Tremor-cancelling spoon for Parkinson's tremors
liftlabsdesign.com
liftlabsdesign.com
Have you thought about open-sourcing your implementation to encourage others to take a jab at it and port it to other platforms?
I recall a post on HN which showed that our vocal signals have enough information to help wwith such diagnosis. Voice as carried by phone's now dont have the spectral resolution for this. However it might have enough bandwidth if voice is coded for that purpose. Seems like a worthy problem to take a stab at.
I think the corresponding NPR story https://news.ycombinator.com/item?id=7752627 was posted a few days ago but did not make the front page. So I am glad this made it.
https://www.youtube.com/watch?v=uBh2LxTW0s0
I didn't realize how this sort of tech can be so life changing (or life giving)
It is so amazing that I am slightly worried that it might be faked.
I really hope that this technology becomes an economically-viable and long-term means of helping parkinson's tremors.
1) Parkinsonian tremor is typically at rest or with distraction. When you actually engage in purposeful action, such as using a spoon, the tremor usually dampens or goes away.
2) The main problem in Parkinson's is actually "bradykinesia" or slowness of movement. A more accurate term, in my opinion, is slowness of motor planning, that is, the brain systems cannot process the information require to, and then generate, a plan of movement for the limbs fast enough. The spoon won't fix that.
3) Parkinsonian and other forms of tremor do have relatively safe and effective treatments in medications or deep brain stimulation implantation.
My thoughts are - this spoon, if it works and isn't a mechanical nightmare, would be useful in a limited subset of cases where the tremor resembles another condition known as essential tremor, where the tremor instead is an intention or action tremor, where purposeful activity amplifies the tremor. Even so, these would only be in those patients who cannot get deep brain stimulation surgery for some reason. The reason being that DBS, while brain surgery, once done, is the more elegant solution. I.e. your tremor goes away, rather than requiring a superficial "hack" like this spoon.
I have an ever so slight tremor that's worsened by the drugs I take but nowhere near bad enough for others to notice let alone be worth any treatment (so far) and I would occasionally kill for something like this to interact with my phone some days. Like this morning I was pinching and zooming up the wazoo to give my thumb a big enough target to hit without hitting things by accident while shaking around. Not sure it'd be that useful at the moment for fine tuned control but...
(oh look I'm having a hard time hitting the reply button now...)
Went from pretty severe tremors to appearing basically completely cured.
This is a pretty good example: https://www.youtube.com/watch?v=uBh2LxTW0s0
The spoon only solves one problem - scooping up liquid food. One can argue that a fork or knife version could help with other food. It doesn't solve writing, playing instruments, typing. Shaving may be a little too delicate for something like this. DBS when done right solves all of this.
The problem with DBS is that best practices for implantation can vary widely, and I've seen it done really poorly, either with surgical groups with crappy experience w/ a lot of infections or poorly targeted leads that are many millimeters off the intended brain target. Our group prides ourselves in being pretty accurate most of the time, and with a complication rate of < 1%; of which I can't recall anyone who had a serious hemorrhage or death from this.
One thing to note, it's a stereotactic neurosurgical setup, which means our surgeon uses a skull mounted frame that inserts the implant in a 1 cm burr hole. It's not a typical open craniotomy where a large segment of the skull gets removed. So in a sense, yes, it is invasive, but no, it's not as invasive as full blown surgery.
We make sure all our patients who are candidates are aware of the risks and what the surgery entails going forward - both the eager beavers raring at the bit and the reluctant folks who are afraid of it. Many of them choose it, some of them don't. Some of them don't qualify, and that's every bit their decision.
That's also called "constructive feedback" or "having something useful to say". OP offered his thoughts on the best cases where this technology could be applied while explaining how Parkinson actually works and how this limits the usefulness of this solution. If this is "such an HN reply", then this is also the kind of reply for which I come back to this site.
Not that the spoon won't be useful in many situations, but I've seen other appliances - walkers with laser cues to try and improve the "freezing of gait" phenomenon, stomach tubes to try and get over the fluctuating levels of medications, all tried. They're nice, they're not invasive, they don't get used.
PD is complicated enough that solutions need to get a hold of the "big picture". For ET, it probably would have more of a role but still, what about writing, handling complex controls, etc? The spoon may fix a limited set of problems in all of this, but the bigger picture is what will get a bed bound or wheelchair bound patient back on their feet and doing all the things they need to do in daily life. There are better solutions available for this than just the spoon.
The device isn't a "hack", but a non-invasive way to deal with the problem.
