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Hack Chat Transcript, Part 1

A event log for Open-Source Medical Devices Hack Chat

Tarek Loubani

LutetiumLutetium 01/29/2020 at 21:040 Comments

Tarek Loubani10:28 AM
You might remember Christoph from such hackaday articles as https://hackaday.com/2017/06/30/3d-printed-halbach-motor-part-deux-tuning-testing/ and https://hackaday.com/2014/05/24/the-hour-of-the-3d-printed-clock-draws-nigh/

Tarek Loubani10:28 AM
You wrote that first one, Dan.

Right, Christophe - knew it looked familiar. Honestly looks like it could snap that PCB in half with a few twists of the wrist

Tarek Loubani10:29 AM
ahaha. Will not seek to confirm.

Tarek Loubani10:30 AM
p.s., here's the thingiverse link, though have patience as the site still sucks: https://www.thingiverse.com/thing:2064269

Tarek Loubani10:43 AM
While I'm here with the world's best hackers, maybe another question: Is it possible to correctly assess these capacitors without desoldering them the board?

Chinna11:19 AM
Hi Tarek, great innovations. I read your papers and it's an amazing work

Tarek Loubani11:19 AM
Thank you so much, Chinna!

Chinna11:22 AM
I suspect you might be working on a electronic stethoscope as well?

Tarek Loubani11:25 AM
Not really. We thought about the idea and let it go for three main reasons: The first is that the electronic stethoscope is a significant step backward with current technology in terms of usability and quality. Any health care provider who's used both can testify to that. They are primarily an advantage for people with hearing issues, and for teaching. The second is that they are largely covered by patents still. And lastly, our project is trying to approach the basics of each piece of equipment. After we get them out there, maybe we'll circle back to upgrade things.

Chinna11:30 AM
Thanks for the reply. It's good to know these reasons from an expert.

Chinna11:31 AM
I mean from you

Tarek Loubani11:32 AM
Thank you for the vote of confidence. Our team is trying to make the best decisions based on the situation as we perceive it, so the decisions are always more discussions and priority-setting than final say

Chinna11:32 AM
I am working on ophthalascope attachment for a smartphone

Matteo Borri11:33 AM
I'm working on a printer for synthetic skin, but I got nothing to show for it yet, am here to learn :)

Chinna11:34 AM
I found that the lenses are pretty costly

Tarek Loubani11:34 AM
@Chinna and @Matteo: That's great. Please let me know how things progress and hwo we can help

Tarek Loubani11:34 AM
@Matteo Borri ^^

Tarek Loubani11:35 AM
@Chinna: The lenses are indeed expensive. It's one of the reasons we started with an otoscope (look in ears). https://github.com/GliaX/Otoscope

Tarek Loubani11:36 AM
I've been occasionally kicking in my mind how we could accomplish an ophthalmoscope in a way that's reliable and sustainable. Haven't quite figured it out yet...

Israel Rosas joined  the room.11:37 AM

Chinna11:38 AM
Yep, I saw your otoscope. It's great. I made one of my own as well, but it's with rechargeable batteries.

Tarek Loubani11:39 AM
What do you mean by rechargeable batteries? I use mine with some rechargeable AA batteries. Would that count?

Tarek Loubani11:39 AM
Also, would be amazing to see your design.

Chinna11:41 AM

Tarek Loubani11:41 AM
Oh!! phone-based!

Tarek Loubani11:41 AM
Cool idea with re-using a stock holder.

Chinna11:41 AM
Yep, but can be used without the phone as well

Chinna11:42 AM
Yep

Matteo Borri11:42 AM
cool!

Tarek Loubani11:43 AM
An amazing hacker named Kliment Yanev made a phone-mounted for us that we could never really get to work. I ended up deprecating it in our otoscope repo: https://github.com/GliaX/Otoscope/tree/phone_mounted

twoxe joined  the room.11:43 AM

Tarek Loubani11:45 AM
@Chinna : Is it FLOSS?

Tarek Loubani11:45 AM
It would be great to link to it at least from our rep

Tarek Loubani11:45 AM
repo

Chinna11:46 AM
I yet to document my design

Chinna11:46 AM

Chinna11:46 AM
This is the opthalscope

Chinna11:47 AM
But the lens I ordered was a fake one, so didn't work as expected

Tarek Loubani11:47 AM
That's a real shame, @Chinna. We've found that documentation is the most important part. It allows us to both succeed and fail gracefully. Because other people have documented their work, we were able to move some projects forward much faster than we thought we would be able to (e.g., our ECG). And lots of people have built on our incomplete projects too

Chinna11:48 AM
I will make these designs open source in the next two months or so

Chinna11:48 AM
Yep, saw your repo and I will make a similar one for my work as well

Tarek Loubani11:49 AM
Excellent. Please share it when you do!

