Smartphone Diagnostics at Home: Interview with CellScope Co-Founder Amy Sheng

cellscope Smartphone Diagnostics at Home: Interview with CellScope Co Founder Amy ShengAmy Sheng is the co-founder of CellScope, a mobile health startup based in San Francisco that is focused on creating optical attachments for smartphones. CellScope spun out of a bioengineering lab at UC Berkeley during product development for mobile microscopes that could be utilized for disease diagnosis in developing countries. The company’s mission is to create the “world’s first smartphone-enabled digital first aid kit” by developing “easy-to-use, at-home tools that capture diagnostic-quality data for remote diagnosis.” I asked Amy about the company, its culture, and her day to day efforts as the head of product operations.

Tom Fowler, Medgadget: Why did you start CellScope?

Amy Sheng Cellscope Smartphone Diagnostics at Home: Interview with CellScope Co Founder Amy ShengAmy Sheng: My co-founder Erik Douglas and I decided to start CellScope in late 2010 because we were excited by the potential to improve healthcare access and convenience for very common medical issues. There was tremendous interest in our work in the Fletcher Lab at UC Berkeley and we decided to spin-out a company to begin commercializing products and services that enable “healthcare from the home.”


Medgadget: There are other companies out there that have been making medical device attachments for cell phones. What makes CellScope unique in this space?

Amy Sheng: CellScope is building a smartphone-enabled toolkit for families to use in the home to get a remote diagnosis for their most common healthcare concerns. We’re starting with the otoscope because ear infections are such a common pain point for millions of families. There are several differentiators about CellScope: We’re positioned at the exciting intersection of mobile, medical device-enabled services and data. CellScope is building products and services for families to get quick relief and peace of mind. Proper diagnosis of an ear infection requires a visual of the ear drum. Since otoscopes are not common household devices, CellScope is leading the way by creating modern versions of traditional medical devices previously only seen in doctors’ offices. oto cellscope Smartphone Diagnostics at Home: Interview with CellScope Co Founder Amy ShengWith Oto HOME, we’re changing consumer behavior as we empower parents to take a diagnostic-quality video of their child’s ear and send it to a physician for a remote diagnosis. Families will be able to visually track their child’s ear health over time and have a better understanding of what’s really happening. By having access to more longitudinal data for both parents and clinicians, we can improve engagement and understanding and hopefully reduce unnecessary antibiotic use.


Medgadget: What is your company culture like? Is there more of a medical or engineering vibe?

Amy Sheng: Our company culture is open, collaborative and inquisitive. We hire people who inspire us, and are curious, creative and driven. We look for people who are good at something, excited to share their perspectives with us and open to hearing other viewpoints.


Medgadget: What is a mistake you have made as an entrepreneur that you would warn other budding enterprisers to watch out for?

Amy Sheng: Stay focused, especially early on when you haven’t yet demonstrated product-market fit. It’s easy to get distracted as an entrepreneur because there’s so much going on and a lot of opportunities come your way. But ultimately the only thing that really matters is if you’ve built something that people love.


Medgadget: If I gave you a $2 billion research grant, what would you work on developing?

Amy Sheng: So many people in the world don’t have access to good healthcare. I would use the grant to massively improve healthcare access and delivery worldwide. I would develop and deploy low-cost tools and systems that deliver care broadly to rural and low resource settings.


Medgadget: Lastly, what is your favorite quote of the day?

Amy Sheng: Startups are hard. Hardware startups add another layer of complexity. Medical device startups add yet another layer of complexity. Medical device-enabled services startups add even one more layer of complexity. This week we’re announcing that our first product, the Oto HOME, is available to consumers in California. It’s an amazing feeling to see all the hard work come together to make this happen.  That is why this quote by Randy Pausch resonates with me: “The brick walls are there for a reason. The brick walls are not there to keep us out; the brick walls are there to give us a chance to show how badly we want something. The brick walls are there to stop the people who don’t want it badly enough. They are there to stop the other people!”

divider Smartphone Diagnostics at Home: Interview with CellScope Co Founder Amy Sheng

Link: CellScope company website…

Flashbacks: CellScope, a “Mobile Phone Based Clinical Microscopy for Global Health Applications”The Latest on Cellscope’s Smartphone-Based Microscope and OtoscopeCellScope for Rural Microscopy On The Go

Lewis Rubinson – 100% Discipline – Managing Patients with the Ebola Virus Disease

Lewis Rubinson, MD, PhD is Director of the Critical Care Resuscitation Unit at R Adams Cowley Shock Trauma Center at the University of Maryland. He recently spent a month in Sierra Leone providing clinical care to patients with Ebola as a WHO consultant. At Kenema Government Hospital, he was one of only two physicians providing daily…

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Progesterone in Traumatic Brain Injury

Two new randomised controlled trials were released online by the New England Journal of Medicine on 10th December 2014.

Both papers examined the role of progesterone on the impact of traumatic brain injury.  Both found no benefit.

Traumatic brain injury accounts for millions of hospitalisations globally each year.  Severe brain injury can result in death in significant numbers, and for those who survive, gross life-changing morbidity awaits.  Health care costs associated with TBI have been estimated in the hundreds of billions of dollars.

So its not surprising that all manner of interventions have been tried in this group.

Interest in progesterone as a potential mitigator of brain injury centres on its role as a neurosteroid which may limit inflammation, reduce vasogenic oedema and control apoptosis.  After apparent success in laboratory and animal studies, 2 small scale, single centre studies suggested a mortality benefit compared with placebo.


The PROTECT III trial was a phase 3, double blinded, placebo controlled RCT that focussed on the early (<4 hours) IV administration of progesterone to victims of moderate to severe blunt head trauma (GCS 3-12).  The study was managed by the NINDs funded network of neurotrauma research centres, including 49 trauma centres in the US.