That's not a rebuttal; the device would be far more useful for essential tremor or Huntington's-like disease sufferer's than it would be for the ordinary Parkinson's sufferer. (For some value of "ordinary", which is hard to come by in the Parkinson's world. Among my peer group - people I've actually met through neurologists, support services, and so forth - there have been a relatively small number of people who have a textbook presentation. But intentional tremor is not a frequent symptom.) The spoon (and similar devices) would be absolutely transformative for some people's quality of life, but putting the "Parkinson's" label on it won't get it into the right hands.
(My father has PD, my father-in-law had PD, I am a webmaster for a PD news/events/support groups website, and we are on the board for Struther's Parkinson's Center in Minneapolis. Which is to say, I live and breathe PD daily, in a very personal way, through relatives and close friends, as well as doctors who have dedicated their entire lives to PD. I see first-hand what PD medications and DBS surgeries do to people, over a period of many years.)
Your post is mind-boggingly misinformed and heartless. The "relatively safe and effective" medications you mention are not safe or very effective at all. They carry serious side effects for most patients and get less and less effective as time goes on. Even in the honeymoon years when the meds are still relatively effective, people still suffer in-between dosages, which is to say several times a day. The fact that people prefer being on them than being without them is a testament to how bad PD is, not how "safe" these meds are.
Likewise, the DBS surgery is quite risky - so much so that you have to be relatively young and healthy to get it, e.g. very few people over 75 are even eligible. Moreover, the improvements are typically in the 40%-80% range, far from the 100% you so happily imagine, so MOST patients who undergo DBS still have to take medication. The risk of stroke from the surgery is 2% and the risk of infection requiring another surgery is super high at 4%, to name just two. If that's not enough for you, the risk of DEATH from DBS surgery is around 0.5%. Moreover, it is NOT a one-time procedure. The batteries implanted in the chest run out, and then you get to have another surgery.
DBS, while brain surgery, is the more elegant solution. Your tremor goes away, rather than requiring a superficial "hack" like this spoon.
What a bad, cruel joke.
That said, this looks pretty neat and seems like basically a spoon version of Canon AF lenses. Will definitely look into these for my grandpa :)
I did at one point did check out my genetic risk factors as determined by 23 and Me, back when they provided trait mapping services. Turns out I have a higher than average lifetime risk.
It's all ugly shit. Even essential tremor is non-trivial. I'm glad innovations of all kinds are being made in this field.
I have to wonder - why is it that it took so long to come up with such a simple idea for such an obvious problem?
I'd like to blame it on the "get rich, web app startup" mentality, but really, that's a fairly recent thing.
Perhaps this is a harder problem than it seems? Or is it true that all our new inventors are chasing riches?
We have people who study earthquakes, and gyroscopes, and nerve disorders. And we have the internet so they can all easily share ideas & research.
Is this idea REALLY so "un-obvious"?
My opinion as a biomedical engineer is that there is a lack of exposure of these real problems because, really, how many people know someone with Parkinsons? But when companies like this solve them in such an elegant way they can appear pretty cool and dare I say "sexy".
So its an obvious solution, but I wouldn't say its an obvious problem. The list of problems is probably huge and a forum for capable engineers and designers to browse and help solve them would be awesome.
That is an awesome idea - it seems like I've seen/heard of something similar, but if not, I'm a web programmer who could bang that together rather quickly.
Before I do, has anyone heard of an existing site/forum?
The key to making this work would be an adequate capture of the context as well as a description of the problem. In the product design world we use "Personas" as a vehicle for packaging problems into descriptions of user needs. They give the user a demographic and allow the designer to imagine that person and how they might use a potential solution. This allows to designer to avoid imposing their own preconceptions or doubts onto the context or idea before it is even a mere wisp of a concept.
If you can capture this in a spam free, usable and elegant website I reckon you'll be on to something. Not sure how you'd monetise the output, but then that's why I've never finished the 50 or so website projects I started.
I'll look these comments & site over and discuss with friends a bit; obviously, creating a site is the easy part
The hard part here is building a community of people who will contribute problems and content around problems. This might be bootstrapped at the beginning either by putting effort in searching the web for such problems, and asking experts around the web about problems, and slowly building a database.
Such content could be a pull for some groups of people, many of them will be more interested in solutions ,but some will be a source of more problems.
And there's also the question of exposing the information in such a way to encourage innovation and not just reading.Not sure what the right way to do this, but it's interesting.
It's not easy to create a high quality content/community site around this , but when solved well this could be a really valuable site.
