Live data from Hacker News

Theranos Is Subject of Criminal Probe by U.S

wsj.com

111–120 of 226 posts

Re: Theranos Is Subject of Criminal Probe by U.S

#111

Earlier quoted context omitted.

> Someone out there needs to attack healthcare. All the attacking that needs to be done is political/social, not technical. Want to attack healthcare? Strip middlemen out so that the money flows to providers and researchers (Single payer + pouring additional money into the NIH/NSF, with the results being public domain). All of these YC startups I see "hacking" healthcare (Dr Chrono, HealthSherpa, etc) are just bandai…

Here is a good factual overview of why Single Payer won't make health care cheap in the US: http://www.bloombergview.com/articles/2014-04-30/single-paye...

That is in their opinion section, and is written by a columnist with an ideological bent so I would hesitate to call it a factual overview.

For those wondering why the US health care system is so much more expensive than any other country, I recommend this nice series of posts from Dr. Aaron Carroll: http://theincidentaleconomist.com/wordpress/what-makes-the-u...

Re: Theranos Is Subject of Criminal Probe by U.S

#112
post #89

Earlier quoted context omitted.

> Someone out there needs to attack healthcare. All the attacking that needs to be done is political/social, not technical. Want to attack healthcare? Strip middlemen out so that the money flows to providers and researchers (Single payer + pouring additional money into the NIH/NSF, with the results being public domain). All of these YC startups I see "hacking" healthcare (Dr Chrono, HealthSherpa, etc) are just bandai…

Single Payer would be great if you can trust the uh, payer. But our government is delightfully corrupt, so I'm sure a lot of people with more rare medical conditions would end up with worse treatment than they can get now.

"Single Payer would be great if you can trust the uh, payer. But our government is delightfully corrupt"

Lucky for us the health insurance industry we have is a paragon of virtue whose integrity is beyond reproach!

Re: Theranos Is Subject of Criminal Probe by U.S

#113
post #59

Earlier quoted context omitted.

No. I multiplied 1 nM by Avogadro's number. Do you have any reason to believe that free IgG is not uniformly distributed at steady-state in circulation? ... Because that's what they're testing for.

Many (most) of the things we're interested in measuring in blood are bound to some sort large macro-molecular assembly... be it cells, lipid vesicles, large protein agglomerates, etc.

In the clinic the most common testing is metabolic paneling (levels of various salts, urea, glucose, creatine, etc.), serology (for circulating antibodies), or cell counts (which they weren't doing, as far as I know).

Re: Theranos Is Subject of Criminal Probe by U.S

#114
post #58
post #49

Earlier quoted context omitted.

No, I'm not wrong. You're talking about testing for cell counts, which is not -- as I understand it -- what this company was approved to do. For molecular and protein components of blood on the nanomolar range, you would not encounter this problem until you were sampling in the femtoliter regime. Just use Avogadro's number, and you'll get it.

A lot of those molecules are bound up in cells, they are not freely diffusing in blood. Even those diffusing in blood are not uniformly distributed, blood is highly dishomogeneous.

Routine metabolic paneling and serology does test for molecules that are uniformly distributed in blood. I can't say it any plainer than that. Of course many possible testing targets are inside cells, but these tests were not claiming to look at any intracellular targets, at least as far as I know.

Re: Theranos Is Subject of Criminal Probe by U.S

#115
post #87
post #31

Theranos isn't even at the leading edge of blood testing. There are now hand-held FDA-approved immediate blood testing devices.[1][2][3] Most of these require smaller amounts of blood than a remote lab, although more than a drop. Theranos is still in the send-it-to-the-lab-and-wait era. Even if Theranos' technology eventually works, it may be obsolete before it ships. [1] https://www.abbottpointofcare.com/products-se…

The healthcare industry is quite inefficient at allocating money to things that are needed and have a decent chance of working. For example, in the field of oncology there's very little money put into cheap accurate early screening. And an almost obsessive pour of money into trying to understand mid-to-late stage cancers. Even James Watson has criticized this. It's a sad situation, because we now know early pre-clini…

There is actually now a LOT of interest in the biomedical community for circulating tumor DNA - a quick Pubmed search yields 3317 results and Illumina is practically throwing money at the field. You have to keep in mind that the sequencing technology has only recently become cheap and sophisticated enough for this kind of highly sensitive testing to be possible.

