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Cue, the home lab for quantified self (cue.me)
76 points by DiabloD3 on May 14, 2014 | hide | past | favorite | 67 comments


This looks like a hypochondriac's wet dream...

As useful as self-diagnostic equipment cam be, the more we can measure, the more likely people with unwarranted health worries can run to the doctor with "My X level is off by 5% says my $150 uncalibrated thing".

I get the feeling that this falls somewhere between very useful (like glucose level to a diabetic), and negatively helpful (a misinterpreted level that causes unhelpful behavior).


Haha yeah, I'm a physician and I can tell you there're few things worse then when a patient get all worked up about some number that is "0.1" too high/too low. It's usually totally meaningless, gives groundless anxiety and waste everyones time.

It's not easy to interpret these numbers and you have to have quite a deep understanding of statistics, i.e you can be in the normal range and be sick, and you can be outside and be healthy. Type i/ii errors, precision, accuracy, calibration etc etc. I'm sure hackernews knows what's up I'm sure.

It's said about 90% of all diagnosis can be made only on taking the history. Tests are normally only done to assure, quantify, guide treatment etc.

* Testosterone: I have no idea why you would be interested in measuring this at home and I strongly suspect this could lead to misguided treatment with severe side effects.

* Inflamation: Probably a C-reactive protein. Pretty much useless on it's own.

* Fertility: Not sure exactly what they measure but I guess LSH/FSH. This job can be more easily done with a thermometer.

* Vitamin D: If you are worried, get it checked ONCE. No need to check day to day. If you take a supplement, your body will regulate the rest.

* Influenza: Again, not sure what they are testing and why you would want to do this as there's no specific treatment. When you do a test, always reflect what you will use the result for.

IMHO this device lacks the "test" that actually would be useful, like * glucose * maybe TSH * your weight * your activity level * your caloric intake * your sleep

Because these are things that actually mean a lot to your general wellbeing.

[not native english speaker disclaimer]


Well, I'm an occasional patient and there're few things worse than when a doctor acts like taking an active role in your own healthcare is an inconvenience.

I, for one, would not shed a tear if the role of human diagnostician is replaced by computer systems with far more raw data to work with than was ever before possible.

Watching a family member with an extended illness, I came to the conclusion that we would be better off if doctors stopped thinking of themselves AS healthcare and were instead the human face of delivering healthcare.


> I came to the conclusion that we would be better off if doctors stopped thinking of themselves AS healthcare and were instead the human face of delivering healthcare.

I believe you are right. I'm sorry you had bad experiences. All physicians are different.

I believe all patients should take an active role in their healthcare (that includes smoking, diet and exercise). My point is only that sometimes a misappropriate amount of time can be wasted on very very subtle differences and we forget the big picture.

Computer diagnostics is the future. I'm on HN for a reason.


Pretty good points, I have few comments.

> It's not easy to interpret these numbers and you have to have quite a deep understanding of statistics, i.e you can be in the normal range and be sick, and you can be outside and be healthy. Type i/ii errors, precision, accuracy, calibration etc etc. I'm sure hackernews knows what's up I'm sure.

Doctors mathematical abilities are less than legendary. I would rather own the raw data and choose my own method of analysis.

> It's said about 90% of all diagnosis can be made only on taking the history. Tests are normally only done to assure, quantify, guide treatment etc.

This is an argument for this device. Having something at home that you can use to test on regular basis will give you the rich historical data you need to make a better diagnosis.

The goal is to discover a problem before you are sick enough to feel the need for constant testing.

The tests seem to interest different groups. I imagine these are the first of many different types of tests planned. You are right about glucose, they probably didn't go there yet because of the competition.

A lot of you arguments are "if you want this tested go to the doctor." Really? do you know what a pain in the ass it is to go to the doctor? First I have to take of work, then I have to wait for him. Then I have to talk to a doctor or nurse about my concerns only to have them act like they are unimportant. Of course there is the cost. Honestly as a consumer I find going to the doctor to be one of the most annoying experiences.

I'll stay at home if I can


People on HN would probably be a good target for this device as most hackers understand data much better than the general population... But a random test here and there... I'm not convinced.

However, medicine needs to develop and home diagnosis and early detection along with encouraging and active lifestyle is the future. There are some tough challenges ahead. Maybe this is a step in the right direction, but as I said, I'm not 100% convinced by this device as i feel it kind of misses the point and focuses on some random fairly unimportant tests.

