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Technophoria: Dissent Over a Device to Help Find Melanoma

Ms. Oppel is a medical assistant in Manhattan in the office of Dr. Doris Day, one of the first dermatologists to buy the machine. Developed by Mela Sciences of Irvington, N.Y., the system uses pattern-recognition algorithms to help a dermatologist who has picked out a suspicious pigmented spot to decide whether to perform a biopsy. The device may find an audience among sun-seekers worried about developing an aggressive skin cancer: the National Cancer Institute estimates that about 9,500 Americans this year will die of melanoma of the skin.

Yet the device is polarizing the field of skin-cancer detection.

For decades, dermatologists have used their eyes, along with a magnifier called a dermatoscope, to try to distinguish abnormal but benign lesions from potential melanoma in order to avoid unneeded biopsies. Some dermatologists argue that these low-tech tools are still the most useful and worry that their colleagues are falling for expensive, cool-looking gadgets that may simply offer extraneous, and perhaps incorrect, data.

“This technology should still be considered to be in the developmental stage,” said Dr. Roberta Lucas, an instructor of clinical dermatology at the Northwestern University Feinberg School of Medicine in Chicago. “We are better off when the system supports doctors who are thorough and unhurried; who examine and listen carefully and who empower patients to practice good surveillance and sun protection.”

In fact, some members of an expert medical panel asked to review MelaFind a few years ago for the Food and Drug Administration warned that the device had the potential to give doctors and patients a false sense of security. While MelaFind can analyze small pigmented spots identified by dermatologists as having signs of melanoma, it is not designed to evaluate other problems: large melanomas, colorless melanomas or two other types of skin cancer — basal and squamous cell carcinoma.

Dr. Amy E. Newburger, a dermatologist in Scarsdale, N.Y., who was a member of that F.D.A. panel, told me that she was concerned that a doctor could inadvertently use MelaFind on a non-melanoma skin cancer, receive a score indicating that the spot was not irregular, and erroneously decide not to biopsy it. She voted against recommending the device for F.D.A. approval.

Some biostatisticians are also critical of MelaFind, saying the device can recognize a high percentage of melanomas correctly because it also falsely scores as positive so many non-melanomas — potentially prompting doctors to perform unnecessary biopsies.

To help me visualize that issue, Jason Connor, a biostatistician at Berry Consultants, a biostatistics consulting firm, compared the accuracy of MelaFind in distinguishing non-melanomas to a hypothetical pregnancy test which, used on 100 nonpregnant women, would mistakenly conclude that 90 of them were pregnant.

“My concern with MelaFind is that it just says everything is positive,” Mr. Connor said. A member of the F.D.A. panel, he abstained on a vote about whether the device’s intended uses outweighed the risks.

“I don’t think this helps an aggressive doctor,” Mr. Connor told me, “and unaggressive doctors could do just as well if they were more diligent without the device.”

To develop MelaFind’s current algorithm, researchers trained the system on digital images of more than 10,000 pigmented lesions, programming it to recognize irregularities like asymmetry, color variability and cellular disorganization characteristic of melanomas. Company executives said Mela Sciences deliberately calibrated the machine to catch as many melanomas as possible, understanding that such a high setting could lead doctors to biopsy normal tissue.

“It will err on the side of caution,” said Claudia Beqaj, director of commercialization at Mela Sciences. “We wanted to set the system to have such a high sensitivity that we didn’t miss any melanomas.”

(In a company-financed study submitted to the F.D.A., the device missed two out of 127 evaluable melanomas. One F.D.A. reviewer concluded: “There is inadequate data to determine any true value added for MelaFind for use by a dermatologist or other provider.”)

Ms. Beqaj emphasized that MelaFind was intended as a supplementary test that provided extra information about a mole, not as a substitute for a dermatologist’s own expertise.

“If they blindly followed MelaFind, they would be biopsying more," Ms. Beqaj said. “The doctor has to make their own clinical judgment.”

Dr. Day finds the system quite informative. Last week, she gave me a demonstration in her office on the Upper East Side of Manhattan.

Dr. Day picked out what she called an “ugly duckling” mole on the left arm of Ms. Oppel, who had kindly agreed to play the role of patient. Another medical assistant removed a hand-held scanner from the MelaFind console and pressed it against the mole.

Gadgetwise Blog: Choosing a Cover for Your Device

When it comes to cases for phones, tablets and even laptops, you basically have to decide between two classes — those that are protective and those that are stylish. Generally, the more protection you want, the less style you get.

The LifeProof iPhone case.

If you want protection from a variety of elemental threats, you may want to go with something like the cases from Lifeproof, which add scant millimeters in thickness, but in addition to offering shock protection are also waterproof to six feet. They are available for a variety of Apple devices.

If water isn’t a concern but jolts are, there are cases made from “rate-dependent materials,” which are polymers that are normally spongy but knit into an armor when whacked. G-Form demonstrates its cases and protective sleeves by dropping a sleeved tablet 100,000 feet (it worked fine), and by treating phones like hockey pucks. Tech21 makes cases of similar material for both Android and Apple phones.

A common complaint is the speed with which phones drain their batteries. If that is your burden, you can lift it with a case that combines protection and a built-in battery. The problem with many battery cases is that they turn a sleek phone into a lumpish brick. But companies like Mophie have managed to combine low-profile designs with significant battery power, as in the Mophie Juice Pack Air. This case has a 2.5-ounce battery that nearly doubles the thickness of an iPhone, but its curved back makes it feel thinner. If you need really heavy protection, there are cases from Pelican, like the i1075 HardBack for the iPad, a variation on its weapons cases for the military that have proved on occasion to be — literally — bombproof.

The Warhol Foundation has collaborated with Incase to make a sixth series of Warhol-inspired cases for Apple i-devices.

