1. Adoption Depends on Meeting Clinical Needs

    Adoption Depends on Meeting Clinical Needs

    Every year, I am amazed and impressed by the number and variety of presentations at conferences in the field of biophotonics . We are blessed by the seemingly endless ways to manipulate and measure light, relatively inexpensively, in our pursuit of powerful new ways to understand, diagnose and treat disease. Much human ingenuity has been applied to overcoming difficult technical problems and pushing back the bounds of our knowledge. But then I usually pause for reflection: How much of this advanced technology and research ends up in practical, routine use by clinicians caring for their patients? Of course, there are some ...

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    On 5/29/17 mebrezin said:
    This is a topic I have spoke on for decades. As a physician, OCT researcher, and co-founder of Lightlab Imaging, I have dealt with this problem for a long time. It is not unique to engineering. Physicians, who incorporate a large amount of information on a patient, want the simplest embodiment that gives the answer needed. Generally they would prefer the information was visual and categorical (ex: mild, moderate, and severe). Also, no device is of value till it shows it alters morbidity and/or mortality. Therefore, the objective is, using business terminology, use the minimal value product in clinical trials. On the other hand, many engineers strive for elegance and complexity. It is also my experience that many engineers avoid going to clinical trials for years, believing that if they reach a certain level of elegance it will be excepted by the medical community without trials. Generally, medical technology only has true value if tested in clinical trials and they should be started early not late. Our experience with single channel PS-OCT (relative birefringence) in arthroscope is an example. We received rapid acceptance by the surgeons with this simple approach that gave the needed information. But we met with constant criticism by the engineering community that complex artifact ridden dual channel PS-OCT was needed to give absolute birefringence. But no one could state what additional CLINICALLY RELEVANT information this increase in complexity would give. In summary, as simple as possible and it needs to effect morbidity and/or mortaility as demonstrated in clinical trials. A basic training in clinical, in my opinion, should be part of any bioengineering program.

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