Moreover, if they had not gotten patent protection on it and then a grant (from how I read their email to me on this subject, included in my other comment), they wouldn't have even been able to finish developing it.
If they hadn't developed it, but only described the idea, people would have probably thought they were nuts.
1) They claim they tested 100 algorithms over 2 years before they settled on one to bring to market. That's pretty much the definition of 'harder than it looks'.
2) This product requires sufficient cheap, powerful, and small accelerometers, processors, batteries, and sensors. All of which have really only come together in the last 4-5 years. Any engineer who made the connection in the 90s might have at most whipped together a prototype before doing the calculations and realizing that that it just wasn't viable.
Conceptually, it's simple. I've personally seen 2 senior year engineering student design projects that more or less do the same concept - do feedback control on the spoon. They even had -ok- looking prototype demos. You could look at their spoon vibrating less, and you could look at their metrics, and see their claims, but then you would really look at it, and think 'man, that 40% reduction in amplitude sure looks sweet, but does it actually do enough?'.
I can straight up tell you that nearly all 'simple' ideas become retarded complicated when they moosh up against a human being (or mother nature...), and 'complicated' ideas become even worse.
Seeing this kind of GOOD being invented makes me happy. This made my day.
It is, however, patented.[2] This single fact allows this company (in its present form) to exist, to have done its research, to have raised its investment, and to bring their prototype in the form we currently see to market, at the price that it is currently listed at.
But patents are "wrong" and "stifle innovation".
Granted it's pretty obvious that this makes a huge difference in people's lives. So perhaps we should leaven our desire that their margin disappear, with hoping that more teams are somehow magically and irrationally in a position to do the world's R&D before losing their shirts as their margins disappear from under them. Having seen the size of this thing, the fact that it's not waterproof, the lack of an existing trusted brand-name behind the product, and a lack of any distribution except their web site (see their FAQ) shows that there is no way that is the best that any team in the world can build now that they've seen how it's done. Therefore, lacking protection, this team would no longer be competitive in a short number of weeks/months.
We can, however, agree that it is good that this has been made. So, how shall we reconcile this? Well, perhaps we should simply hope that funding, such as they have raised, would magically continue to be available even without any any margins that are guaranteed in the results (should they succeed in embodying their claims), which would allow the investors to recoup their investment. In short, we need investors to be crazy enough to keep funding innovations such as this one, while we remove the protections that would justify that craziness. Basically, we would have to hope that investors never catch on.
This is crucial for our purposes, as otherwise ideas such as this would not exist. Someone could have had this idea in 1999 or 1989. But without the investment, it might have stayed at the "worth-nothing" idea stage, rather than what we might call the "worth-nothing-but-has-now-actually-beend-developed-and-actually-been-built-and-proven-and-it's-no-longer-a-pipe-dream" worth-nothing stage. Which the rest of us deserve to access for free without investing anything.
There is an analogy to be made here with Tesla, who died nearly penniless: his meager earnings had come from his patent royalties. Imagine if we had the ability to rewrite history and take even this away from him, along with the food from his stomach and equipment from his labs, so that Edison and the rest of the world's teams would have full access to all of his inventions, working or impractical, without any protection. Imagine what progress that would have led to.
In summary:
1- ideas like this deserve no patent protection
2- teams should prove incredibly speculative techniques such as this for free and with no compensation or protection
3- investors should continue to invest in such ideas forever, even after it becomes abundantly clear that there is no way to recoup the investment in such a fledgling idea.;
</sarcasm>
Just kidding!! Phew. I hope we can all agree how ridiculous the above position would be. It's great that these guys brought their patented, high-margin product to the world. All this could have been done in 1984 - 40 years ago - if someone had had the 'wortheless' idea then -- and we would all have access to it today.
It took a team's phenomenal genius and dedication today to bring this to market, and the whole world will have it soon - unlike any of the Idea Sunday ideas that have no such protection, were never fully developed, and for which the entire program was crapped.
Here's to sane patents and to the progress they bring!
[1] http://store.liftlabsdesign.com/ $ 295.00. Note that my estimated margin at this price: (for copycat) 98.64% margins - ex assumed "worthless" idea - assuming a COGS at scale of $4, which is enough for several batteries, gyroscopes, microchips, cases, what have you. If we assume a $20 cost of goods that margin shrinks to 93.22% gross profit, again excluding the idea (which we assume is "worthless") or its development (which we assume the world should have access to for free, now that they've proven it.)
[2] http://www.cnet.com/news/smart-spoon-helps-stabilize-parkins...