Re: Theranos Is Subject of Criminal Probe by U.S

#116
post #91

Earlier quoted context omitted.

two things struck me as a little odd. One, the private costs are off the chart with regard to our peers, but the government spending is just "more than average". but more than average is presented as being just as bad as the outlier we are in the first case. Two, medicare is responsible for the most expensive health years of a person's life. The time when our bodies just start to fall apart and require a lot of speci…

I think the argument is that US government financed health care that only pays for maybe half the population is already more expensive then paying for 100% of the population in other countries. So it's a stretch to imagine that having the US government take on many more patients would lower costs.

[deleted]

Re: Theranos Is Subject of Criminal Probe by U.S

#117
post #41
post #35

Earlier quoted context omitted.

> blood constituents are not evenly distributed at small volumes You're saying they're running into statistical stochasticity? Are you claiming they were sampling femtoliter volumes? That's the how small you'd have to get for your claim to be true.

Actually, yeah. The variance in the amount of quantities present in the blood draws by Theranos is too high to get useful measurements (without very many replicates, defeating its purpose) according to published research: http://ajcp.oxfordjournals.org/content/144/6/885.abstract I was also utterly astonished when I read this. Even if the experimental error of the instrument was zero, you cannot reduce the biological…

Actually, that paper states that the standard deviation from finger pinpricks is about 5% of the mean value of, for example, platelets. The normal range has a standard deviation of about 25-50% of the mean https://www.nlm.nih.gov/medlineplus/ency/article/003647.htm. So, if anything, this study supports the conclusion that fingerprick tests have clinical utility.

Re: Theranos Is Subject of Criminal Probe by U.S

#119

Earlier quoted context omitted.

> For example, in the field of oncology there's very little money put into cheap accurate early screening. And an almost obsessive pour of money into trying to understand mid-to-late stage cancers. Even James Watson has criticized this. I'm in no way an expert, but isn't part of that related to increasing evidence that early detection of a tumor isn't necessarily a benefit? I recall reading many tumors stop or grow s…

You're definitely right that merely detecting tumors earlier doesn't always help, because many of them are relatively slow-growing and fairly harmless. But this actually makes a very specific kind of early detection research even more important: research to help us predict which early-stage tumors will progress to becoming deadly, and which ones won't. Currently we're pretty bad at making this prediction for many kin…

Got it - so really, it's not "earlier", full stop, it's "identify bad tumors vs. okay tumors early".

Thanks for the clarification.

Re: Theranos Is Subject of Criminal Probe by U.S

#120

I think the reason we (maybe secretly) take so much satisfaction / schadenfreude at this story is that someone who was so hyped and the darling of Silicon Valley got so much funding and attention. While others who toil away on good ideas, without nearly so many connections and silver spoons, struggle to even get 1 minute of air time with the kind of funders and backers that she got. That, plus seeing the cluelessness…

Agreed. Most tech investors are not savvy enough to make informed decisions when it comes to high-tech ventures. A lot of investors rely on other investors' opinions as a barometer for quality/value because they don't understand what they're doing.

When you have too many empty suits at the top making all the decisions, then you get into a situation of the blind leading the blind. It is shocking that it can happen at such a scale.

It's frustrating for intelligent, motivated founders who do the hard work to watch vaporware competitors getting billion dollar valuations and taking all the market share right in front of them.

Too many investors don't have a clue about what real innovation/value looks like because they've never actually seen it - Most of them probably got into their position through a combination of hard hustling and luck instead of through hard work and critical thinking.

Unfortunately, hustling doesn't advance science or human knowledge.

Post reply on HN