Most people do not need that much protection for their devices; they just want to avoid scratches and add some style. The choices for this kind of protection are legion. LightWedge makes book-like covers, like the Verso Scholar, which looks like a marble cover composition book. When it comes to groovy retro, it’s hard to pass up the InCase Andy Warhol collection, which puts Warhol’s pop artwork on covers for a number of devices.

For the ultimate in personalization, companies like Case-Mate and Uncommon make covers that can be printed with one of your own photos. Just load the image online and the companies will print a scratchproof copy of your photo or design on a hardy plastic cover.

Gadgetwise Blog: Q&A: Keeping an Android Device Secure

Do I need to get an antivirus program for my Android tablet? How much of a threat is out there?

The amount of malicious software aimed at mobile operating systems like Android is growing. Although Google scans its app store regularly for malicious apps, malware has been entered it before.

Security-software businesses, which have a considerable interest in the topic, issue regular studies that include sections on threats to mobile devices. Companies like McAfee, Symantec and Lookout have reports online that will give you an idea what is out there.

Installing a security app on your tablet may help protect against certain threats. Some programs designed for tablets and smartphones include recovery and remote-wipe features that you can activate to protect your personal information if your device gets lost or stolen. If you are shopping, there are plenty of Android security apps around. Norton, McAfee, Trend Micro, Avast, Kaspersky, AVG, Webroot and others now offer security software for mobile devices. Many apps are available in the Google Play store, along with user reviews.

Device Sends Message to Swiss Farmer When Cow Is in Heat

That is because Mr. Oesch, 60, who cares for a herd of 44 Red Holstein and Jersey dairy cows, is helping to test a device that implants sensors in cows to let farmers know when they are in heat. When that is the case, the device sends an SMS to the farmer’s phone. The Swiss do not settle for half measures: the SMS can be in any one of Switzerland’s three main languages — German, French and Italian — plus English or Spanish.

If there is anything to be learned from this project, which will bring the devices to market early next year, it is that Heidi’s world of goats — or cows — placidly grazing in Alpine meadows is gradually becoming the stuff of storybooks.

The electronic heat detector is the brainchild of several professors at a technical college in the nearby Swiss capital of Bern. It fills a market gap, they say, because dairy cows, under growing stress to produce larger quantities of milk, are showing fewer and fewer signs of heat. That makes it harder for Swiss farmers to use traditional visual inspections to know when to bring on the bull or, in about 80 percent of the cases these days, the artificial inseminator.

The sensor implanted in the genitals of Fiona or Bella (favorite names for Swiss cows) measures body heat, then transmits the result to a sensor affixed to the cow’s neck that measures body motion. (Cows in heat become restless.) “The results are combined, using algorithms, and if the cow is in heat an SMS is sent to the farmer,” said Claude Brielmann, a computer specialist who helped design the system. The detector on the cow’s neck is equipped with a SIM card so the farmer can pay for the calls.

“Our recognition rate is about 90 percent,” Mr. Brielmann said.

The device, known as a heat detector, raises concerns among animal rights advocates, not so much because of its intrusiveness in the private parts of the cow — its use involves inserting a thermometer with a tiny transmitter and antenna in the cow’s genitals — but because of what it says about the stressful lives of Swiss cows. It also prompts skepticism among dairy farmers, who are startled by its cost, which is expected to be at least $1,400 per unit.

“Will it bring anything financially?” asked Ulrich Tschanz, 76, who raised Red Holsteins in the neighboring town of Oberlindach, where the clanking of cow bells is everywhere, until he turned over his herd of 40 cows to his son some years ago. “Always keep an eye on your cows, keep an eye on them,” he added. “That’s the best.”

But experts say measures taken to increase milk production — adding proteins, minerals and vitamins to their feed— upset the cows’ metabolism, making the device increasingly necessary. “With greater productivity there is a drop in reproductive activity,” said Samuel Kohler, a veterinarian who is among the developers of the device and now serves on the board of the company, called Anemon, that hopes to sell it. “It happens fairly frequently that you miss the right moment.”

Few people anywhere are as sensitive to animal rights as the Swiss, who have some of the toughest animal rights laws in the world. A comprehensive law enacted four years ago, for instance, obliges dog owners to take a course on the proper treatment of their pet and requires that certain animals deemed social, like guinea pigs or canaries, have one or more companions in captivity. (Even the Swiss have their limits. In 2010, voters overwhelmingly rejected a proposed law that would have appointed free lawyers to represent animals in abuse cases.)

Gadgetwise Blog: Device Protection, Without the Armor Plating

Phone and pad covers generally fall into two categories: highly protective with the delicate design of an M1 Abrams tank, or chic and generally useless.

Hard Candy has split the difference with its Bubble cases for iPhones 4 and 4s, iPads and Kindle Fire tablets.

All the cases in the line have a 1960s-looking pattern of polka dot indentations. Austin Powers might feel pretty groovy carrying one.

The iPhone version is hard plastic, available in an imitation metallic chrome, gold or glossy black, or a soft textured matte red, pink, black or white case. The bottom slides off for charging. The case is priced at $35.

The $40 Kindle case comes in black and white with rubberized protective edges.

But for protectiveness, both pale compared to the $60 Bubble 360 case for the iPad, which advertises itself as “bump proof, kid proof and even latte proof.” I’d say it’s more like resistant.

While it does have rubber edges, like the Kindle case, the Bubble 360 has very little padding inside, which makes me wonder how much of a bump it can really take. The screen is covered by a thin sheet of plastic, but if you splash it with a latte, don’t dawdle mopping it up. The screen on my test model didn’t seal all that securely.

Still, without adding much bulk, the case added more protection than the average fashion case, and it certainly looks more stylish than a tank.