That said, I was strongly inclined to ding you for the sarcasm. Any point you might have been trying to make is obscured by the cloud of superiority and smugness your tone radiates, and, personally, I find that both off-putting and un-constructive. You could most assuredly use this invention as a means of starting a discussion about crap patents — a position with which I probably even agree in this instance — without burying your point beneath your invective.
The sarcastic part literally sounds pretty good to people here, and two posters have expressed agreement with it.
And look at the result. We have two very good comments agreeing with the sarcastic part (or denying its premise), and which we can now turn to.
so this certainly identifies an avenue for discussion, even if you do not prefer this way of bringing it up.
For example, separately, I actually wrote to this company during the comment thread, and received a reply. I found their reply very informative and posted it to the main thread (here: https://news.ycombinator.com/item?id=7753308) with a simple statement which nobody could find objectionable. It is my impression that someone nevertheless managed to find the facts themselves objectionable.
You might even find a better algorithm or at least match theirs, which adds another competitor to the market. In the end everyone (especially the consumer) wins.
Not a very good defense of patents to be honest.
-----
Also, this is not an instance of crap patents (rounded corners anyone?) which are the controversial ones. If I can copy your invention without any effort just by looking at it... is it even worth to grant the patent?
Patents are a means to encourage companies to share trade secrets, not a tool to turn them into monopolies. If your trade secret is not secret, why would the people (remember the governments, i.e. the people, are the ones granting patents) grant you any privilege so you would disclose what is already public and/or obvious?
OTOH, it's in the people's interests that Lift Labs share their data (which algorithms they tried, their performance, etc.) so a patent makes sense in this case. Patenting rounded corners? Not so much.
How long do you think it took them to get to just the current, non-waterproof (eating utensil!) stage? I invite you to write down a guess before continuing to read this comment.
http://leadersinheels.com/tech/interview-anupam-pathak-found... states "The entire process took about three years from start to finish."
And whereas you open your comment "I suspect if you tried to copy..." but I hope you can extend that "you" to 3 years - or even six months - of Samsung, G.E., Roche, or Eli Lilly copying their prototype. Meanwhile, six months from now their prototype still won't be waterproof, and will still be the size it is now.
Regarding the part after your ------:
The problem is that what you call the "controversial" part is precisely the type of "idea-only" thing that is at issue here. If you're a product engineer for G.E. you can literally copy this invention in 6 months given nothing more than a budget of $1M and this video - literally zero other information.
At $295 that equates to 3389 units sold worldwide to generate that in gross revenue. (Meanwhile "Approximately 60,000 Americans are diagnosed with Parkinson's disease each year" according to http://www.pdf.org/en/parkinson_statistics).
If Eli Lilly had the right to do it, writing that check would be a no-brainer. How does Eli LIlly's manufacturing, distribution, and credibility in the medical space as well as access to care providers and brand name, relate to "Lift Labs"'s? If Eli Lilly were allowed to write that check and come onto market, six months from now Lift Labs would be a footnote.
Instead Lift Labs is afforded the sole right to provide all 60,000 sufferers detected every year, and every existing sufferer, with their solution, as well as to license it to Eli Lilly or any other company it wants.
This is progress in action.
The product is naturally high margin because there is a small, niche market. The first mover has a massive advantage, if they do a good enough job. It's unlikely that a copycat competitor would challenge someone in a good position, unless they could provide something cheaper or better.
Patents don't change this, but they do allow the patent holder to do a poor job, that doesn't fully reach people who need this product, and allows them to stifle competition who might be able to develop the idea further.
What is the unit margin on a printed copy of a Finnish translation of Mark Twain's Huckleberry Finn which is now in the public domain? (Obviously very low). Is that because it is a "small, niche market"?
The view that whether a market is a) small, b) niche, determines price, clearly has its limits.
In formal terms, the price we are looking at is the "monopoly price". It maximizes the profits given a single supplier (as for Microsoft Office.)
If Microsoft Office were more niche, it may cost $20,000, e.g. for excel in use just by a few wall street firms and nobody else -- we are talking about a situation where the software itself is exactly the same -- whereas if it were even more mass market, it may have a lower price.
At the current price for Microsoft Office, it is a steal for Wall Street trading firms doing some quick rough calculations, whereas it is expensive for students and families. Nevertheless, it is set at the monopoly price.
If the product we were talking about were a utensil everyone would want to use, it may have a price at $99 or $50 or even $20, depending on the scale the monopolist wants to hit.
You are right that the price depends on the demand curve. But in a monopoly, it depends far less on the supply curve.