Well let's say your CRP went to a 100, your nose is running and you have a a cough... what would you do?

> Doctors mathematical abilities are less than legendary.

True that :-)


Agree 100%, especially about knowing what you will do with the result before you take a test. FYI, your English is great.


Thanks.


If you go to the "product" page, it tells you what they are testing for on each.

Testosterone: saliva sample, free testosterone

Fertility: blood sample, Luteinizing Hormone (LH)

Inflammation: blood sample, C Reactive Protien

Vitamin D: blood sample, 25(OH)D Vitamin D

Flu: nostril swab, Influenza A

any further thoughts?


I think it's kind of a weird panel of tests. I wonder what selection criteria they had.

Testosterone: still not sure why you would like to test this regularly at home. But I'm not an endocrinologist.

CRP: Very unspecfic marker of inflamation.

LH: I guess I was wrong and this could be quite useful http://www.ncbi.nlm.nih.gov/pubmed/950047

Vitamin D: Severe depletion can give you unspecific symptoms so it's not bad. There's just no need to test it more than once really. If you are depleted just take supplements.

Flu: Still beats me why this would be useful other than general interest (which sometimes is enough I guess).


> Flu: Still beats me why this would be useful other than general interest (which sometimes is enough I guess).

Babies


Physician here. I think the concept of having a personal device to perform biometric testing on is interesting. I support my patients having full access to their information and taking an active role in their care as a partnership. The physician's office is no longer the silo to store and withhold a patient's information from them.

My concern with Cue is both medical and practical. I'm a Rheumatologist, so I deal with CRP/Inflammation a lot. Its an incredibly non specific test, with large variability. It does have a utility in monitoring disease activity but usually in conjunction with a physical exam and other testing. A positive/elevated test with poor specificity has a poor positive predictive value. So my practical concern is, lets say you use cue to check your CRP, and its elevated. Okay, so what? What information did one just gain from this device. I think the same can be said from the other tests.

In the words of Horace Dediu, I'm not sure what the "Job To Be Done" is for Cue. What is someone hiring Cue to do for them? I really don't know.


I'm really fed up of sites like this that hijack scrolling, it prevents you from skim reading. Instead of scanning 100% of the page's content I've just left the site after reading about 20%.


Not only did they screw with vertical scrolling I can't swipe to go back in history, it just moves up a slide. Super annoying.


But it's so hip!

bleh


I didn't even notice, I just assumed I reached the end of the page after scrolling one "page" and swiping down on my trackpad didn't do anything more.


I would have thought 20% was skim reading?


There's a difference between reading 20% of 100% and 100% of 20%.


I totally like cool products like the one on display here. But i'm so tired of those preordering-sites.. really, i want to order your stuff. now. Tell me when it's finished, put the site online. If you really need an indication whether someone likes/needs it, perform market research without irritating potential customers. And if you need additional funding to make your vision happen, sites like kickstarter offer a clean and generally well understood way of making that happen.

No, I'm not going to preorder a product now that ships sometime in 2015. Not even for a 50% discount.


> But i'm so tired of those preordering-sites.. really, i want to order your stuff. now.

Agreed, but unfortunately the business environment has changed. The cost to start a business has decreased so much it is much harder to convince investors to drop a few million into something when there are so many cheaper alternatives.

Additionally everyone is doing preorders, and you are not, you are probably at an disadvantage.

> And if you need additional funding to make your vision happen, sites like kickstarter offer a clean and generally well understood way of making that happen.

They do not allow medical devices.


> They do not allow medical devices.

thank you, i was wrong there.


I understand your frustration but I think pre-orders are important for them to understand how many units to manufacture. What if they produce too many, and people don't buy them ? what if too little and they can't cope with the demand ?


Another way of looking at it is that the delivery horizon is too long. In six months there will be other similar products announced and probably released. I fell like 2015 so so far out that the value of pre-order as a forecasting tool is minimal.


Acceptable and calculable business risks. How did new products launch before the internet?


I can think of an example of an industry that has been doing pre-sales to fund production for a long time and that's property development.


That's what market research really is good for. And frustrating potential users to minimize your business risks isn't acceptable, in my opinion. There's always risk involved. That's the nature of business.


"That's what market research really is good for."

Pre-orders can be an excellent form of market research.


Don't think you can consider it research if you are billing people, it's just business/sales.


It seems like getting people to commit to pre-orders is possibly the best form of market research. You've done enough R&D to get a solid outline of what the product will be, and you're testing whether or not people are actually willing to put money on the line to get ahold of it.