The dose was weight based, front-loaded and extended over 72 hours by continuous infusion.

The primary outcome measure of an extended Glasgow Outcome Score at 6 months, classified as either a good or bad outcome.  The definition of a good outcome as measured by GOS changed depending on the initial severity of injury, as defined by initial GCS.

The study aimed to include over1100 patients  in an attempt to detect a 10% difference in favourable outcomes.  It was ceased at the second planned interim analysis based on a predefined futility stopping rule.  Ultimately slightly more than 800 patients were included, about half of which had "moderate to severe brain injury" (GCS 6-8).

The primary endpoint was similar in both groups, with slightly more than 50% of patients having a good outcome.  Mortality was also unchanged.  No apparent increase in complications of progesterone therapy were noted.


The SYNAPSE trial was a multinational, placebo controlled, blinded, randomised trial involving trauma centres in over 20 countries.  It included patients with moderate-severe brain injury, and treatment was initiated within 8 hours of injury.

Again, weight based treatment was given intravenously, with front loading and completed over 120 hours.

Similarly, the primary endpoint was a functional outcome, the Glasgow Outcome Score, measured at 6 months.  Extended GOS was also calculated, and unlike PROTECT 3, more refined rehabilitation measures such as the SF-36 were reported.

Like PROTECT 3, the study aimed to recruit 1200 patients to detect a 10% difference in a "good" outcome.  Drug levels were monitored, and were consistent with previous trials that demonstrated efficacy.

The results were almost identical to the PROTECT 3 trial - no difference in the primary endpoint; around 50% had a bad outcome, of which 20% were deaths or vegetative.

So what's the upshot?

At least for now, there is no reliable evidence for the use of progesterone in brain injury.

These trials join more than 30 other trials on the TBI scrap heap.  Together, they (yet again) raise the question, how can so many confirmatory phase 3 trials be negative, despite such encouraging work in early phases?  Can we continue to invest enormous quantities of research funding in this way?  Or do we need to look closer at the criteria for commencing these trials?

It also calls into question the persistent hope that a single agent or therapy will influence a complex pathological process such as brain injury.  Or sepsis.  Or ARDS.


  1. PROTECT 3

The Stiell Sessions – Clinical Decision Rules & Risk Scales Survey & Podcast

Dear EM Cases listeners,

We have a special request.

In looking at how we can assess the impact of podcasts on EM providers' practice we would be thrilled if you would be kind enough to take a 2 minute survey, at the end of which you will be given free access to a full length podcast where Dr. Ian Stiell discusses with Dr. Hans Rosenberg and I, a rational approach to the use of clinical decision rules and his latest, hot off the press risk scales.

Dr. Stiell's one minute invitation to participate in the survey and listen to the podcast....

[wpfilebase tag=file id=527 tpl=emc-play /]

LINK TO SURVEY to get access to the podcast -

Stay tuned for a bonus podcast on Dr. Stiell's take on the latest Atrial Fibrillation Guidelines in one week with a 15 second post-listening survey.

Please feel free to share this with any EM provider who might be interested.

Download Dr. Stiell's Clinical Decision Rules & Risk Scales with all their inclusion and exclusion criteria in the EM Cases section of the AgileMD app for use at the bedside.

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One million and counting

Today marked a big milestone for the EM Basic podcast

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One million downloads.  I look at that number and I seriously can’t believe it.

First of all- a few thanks are in order.  Thanks first to Christin, my wife, who has been there since day one (when I had the idea for the podcast while walking our two dogs) and has done everything she can to support this project.  She is always there to listen to my many crazy ideas and provide sound advice- especially in anything pediatrics (her specialty- soon to be Peds critical care).

Thanks also to those who have supported the podcast through submissions to the EM Basic project.  Your help has been invaluable in continuing the podcast with fresh ideas and input.  Thanks especially to Dr. Andrea Sarchi who has been the workhorse as of late by providing scripts for five episodes- two of which are yet to be published.

Finally, thank you to all the listeners out there who give me the motivation to continue this project.  Each episode takes a lot of work but it’s incredibly rewarding to see the download stats continue to climb.  Even more rewarding are the emails that I get saying how much the podcast has helped out in people’s everyday practice of EM.

I did this post not to brag about numbers (I’ve got nothing on EMCrit- we’re talking orders of magnitude…) but to say thank you and to also show how far FOAMed has come in the past few years.  I started this podcast about 3.5 years ago.  I relied on word of mouth and a few recommendations from established websites like Life in the Fast Lane and shout-outs from the gurus like Rob Orman from ercast to get it off the ground.

Since I started EM Basic, there has been an explosion of FOAMed in all areas of EM.  We still have a long way to go in terms of covering the less “sexy” topics but we are making progress.  For example, FOAMcast (another EM core content podcast) recently announced that they hit the 50,000 download mark in about 6 months.  It took me more than a year to do the same with EM Basic.  We have now created a network of knowledge sharing that allows new quality FOAMed to be rapidly distributed and disseminated to all corners of the earth (literally- I can confirm at least one download from Antartica!).

That’s all I’ll say about stats- forever.  Among podcasters, it seems like the first rule of podcasting is you don’t talk about your download stats.  The second rule of podcasting is…well, you know.  That’s also it for the philosophizing.  As I said before- I don’t do this to brag but to say a heartfelt thank you to everyone who has helped this project along the way.  I hope to continue this project for a long time and I’ll be counting on your support and contributions to keep it going.

Take care and remember- as Mel Herbert (the god of all EM podcasting) says- What you do matters…