and I doubt it is, like c'mon) then it could be used for early detection of cancer.

From what I've read, full body scans are awful for this--your body forms and kills tumors all the time. The false positive rate is ridiculous.

The more we measure, the better we get at separating the false positive cases from the serious ones. Especially in a world where AI plays a bigger role in the development of the medial sciences.

Going forward into the future and not measuring more accurately because we are worried about false positives in our current limited understanding is a very conservative take.

> The more we measure, the better we get at separating the false positive cases from the serious ones.

On what basis do you say this? There is an extensive literature that refutes this. Scanners have been getting much better since the first CT scans and many more people are getting them.

False positives aren't a consequence of having the data, they're a consequence of misusing the data to issue diagnoses with insufficient evidence. "Just" don't set your thresholds for diagnosis so that you do that.

> your body forms and kills tumors all the time. The false positive rate is ridiculous.

Um, that's still a tumor.

Yeah but it's not cancer.

I'm not so worried about the data being useful, I'm worried about the machine actually working.

I mean, with that much data, you may be able to understand under what timeframe a tumor is actually of concern. What's so bad about having some false positives?

> What's so bad about having some false positives?

Having invasive surgery. Undergoing chemotherapy. The former is bad, the latter is basically a 'lets hope it kills the cancer before it kills you' situation.

It's arguable which one is worse, but I'd rather not have to ever partake in either of them again.

Why would you jump from an ultrasound to chemotherapy? It's not meant to be a definitive diagnosis, it's just an early screening process...

Because that was exactly the jump for me. Ultrasound led to expedited surgery that happened within 2 weeks of the ultrasound. The results of the surgery led to chemotherapy. It wasn't long between the ultrasound and BEP being hooked up.

Ultrasound can also detect (some) kidney stones before they start moving and become painful, allowing an assessment of whether a medical intervention is useful or necessary. When I used to get kidney stones more frequently, there was a year or so when my doctor sent me for an ultrasound every few months to try to detect them in advance (!).

I think this is currently seen as too expensive to do for people who have lower risk, but I mention it as an example of something that one could check for more routinely given much cheaper ultrasound scans.

Prophylactic ultrasound exams are also apparently much more plausible on medical cost/benefit than prophylactic CT exams, because the CT exams very slightly increase one's cancer risk (https://xkcd.com/radiation/), where ultrasound doesn't.

(At a friend's doctor's suggestion, I started taking alkali citrate supplements and switched from almond milk to oat milk; I now apparently rarely get kidney stones.)

There's no reason that ultrasound imaging equipment needs to be expensive. Overall the parts are pretty cheap. I think everyone should have one next to their toothbrush. Whole body ultrasound scans would also be useful, although harder to place inside everyone's homes.

I would guess build a health prediction model. Instead of next text token or next frame in a video, how about next 12 months or years of body health?

Hopefully it doesn’t become Gattaca.

> What possible use could there be for doing this?

The point is to generate an enormous unlabeled dataset. Historically, ML for medical imaging depended on a small number of labeled images - small because you needed to have an expert study the image and label it as healthy/cancer/etc. But the "GPT breakthrough" was that it was better to use vast unlabeled datasets - in the case of LLMs, text - than small labeled ones.

Who reads these scans and who assume liabilities for missed reads?

AI[no one]. The customer.

Lol. This isnt for everyone. This is for the rich. They are going to sell these things for personal use, for installation in homes. Take the top 100,000 families in the US, those that can afford a home unit. Scans then become as normal as taking a bath.

We are well on our way to that classic scifi trope of the villian being introduced as they soak a special tub of goop. (Dune, GOTG, Star Wars)

The top 100,000 families taking this scan every day would still put them 2 magnitudes below the target.

A Ferarri can do 200mph, but almost never does. Rolex watches come with helium valves, not that anyone understands what they are for let alone uses them. Luxury goods are always about untapped capacity.

What? This comment chain is specifically about the target of a billion full-body scans a month using 50,000 units.

That's about 1 scan per unit, every 2 minutes, 24/7.

50,000 hypochondriacs could pull that off easily

It's really not OK to victimize the rich like this either.

I can’t tell if this is serious or a top tier joke.

Hot take: the rich (especially the upper strata of the rich) are perfectly comfortable victimizing the non-rich in some material ways (from monopolistic practices, to lobbying against labour interests and union busting, to regulatory capture, to name a few).

To the extent you can really call pointing their behaviour out as victimizing them, I would consider bad PR to be a fair tradeoff.

Rich people have a phobia of death, unlike the rest of us for whom depression, disease, and injustice have really removed the sting of death and turned it more into "eh, if it happens it happens." So worry not: The rich wasting their money on biohacking fads are not being scammed, they are being consoled.

Isn't therapy or enlightenment ultimately cheaper?

Poor good. Rich bad. Good stuff should go directly to poor good people, never go to rich bad people. But that thing is for rich so by definition it is bad and not for the poor

> What possible use could there be for doing this?

Umm...the same use we get out of an annual physical or dental checkup.

> What possible use could there be for doing this?

Early detection of disease, as well as every kind of physical issue with the body you can imagine.

The incredulity of the question seems rooted in the medical culture of our current time. It's easy to imagine a science fiction future where scans happen not every 9 months, but daily, in your home, and the idea of not constantly checking your full body would be as strange as not brushing your teeth is to us...

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