This is great, but the video seems a bit misleading. Seems like a all-in-one device with a magic collector capable of getting instant results of several indicators on a single sample, be it blood or saliva. But the site make it clear that an analysis package is needed for each molecule being tracked and that results take minutes. Nothing is said about packages lifespan and sample collectors reusability. Anyway, could someone familiar with this matter give us some background on the hardware?

UPDATE: from the FAQ:

"Cartridges are single-use and disposable. To enhance user safety and hygiene as well as minimalize contamination of samples, the Sample Wand permanently locks inside the cartridge and is disposed of with the cartridge." (...) "A 5-pack of inflammation vitamin D, fertility, testosterone, cartridges costs $20/pack. A 3-pack of flu cartridges costs $30."

Definitively not the everyday tracking thing seen on the video.


From the FAQ:

You can track 5 key health molecules: inflammation, vitamin D, fertility, influenza, and testosterone in just minutes, at home.

I was trying to figure out what the device can tell you about yourself, and it appears it can't tell you very much at present. Also, these things aren't 'molecules'.

As an MVP this is exciting stuff! In a few years we might have something that is actually useful.


Well, 2 out of 5 are actually molecules. But this kind of sloppy language doesn't exactly inspire confidence.


It also looks like you need a different cartridge to measure each of those 5 things which would be terrible.


On a scale of 1-10, how bullshit is this?

I'd actually benefit from being able to monitor my testosterone levels, so this interests me.


I worked for a company in this space for a bit. My 2% of a dollar: the tech probably isn't BS. They're most likely using direct colorimetric assays, and also possibly immunoassays (think ELISA). I'd be concerned about the sensitivity of their assays from such a small sample volume (a drop of blood is about 20 microliters). Vitamin D in particular is tricky due to its low blood concentration. I'd hope that they are doing something clever with fluidics to amplify the signal. The price of the reader seems about right (if just a bit low to encourage adoption). Their business model is likely a) dependent on a razor-and-blades strategy, with expensive consumables, and b) dependent on the system cost being reimbursable through insurance.


Looked up the founding team and advisors, they're backed by some serious science. This is probably fairly accurate.


I would love to comment on the product, but the site's scrolling locks up every now and then and most images flicker or don't display in Chrome Canary. Designers, please don't break the Web by overriding spacebar :(.


I wish this product explained in one sentence why I need it.

How would my world come to an end without it? I often wonder if the ADHD you get from availability of all this data subtracts more than a product adds.

"Be your most motivated". How did our ancestors do it? Keeping things simple is as important as having the power promised by information. We still fail at the simple things, while getting distracted by complicated things.

"Add a sample". A sample of what? I'm also curious about how they measure how well you sleep and how they achieved wireless charging.


A sample of something containg testosterone, flu, inflammation, vitamin D and fertility! Not sure how something can contain fertility, but still.


Maybe hormone stuff, at least for women?


By elimination it must then be one of those secretions they wouldn't name in an ad ;-)


That would most likely be a capillary blood sample. Source: I'm a physcician.


The FAQ says it's a sample of blood, snot or saliva depending on the test with the most common one being blood (for 3 of the 5 tests).


I'm not sure about anyone else, but the fact that they kept using the word 'sample' instead of what sample they were referring to bothered me. Thankfully further down in their FAQ (the hardware FAQ) it mentions what samples are (blood, saliva, or nostril swabs).

I kept imagining this "simple and easy to use sample wand" as a massive self-administered spinal tap, sort of like those water extractors from the 'Tank Girl' movie.

Sort of funny when you're to the point that marketing talk makes you assume the very worst possible scenario.


First, a fabulous idea that is simply not ready.

I like the concept here, but the mobile integration seems wholly arbitrary and shoe-horned. Yes, we want everything mobile, but if I'm sticking my blood sample in this thing I don't know why I couldn't just get an email or have it connect directly to my device.

Like others here have said, I would mostly want guarantees about the efficacy of the device wrt results. And I'd want a whole bunch more than fertility (is this just a LH measurement), "inflammation," vitamin D and the flu. Perhaps that's a phase two?

And to echo others, please stop scrolljacking. Thanks.


"Inflammation" is likely measurement of C-reactive protein (CRP) concentration.


I'm not doubting they can quantify it, I'm just not sure what that info alone tells us.

And there's such a disparity of metrics here that you're getting a pretty incomplete health picture unless you want to know if you're infertile or have the flu.


