Saturday, October 19, 2019

BUTTERFLY IQ: GAME-CHANGER IN DIAGNOSTIC TECHNOLOGY? PEOPLE WANT SOLUTIONS, NOT GOLD-STANDARDS IN DIAGNOSTIC TECHNOLOGY

It's called the Butterfly IQ.  It is a handheld ultrasound that connects to your Android so that you can see images of tissue on your phone rather than having to go to an expensive specialist to see.  You'll still need some knowledge to be able to identify or discern features in the images, like blood, fluid, muscle, connective tissue, and so on.  You'll also need to have some medical or scientific background to determine if something is wrong or ill.  But it may be a case that the days of the stethoscope are over.  But so what?  I mean, what's the big deal?  Does the app self-diagnose?  Probably not.  Does it give you insights that you might take to your doctor and hammer out a therapy protocol together to solve your condition?  Probably not.  The medical-industrial complex is not going to suddenly step aside just because one clever tool was designed and manufactured.  But Dr. Stephen Stokes says it's a big deal.  
This is the most important piece of diagnostic equipment I have in my office right now. 
From Dr. Stephen Stokes.  


From the Butterfly Network.  So what exactly are the benefits, and for whom are the benefits delivered?  First, it's not the only pocket ultrasound diagnostic tool on the market.  See this list for others.  It's main benefit seems to be its competitive price of $2,000.  
Some of the particularly favored features of the Butterfly iQ are the price, single probe system, and storage capabilities.  The price point is far less than any of the other competitors.  For less than $2000 an individual has an ultrasound machine that can literally fit in a pocket.  Additionally, there are not multiple probes that have to be carried around.  The GE Vscan is the closest competitor with two heads to one probe, but it has other major detractors such as the quality of the images in comparison and its price point.  In addition to being able to storage images to PACS, Buttefly's images are save to a cloud based system which also allows users to share de-identified images to others.  Below, are some images from the first time of using the author's own device on himself. 
The point made here addresses my question about its diagnostic value. 
In EMS, ultrasound is not meant to be used to diagnose conditions such as appendicitis.  However, it can identify serious pathology and help develop an appropriate differential diagnosis as well as change care.  This can drastically change the course of management such as where a patient may be transferred.  For example, a hypotension chest abdominal pain patient with evidence of a large AAA should go to tertiary care rather than a community hospital.  

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