sxg
Joined 10 years ago
Joined 10 years ago
Like the video says, this isn't a replacement for MRI or CT. Ultrasound has amazing superficial spatial resolution, but it falls off dramatically with depth, so the center of your body is essentially un-imageable. Ultrasound also struggles to penetrate air and bone. The video says having multiple probes around your entire body helps mitigate this, but I'm skeptical about how much that helps in practice. Your lungs take up the vast majority of your thoracic cavity, and your partially air-filled GI tract takes up a lot of your abdominopelvic cavity.
Based on how other preventative care and screening tools have panned out in recent years, I think this is going to yield pretty blurry images in relatively healthy patients that push them into getting more conventional imaging (e.g., MRI or CT). This in turn yields more false positives and biopsies with non-zero risk that likely outweighs any potential benefit of whole-body ultrasound. Counterintuitively, it's rare for proactive/preventative interventions in medicine to actually help people.
I'm no fan of pseudoscience either, but this is where things get blurry. The placebo effect is real even if patients are aware of it. If you give a patient a homeopathic drug while informing them of potential side effects (if any), and then they feel better, have you hurt them? Or have you helped them?
I personally have no interest in trying homeopathic medicines, but the reality is that many patients do take these and are adamant they help. As long as any risks are communicated and there are no serious side effects, it's difficult to make an argument against their use in patients who report a subjective benefit.
Similarly with LLMs, you can't just write them off entirely because they sometimes provide misleading or incorrect advice. The positive utility maximizing view is to learn when you need to call in an expert. I recently moved in to a new house and have used Claude extensively to figure out basic things (e.g., adjusting the garage door height, how to mount a TV). However, when the HVAC suddenly stopped working, I gave Claude a shot for an hour and tried some non-destructive fixes, but then realized I had to call in an HVAC expert.
Edit: I should mention that ultrasound is basically unusable for evaluating bones. Sound waves can't penetrate bone, and so you end up just seeing a huge black void. That's a huge orthopedics use case that ultrasound just can't benefit. However, ultrasound is fantastic for evaluating muscles, ligaments, tendons, and other superficial soft tissues.
> They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification.
Ultrasound isn't a great way to assess for calcification. It'll find large calcification but easily miss small ones. Plain radiograph would be more helpful, but the MRI may have revealed it as well. Either way, shockwave therapy isn't harmful in the absence of calcification--it's just not helpful.
Edit: when a radiology report says something isn't present, there's always an implicit caveat that the finding isn't present within the context of the modality and images obtained. So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon, but clarifying this in reports would make them sound even more qualified, "hedgey", and annoying to read than they already are.