ifty years ago, the “Star Trek” series envisioned a handheld medical device that could diagnose every condition with just a swipe over the patient’s body. The tricorder was just one of the show’s futuristic gadgets — but it’s one that real-world scientists seized upon.
And some have spent years working to bring it to existence, under the banner of the Qualcomm Tricorder X Prize, a competition launched in 2012. From a starting roster of over 300 teams, just two are now in the running.
The competition has just a few rules: Each prototype must have the capacity to monitor five vital signs and diagnose medical conditions, send data to the internet, and weigh under five pounds.
That’s not quite the gadget Dr. McCoy made famous. For one thing, the real-life versions being developed now aren’t no-touch wands but rather what look like iPads with associated sensors — electrodes, cuffs, probes, and clips — linked with or without wires.
But it’s also intended for a different user: Not a doctor, but rather the patient him or herself. The tricorder, then, is more akin to the “quantified self” trend — gathering all manner of data, on an ongoing basis, to “allow individuals to incorporate health knowledge and decision-making into their daily lives,” the prize website says.
For now, that seems some way off. The working designs by Basil Leaf Technologies, a Pennsylvania-based medical device startup, and the Dynamical Biomarkers Group (DBG), a research group out of the National Central University in Taiwan, are still somewhat bulky and accompanied by lots of little doodads. But as sensor technology improves, it’s not hard to imagine wireless electrodes stuck to our bodies or wired into our implants, keeping running tabs on our health.
Searching for indicators
Sequestered away in a computer-filled basement of Beth Israel Deaconess Medical Center in Boston, the DBG has a team of 40 people working on their tricorder project. Using decades-old patient data from the hospital, and current clinical trials in Taiwan, the team had been steadily tweaking and evaluating its design.
On a desk in the lab sits their most recent prototype, a nondescript, eggshell-colored box about the size of a toaster oven. A smart phone sits in a hub on top. Drawers on three sides open to reveal compartments holding various fobs and attachments. With them, the device measures heart rate, blood pressure, and other vital signs, wirelessly sending the readings to the smart phone.
In its most recent round of testing, which took place in 2015, X Prize evaluators tested the gadget’s ability to diagnose 10 required conditions: Anemia, atrial fibrillation, chronic obstructive pulmonary disease, diabetes, elevated white blood cell count, pneumonia, middle ear infection, sleep apnea, and urinary tract infection. Competitors also had the option of diagnosing the absence of those core conditions and for the presence of additional conditions, such as melanoma, mononucleosis, or shingles.
Now the finalists’ devices are in the consumer-testing stage, which began in December. For this stage, a coordinator trains consumers to use the device. Afterward, consumers get a 90-minute session in which they independently use the device to diagnose themselves.
One goal of the competition is to raise the possibility of more precise diagnoses. Dr. Andrew Ahn, DBG’s lead medical advisor, suggested that the use of dynamic biomarkers — ongoing readings of vital functions — could improve medical treatment.
“Right now, medicine is based on one-time readings,” he said. “But the science of medicine needs to be able to work with continuous data.”
He added that the way that a vital sign changes over a period of minutes or hours can be more meaningful than individual readings taken weeks or months apart. This is the “hidden data” of medical diagnosis, said DBG team leader Chung-Kang Peng.
“There could be all kinds of hidden indicators we’ve been missing,” agreed David Sept, a University of Michigan professor of biomedical engineering, who is not involved with DBG or X Prize. “You could collect a large, complex dataset of vital signs that might be an indication of something.”
Sept cautions, however, that more data does not mean better information.
“It might be that only one or two specific factors are correlative to a specific disease state,” he said, adding that having the capacity to take many and varied measurements does not mean it’s always useful to do so.
Sept added that the technology might not take medicine far enough beyond what it does already. “Correlations [between indicators and diagnoses] can be extremely useful without a showing a direct causative effect,” he said. “But we’re still not predicting causation.”
Sept likes the idea of competitions like the X Prize, however.
“They do seem to get people to innovate in great ways,” he said, “so I see it as a worthwhile endeavor.”
After refining the requirements and extending the deadline last year, X Prize plans to pay out its grand prize of $10 million in April.
Win or lose, Team DBG hopes to continue developing its prototype. But whether the device would ever be commercialized is still up in the air. The Food and Drug Administration has been offering advice to help teams prepare for potential FDA review post-competition. But X Prize did not require or conduct clinical trials of the devices, so the designers may also have to clear that hurdle with an FDA-approved trial.
For now, Ahn said, “Our primary goal is to enhance health and empower patients… It’s an exciting time to be working on this.”