Chinna11:49 AM
You are very inspiring and I hope to contribute to your efforts when I can

Chinna11:50 AM

https://hackaday.com/2019/09/20/fitness-tracker-hacked-into-optical-density-meter/

HACKADAY DAN MALONEY

Fitness Tracker Hacked Into Optical Density Meter

What do fitness trackers have to do with bacterial cultures in the lab? Absolutely nothing, unless and until someone turns a fitness band into a general-purpose optical densitometer for the lab. This is one of those stories that shows that you never know from where inspiration is going to come.

Read this on Hackaday

morgan joined  the room.11:51 AM

Chinna11:51 AM
By the way, the above article is about my work and we open sourced that project completely

Tarek Loubani11:52 AM
Great project, and great article! Thank you for sharing.

Israel Rosas11:53 AM
@Chinna great work, inspiring

Tarek Loubani11:53 AM
I'll bookmark this for when Glia starts work on some of our diagnostics equipment.

Chinna11:53 AM
Thank you

Tarek Loubani11:58 AM
Alright, finally ready for the hack chat!

Tarek Loubani11:58 AM

Jim joined  the room.11:59 AM

Hi everyone, time to get started officially. I want to welcome Tarek Loubani to the Hack Chat today to discuss the open-source medical devices he's been developing.

kyle.kmetz joined  the room.12:00 PM

Tarek Loubani12:01 PM
Thank you for having me, Dan! I'm a long time reader and fan, and happy to be here!

Can you tell us a little about yourself and how you got into rolling your own medical instruments?

Atom Atom joined  the room.12:02 PM

Tarek Loubani12:02 PM
I'm an emergency physician who's been a tinkerer from a really young age, I suspect much like all of us here.

nate joined  the room.12:02 PM

Michelle joined  the room.12:02 PM

Tarek Loubani12:03 PM
I am also a refugee to Canada, having been born a Palestinian refugee in Kuwait, and then having escaped again after the first Gulf War in 1990

Tarek Loubani12:04 PM
When I got into medicine, it was important to me to do work in the places that I escaped that so many of my friends never managed to. My classmates were all smarter and better than me at so many things when the war hit, but I was the one who had an uncle in Canada, so I was able to escape. They were never able to realize their potential, ending up mostly in refugee camps in jordan, syria, lebanon and elsewhere.

Don Randolph joined  the room.12:04 PM

Tarek Loubani12:05 PM
Once I started going to conflicted regions like Israel/Palestine, Iraq, Lebanon, Venezuela, Colombia, I realized that my ideas about high technology and how it could help were stupid.

Tarek Loubani12:06 PM
Instead of robots and some kind of high tech utopianism, what people wanted and were asking for - for that matter, what I needed as a physician - were the simple things.

Tarek Loubani12:06 PM
I was trying to treat patients in Gaza during the 2012 war, and I just couldn't. We didn't have enough stethoscopes, never mind advanced machinery like ultrasound and CT that I depend on in my canadian practice.

Tarek Loubani12:06 PM
My nephew's toy stethoscope got me thinking after I listened to it and realized it wasn't total shit.

Ryan Nibouar joined  the room.12:06 PM

Dr. Clint LeClair joined  the room.12:07 PM

Tarek Loubani12:07 PM
That was the genesis of Glia.

Tammo Heeren joined  the room.12:07 PM

Funny - my kids had one of those too, and I found it fairly useful. I mean, there's not much to a stethoscope really.

Tarek Loubani12:08 PM
I think my first printer was a prusa i1, so I was already thinking about the tech.. But it was really with the help of some of this community like Kliment Yanev and Jennifer Glauche that we got started trying to turn it into something that could help in a professional way.

brian dolge joined  the room.12:08 PM

Tarek Loubani12:08 PM
Yeah, the stethoscope is not a technology problem. It's an economics problem.

Tarek Loubani12:08 PM
There's no patents covering it. It's not a special tech. It's just that there is essentially a duopoly that means that if you want a good one, you have to pay $200-$300 USD for it.

anfractuosity12:09 PM
Regarding the stethoscope, i'm just wondering i saw there actually seem to be ones from China for around $3, with a metal parts, have you looked at those out of interest?