For some reason I feel this will be bought by a Google or Facebook before making it to market. I can't explain why, I just get that vibe.


I hope more of these type of products come out. I think real time tracking of a persons biomarkers will be evolutionary in the health space.


So what are they going to do with all the health data they harvest from this? I don't suppose the device will be offlinable.


From the FAQ:

How accurate is Cue?

We use rigorous, gold-standard internal testing and validation techniques to evaluate the performance of Cue. We cannot make any specific claims on the performance of the device, because it is not yet cleared by the FDA. However, we will not release Cue until it has met our own internal performance standards.


> because it is not yet cleared by the FDA.

I confess I'm dying to know how "Inflammation is elevated, recover with a green smoothie" is going to get past the FDA.

What is the measure of inflammation? Are they really measuring ESR, CRP, and PV? If so, how would you predict that recovery would occur via the medicinal green smoothie, as opposed to knowing that there are early signs of, say, psoriatic arthritis?

Kudos if they can pull that off.


They can pass the FDA as being validated to measure certain biometrics, but it's going to be really difficult to be considered a treatment.


Spoiler alert: they can't.


For me on Chrome, there seems to be some broken loop somewhere. It continually requests and then cancels those requests to certain sprite images. It still downloads at least part of them though, so you're getting maybe ~100kb/sec continually downloading for as long as you're on that site.


Someone needs to make a parody video of this ASAP: "Man takes cue out of his mouth...smartphone says: You have 4 hours to live." "Woman pulls cue out of her ear...smartphone says: You are deaf"


Very interesting device. I would be very interested in getting one, but again, before there is actual device on sale, I am not parting my money for video alone.

I wish you produce it as soon as possible and get my money.


I don't know why, but it creeps me out. If it's that easy to test your body for "molecular" levels . How long before you are asked to be tested at your workplace, on interviews, etc.

Gattaca anyone?


It's already easy to test for political affiliation / religious beliefs as part of the interview process, but people aren't doing that. No reason to believe that something like this will be different.


The issue with political and religious beliefs is that they're generally irrelevant to your work but may be basis for discrimination. The chemical composition of your blood and other tissues may be relevant to your work but is generally not expected to be basis for discrimination.

This is why I think you counterpoint is not exactly spot-on. On the other hand I share your disagreement with Gattaca-inspired fear mongering: if chemical analysis of your tissues can provide useful information for recruitment we should embrace it. Interviewing is flawed and hard as it is, so any improvement should be welcome. My fear would be that chemical composition turns out completely useless like many other simplistic solutions to complex issues around selecting the right humans for any job.


>if chemical analysis of your tissues can provide useful information for recruitment we should embrace it.

I disagree.

There are no fields in which poor health is an advantage. So, that idea extrapolated, their are no jobs which wouldn't benefit in some way from having the most healthy staff possible.

I'm of the opinion that it is the job of recruitment staff to secure employees who are capable of doing the job that's asked of them, capable of advancement, and capable of a degree of amiability which will allow them to work well with the other parts of the system.

If chemical analysis were to be used normally in the course of recruitment, it'd no longer be a game of determining if the candidate was capable of the task, but rather a min-maxing of attributes which would be expected to produce a company with the results desired.

Simply put : I, too, fear that chemical composition is far too simple a criteria to judge a possible (human) candidate on.


So what does this thing actually measure? I have zero reason to think that the tech can deliver on this. It's raman-spectroscopy-on-a-key-chain over and over, and at least they had a faux demo.


It will be interesting to see if the FDA comes down on this. On the one hand, they aren't selling anything, yet. On the other, they are making promises about efficacy for the initial users.


It looks like they are in the data gathering phase for a 510(k), as an exempt IVD. From their site:

"Cue Inc. will be conducting tests and collecting information and data from a number of individuals to ultimately support submission to FDA of a pre-market notification 510(k). We hope that you will consider voluntarily participating in these tests. These tests are exempt for Investigational Device Exemption requirements because the testing (a) is noninvasive; (b) does not require an invasive sampling procedure that presents significant risk; (c) does not by design or intention introduce energy into a subject, and (d) is not used as a diagnostic procedure without confirmation of the diagnosis by another, medically established diagnostic product or procedure."

I'm curious what they'll cite for predicate devices.


The broken scrolling totally destroys the experience. Also, the lack of text made me wonder whether the page was loaded completely.


scrolling is totally broken on chrome mobile, I can't even see half of the pictures


Apple is buying this thing in no time




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