Your argument about the first mover's advantage is not specific enough - can you state your premise more specifically, especially for hardware, maybe given some non-protected innovative examples (such as Pebble versus the Samsung Gear watch)? Then we could discuss it.
Where you say "unlikely that a copycat competitor would challenge someone in a good position." Out of curiosity, would you consider Lift Lab's position currently "good" if it did not have any patent protection?
Finally, you are completely correct that patents allow the patent holder to do a "poor" job, that "doesn't fully reach people who need this product". In terms of execution, how close do you think to optimal is Lift Labs doing in terms of executing on its idea?
For both of the last two paragraphs you could look at these common questions for example: http://store.liftlabsdesign.com/pages/faqs
If that really is the main role patents play, it seems like there ought to be a better way though. One that is more sustainable and less abhorrent than keeping a huge, increasingly unknowable set of mechanisms/solutions "you may not use" when solving problems. I am cautiously optimistic that something like widespread crowdfunding, along with with a better social safety (universal basic income?) that makes risk-taking easier, could possibly fill that role instead and make patents unnecessary. Then again, maybe I'm overly idealistic...
Let's say they didn't have a patent.
You'd need a significant investment, so you couldn't produce it at unit cost.
There's development. A good engineer costs what ... 200k? Including stuff like taxes, overhead, etc. Let's say you need several (because there's the control systems, hardware design, casing, manufacture, etc). You'll need supplies.
Then you'll need testing, legal, etc. You'll need to set up manufacturing (China? A US shop? Let's assume you're not building your own plant).
Complete ass-pull guess - it's $10 million to bring a clone to market, in the US. It's a medical assistive device (is that the right term?) - you can't do it cheaply and legally.
So there's ~600k (~1/500) people in the US with Parkinsons. Maybe 10% want your spoon (because there's other spoons, or some have treatment that makes your spoon useless, or they are too stubborn to use it, or they just don't want it). That's 60k.
So you're looking at maybe $160 overhead per unit. Add $50 sales cost, and $50 to manufacture it (medical device), and you're not looking at a cheap spoon.
Yes, going international could make it cheaper. Presumably, the company selling this spoon will also get cheaper with time.
I'm also sure that even with patents, there will be clones. People will come up with similar ideas, and make them just different enough to squeak past, legally speaking. But given the high costs of developing assistive devices, it's not going to be profitable for every man and his dog to make a clone. So you'll go from a monopoly to a near-monopoly. Just because there's some competition doesn't mean that the price will dramatically drop - you need a lot of competition with identical products for the price to go to unit cost.
Patent 08308664 - Tremor stabilizing system for handheld devices United States
Assignees: The regents of the University of Michigan.
... Anyway this is a great invention, even if it's not intended to be used during earthquakes ;-)
(the bottom just quotes my letter, already visible)
This product and company would not exist without patents on what amounts to an idea.
In fact, it doesn't even prove that: If a stranger approached me about my company's patents, you can bet I'd smile and nod say, "Yes, they're important", like he did -- regardless of what I actually believe.
Establishing a written record of anything else sounds like a great way to throw that investment -- valuable or not -- in the trash. Especially when the remark is made to someone like you who then turns around and posts it to the public!
As someone who both holds several patents and has actually seen this device in person, I think you're trying way too hard to craft your point.
(throwaway because my anti-procrast is on, oh well)
As it's all in the past, I don't see that this would help his patent case today in any way. ("Please uphold the patent, because I really needed it back when it was just an idea" doesn't seem a convincing reason to uphold a patent today, as they are now on the market.)
So I read the information he volunteered as stemming from his experience and perspective, rather than his interests.
I also see projects fail completely every day which could have succeeded with a minimum level of patent protection on their narrow inventions. So there may be a built-in survival bias, and you will not necessarily hear about these projects, which fail to raise even a preseed research grant "round" to complete development, but are abandoned isntead.
Page Rank was also patented by Larry Page. In stark contrast to the view presented on Hacker News, ideas are extremely worthwhile and patents are one of the most important tools any entrepreneur has for getting to market with real innovation, which is unsure and costly, and requires people to buy in at a pre-revenue stage.
The mechanism patents due this via is a full monopoly for a limited time. We can see this in the price set on this invention (that we're discussing), which is a monopoly price and will be upheld due to the fact that competitors are not allowed in the same space.
In countries that do not acknowledge these patents, a $79 equivalent could appear shortly. It can even be objectively better. Nevertheless, this is the price we pay for this invention to exist at all, and but for the patent system this invention would not exist at all. (In reality.)