Tarek Loubani12:09 PM
So we knew it was attainable.

Tarek Loubani12:09 PM
@anfractuosity : Yes, of course. We started this project with smuggling stethoscopes we bought outside.

Tarek Loubani12:09 PM
But those stethoscopes aren't validated and when we tested them, they were terrible.

Tarek Loubani12:09 PM
for example, pvc tubing, poor acoustics, terrible diaphragms.

anfractuosity12:10 PM
gotcha thanks!

Tarek Loubani12:10 PM
It turned out that Yes, Virginia, you CAN fuck up a stethoscope.

Tammo Heeren12:10 PM
How would you need to validate stethoscopes?

lol

riley.august12:10 PM
That doesn't really surprise me. The QC on low grade analog instruments is usually pretty poor.

Elias Jaffa joined  the room.12:10 PM

Tarek Loubani12:10 PM
Those stethoscopes are actually available in Gaza for the cost of around $5 USD. But nobody uses them because they are.. unusable.

anfractuosity12:10 PM
ahh

Tarek Loubani12:11 PM
When we give a Glia stethoscope to people there, it's like you gave them sight for the first time. it was such a problem that we actually had to start training people in auscultation (listening with a stethoscope) because the art was lost in Gaza.

Dr. Clint LeClair12:11 PM
to be candid, I thought the greatest use of the 3d printed one would be for add-ons...ie-help training of interns or pre-clinical provider QA with a recordable box in the auditory transmission line, for playback during a clinical-debrief

Tarek Loubani12:11 PM
@riley.august : Exactly. Glia's "product" is not the stethoscope. It's the recipe (source / files / bom) and the QA process (how you know you got it right)

What's the key to a quality stethoscope? Diapraghm? Bell shape? Something else?

Tarek Loubani12:12 PM
@Tammo Heeren : We did acoustic testing to prove the equivalence. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193087

riley.august12:12 PM
I'm left with a simpler question. Why hasn't anyone developed a digital stethoscope yet? Audio fidelity's been there for fifty years.

Dr. Clint LeClair12:12 PM
thanks for the reference...will read

Elias Jaffa12:13 PM
@riley.august There are plenty of examples of electronic stethoscopes out there, but they tend to be pretty expensive

anfractuosity12:13 PM
I'm just wondering, do you ever need to sterilise a stethoscope?

Tammo Heeren12:13 PM
@Tarek Loubani Right. Equivalency might not be required. Something is better than nothing.

Israel Rosas12:13 PM
@riley

Dr. Clint LeClair12:13 PM
have you ever considered publishing a followup in JET-EM for broader clinical adoption?

Tarek Loubani12:13 PM
@Dr. Clint LeClair: That's one of the important contexts for the stethoscope, and perhaps the greatest use in a rich context. The greatest use in a place like Gaza or any place that is resource poor is giving it to physicians, nurses and paramedics and having them auscultate with it

Aharon joined  the room.12:13 PM

Elias Jaffa12:13 PM
For example, https://shop.ekohealth.com/products/core-digital-stethoscope?utm_source=Google&utm_medium=cpc&utm_campaign=Shopping&gclid=CjwKCAiA98TxBRBtEiwAVRLquzuEPWTqmW2PQ04wotnpC6RLnY_0KTCqVfFRmAMMMEWsFb7MWK75CRoC1bUQAvD_BwE

Elias Jaffa12:13 PM
$250

Tammo Heeren12:13 PM
So, where do you need help?

Tarek Loubani12:14 PM
@Dan Maloney : The tube size, it turns out... though the other things do matter. But we found that what cripples it the most is the tube.

Lazer.Coh3n12:14 PM
@riley.august I know I'm coming in the middle of a conversation but I'm assuming that a stethoscope is simple it works and needs to be reliable so good old tech could do that.

Tarek Loubani12:15 PM
@Elias Jaffa is a fellow emergency physician and big part of the Glia team!

Elias Jaffa12:15 PM
Hey everyone!

Marek Cermak joined  the room.12:15 PM

Elias Jaffa12:15 PM
Yes, I'm Eli Jaffa, an EM doc in South Carolina, USA and a fellow tech / open-source enthusiast

Hi Elias! Welcome!

Tarek Loubani12:15 PM
@riley.august : Electronic stethoscopes just aren't the priority right now.. That's all.

Elias Jaffa12:15 PM
Though less of a straight-up expert like the good Dr. Loubani

Israel Rosas12:16 PM

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