HEALTH HEALTH

CAN WE MAKE A REAL TRICORDER?

A Star Trek-style scanner would eliminate routine trips to the GP, allowing any of us to claim: “Dammit, Jim, I’m a doctor!” Lilian Anekwe reveals the future of healthcare

HE CREW OF the USS Enterprise became ill with alarming regularity. From Andorian shingles to Zanthi fever, all manner of intergalactic diseases were waiting to pounce on the crew whenever they set foot on alien planets. Mercifully, the ship’s doctor always had a tricorder to hand, which could diagnose all manner of alien ailments in seconds. A quick once over was all it took to find out if a patient had a case of choriocytosis (a deadly disease for Vulcans) or just a common cold. There were no lab tests, no needles and no waiting. It’s an idea that seemed more science fantasy than fiction, but that might be about to change. Last year, a new $10m (£6.5m) X Prize was launched that challenged inventors to build a real-life tricorder. The X Prize’s philanthropic backers are offering to fund a team that can design a device weighing less than 2.3kg that is

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“There hasn’t been innovation in tracking HOW DOES THE Q-POC WORK? “capable of capturing key health your health at THE FIRST GENERATION of the Q-POC will be 2. BREAKDOWN 3. CAPTURE metrics… to accurately diagnose 16 built to detect malaria in blood, but the team health conditions [and] five real-time home since the is also working on other versions that could The blood is then broken down in a process The DNA needs to be separated from health vital signs: blood pressure, heart diagnose tuberculosis from spit. They are called lysis. For this to take place, the sample all this molecular junk, so a special molecular rate, oxygen saturation, respiratory rate thermometer” even considering a device that would be is channeled into a chamber containing a small filter is added. This gets rid of the and temperature.” Okay, so it might not be able to detect cancer in biopsies. motor – the kind that makes your smartphone all the rubbish, leaving only the genetic smart enough to take to an alien planet vibrate – that has a blade attached. This material behind. The traditional lab approach any time soon, but could it launch a miniature blender breaks down the cells into involves ‘rinsing’ the junk away from the RIght and below: Star revolution in personal medicine? Trek’s Dr McCoy and the 1. THE SAMPLE a soup (called a lysate) containing DNA and DNA, which requires clean water and takes The X Prize’s 10 finalists were show’s vision of a medical the rest of the molecular junk, such as cell one to two hours. The Q-POC can do it in announced in September 2014, and one of scanner – the tricorder A drop of blood is taken from the finger of a membranes and proteins. three minutes. the front-runners and favourites is Bottom right: Unlike its patient. This is then loaded onto a cartridge Scanadu, a medical technology company Star Trek equivalent, the and inserted into the Q-POC device. Scanadu Scout has no based at the NASA Ames Research Center display, instead sending in southern California. The group is led by data to a smartphone Dr Walter de Brouwer, a Belgian inventor 4 who says he wants to build a ‘Google for health’. This would be a global shared ‘brain’ of digital health data that 5 inventors, researchers, doctors and the 2 public could all benefit from. The device, the Scanadu Scout, is a vital 1 3 signs monitor that takes your readings when you hold it to your left temple. In seconds, it measures your heart rate, temperature, oxygen saturation and blood pressure. It sends the data to your phone CARTRIDGE via a Bluetooth connection – allowing you to view and track your vitals wherever you are. If you add the Scanaflo, you can pee on a stick to test your levels of glucose, 4. AMPLIFICATION 5. ANALYSIS protein, leukocytes, nitrites and more. The DNA moves into a channel where it is This solution is passed over a series of heated and cooled. This separates the two nanowires embedded onto a chip. The wires POWER TO THE PEOPLE strands of the DNA helix, allowing a special are so tiny that 100,000 could be squeezed This concept is long overdue, de Brouwer enzyme to copy the DNA. There could be lots onto a human hair. These wires act as says. “Shockingly, there hasn’t been of different strands of DNA from pathogens biosensors. Malarial DNA binds to the wire innovation in tracking your health at inside the sample; the enzyme is selected to when it passes over it, causing a change in home since the thermometer.” only reproduce the DNA sequence relating to resistance. This tells the Q-POC that malaria is Being able to wave a device at someone one disease, in this case malaria. present. The whole process takes 15 minutes. and get potentially lifesaving information about their health could drastically shift THE FUTURE the dynamic between medics and patients, and make amateur doctors of us Without Q-POC, a sample would need to be all. You may be used to giving your sent to a lab, wasting days at a time. The symptoms a quick Google before visiting traditional process takes a lab technician an the doc, but a tricorder-style device could entire day to complete. The goal is for the refine your knowledge and arm you with Q-POC to be able to test specific symptoms. richer and more accurate data. “My goal is quietly working on modern tricorders. analyses DNA and delivers the results of If a patient reported a fever, for example, a to make this the last generation to know In the UK, the biotech company a battery of diagnostic tests in a few cartridge could confirm that the pathogens so little about their health,” de Brouwer QuantuMDx makes diagnostic devices minutes. The device reads and sequences responsible for inducing fever were present. states. And it seems the demand is that the company says could play a role DNA and converts it into binary code The company also hopes to charge the definitely out there, as the Scanadu Scout in addressing humanitarian health using a tiny computer chip. The sequence Q-POC with solar-powered battery packs raised more than $1.6m (£1m) in funding challenges, such as malaria, cancer and is then translated into a simple message so testing can be done even if electricity during a 2013 crowdsourcing campaign. drug-resistant tuberculosis. for the user to read and interpret what the 5 isn’t available. The system doesn’t require Away from the prestige of the X Prize, The jewel in QuantuMDx’s crown is the DNA analysis actually means. You water, making it perfect for helping deliver there are other research companies Q-POC, a ‘handheld laboratory’ that simply place a sample into the treatment to developing countries. 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cartridge, insert the cartridge into the device and press ‘Go’. In around 15 minutes your results are PATIENT, HEAL THYSELF presented on the screen. Can’t wait for your tricorder? These high-tech health helpers are available now HEALTH HELPER “The Q-POC does the work of four different machines in one handheld device and generates an output that XXXXXXXX is an astronomy writer and can be used for diagnosis,” explains co-author of The Big Questions In Science QuantuMDx’s chief executive Elaine Warburton. “It might sound like the sort of thing that you see on CSI Miami, but we took that technology, then re-engineered and miniaturised it into a cassette the size of a credit card.” The Q-POC can also be used to track outbreaks of infectious diseases, by 23andMe First Derm sending up-to-the-second test results via 23andMe’s test analyses the DNA in saliva If you’ve got a skin complaint that you’re GPS and mobile networks. In developing and tells you if you’re at low, typical or high concerned about, simply snap a picture, fill in countries where resources and healthcare risk of diseases such as Alzheimer’s and a form and send it off to First Derm via professionals are scarce, the impact of this Below: X Prize finalist Above: Elaine Warburton the Dynamical Biomarkers at Downing Street with Parkinson’s. It also tells you if you have genes the website or the iPhone app. Within 24 kind of device could be profound. Group created this an early Q-POC prototype that are linked to inherited conditions like hours a dermatologist will let you know what The makers of both devices say that the tricorder concept with accessories that can test Right: The Scanadu Scout cystic fibrosis. to do next. aim is to eventually make their tricorders blood, breath and urine is held against the head to available direct to consumers. But both take health readings still need to be tested in clinical trials and approved for accuracy and safety by the US Food and Drugs Administration in the reassured and will then smoke, drink and case of the Scanadu Scout, and by the UK eat to their heart’s discontent. Or if it is CE marking body for the Q-POC before its positive, then a patient may live the rest of slated soft launch in late 2016. their life with the Sword of Damocles De Brouwer is convinced that giving hanging over them.” everyone this level of information about Despite the doubters, de Brouwer is their health is an empowering force for convinced the potential for the Scanadu good. “Having that knowledge empowers Scout is limitless. He states that you to have more informed conversations consumers want to be more informed, so Cloud DX Pulsewave Peek Vision and more productive visits with your the potential market is huge. This is The Pulsewave is worn as a wrist cuff so The Peek Vision app and adapter turns doctor,” de Brouwer states. backed up by the diverse group of PATIENT,you can check your heart HEAL rate and blood THYSELF your phone into an eye examination kit. It And Warburton agrees with him. prospective customers that Warburton Standfirstpressure, in hereand test standfirst for heart inanomalies. here standfirst standfirstcan check visual in acuity, scan the retina and “We’re working with clinicians on the says is already interested in the Q-POC. The data is stored by Cloud DX and can be identify cataracts. It gives quick and easy nature of the output – the actual results These include Western governments accessed and tracked, allowing you to look access to the tools needed to the Q-POC generates on-screen. They interested in detecting biological for trends and patterns. prevent blindness. need to be accurate, of course, but also weapons, forensic police units wanting presented in a way that is most useful to them for crime scene investigations, and the user, be that a pathologist, a archaeologists identifying fossil species. healthcare professional or Joe Public.” But it’s in the medical field that a But there’s scepticism from the medical tricorder could really create a community about whether the tricorder fundamental change in how we think could ever be useful. Dr David Warriner, about our health. Checking your a member of the Royal College of General results and rush to their GPs for symptoms online could become a vastly Practitioners’ overdiagnosis group (and reassurance. Nevertheless, de Brouwer different experience, and it could soon a Star Trek viewer in his youth), says the insists that being aware of your health “It is patterns, be the norm for your GP to take a look at tricorder pretenders are some way off data can alleviate anxiety. your symptoms with their smartphone. being diagnostic devices in the clinical While Warriner agrees that the devices which emerge over Dr McCoy would be proud.  sense. Warriner argues that when will empower patients, he cautions that Cardiio Cellscope Oto Home it comes to our health, more information one-off measurements are seldom of use. time, that indicate The Cardiio app transforms your iPhone The Oto Home device is inserted into the ear, is not always better. By giving everyone “It is patterns, which emerge over time, LILIAN ANEKWE is a medical journalist or iPad into a heart rate monitor. When and the app guides you through the process access to their health data out of context that indicate the presence of significant the presence and editor at Pharmafocus your heart beats, more blood rushes to your of taking an examination. It’ll offer a doctor’s and without any medical counselling, it pathology. Simply measuring and of significant face. Cardiio’s software is able to detect response in just two hours. At the moment, could mean that doctors are left to deal recording the data is not enough,” he To watch an episode these tiny changes when your device is held Oto Home is only available in California, but with the fallout from these devices when explains. “If a test is negative, then there pathology” of Click that covers in front of you. may be rolled out further. worried patients incorrectly interpret the is a danger the patient will be falsely tricorder devices, visit

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