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At Theranos, Many Strategies and Snags

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Re: At Theranos, Many Strategies and Snags

#71

Post by enraged_camel »

learc83 wrote: post #44
brandon272 wrote: post #22

Earlier quoted context omitted.

Couldn't this be alleviated with a finger prick method that prevents the droplet from sitting on the surface of the skin before it is collected? (i.e. a tiny needle that reaches below the epidermis to extract a drop of blood)

The needle breaks the skin and moves through any contaminants that were on the skin's surface--potentially mixing the contaminants with the sample regardless of whether the blood sits on the surface of the skin or not.

Isn't it common practice to wipe the skin with a disenfectant to prevent this very thing? A 60-70% alcohol-based solution will kill the vast majority of germs on the skin.

Re: At Theranos, Many Strategies and Snags

#72

Post by XorNot »

jjoonathan wrote: post #52
Zigurd wrote: post #28

Earlier quoted context omitted.

Well that's all very moral, but what Theranos is doing is mostly engineering. So while "hype the fuck out of it, raise big money, and fake it 'till you make it" might feel all icky, it's not a unique plan. Will we be saying the same things about Palantir? Maybe, maybe not. There's not that much difference between Palantir and Theranos. What has Palantir got that others don't? Answer: The ability to raise money at inc…

That's what I thought at first, but $400M and 12 years should have been enough to put together a pretty solid uTAS seeing as microfluidic integration wasn't exactly bleeding edge back then either. But they seem to have drunk their own kool-aid and created a working environment so toxic that they sabotaged their own chances to fake it till they made it. They might still get there, but even if they do there's a lesson…

Anyone working in microfluidics would've been skeptical at the time and is probably not surprised now. Microfluidics is amazingly hard to make work properly, and the history of the field is littered with great ideas which proved to be much harder to execute reliably.

Re: At Theranos, Many Strategies and Snags

#73

Post by ekianjo »

epistasis wrote: post #69
ekianjo wrote: post #49

Interesting, Theranos' funder's behavior is what you would expect from someone who knows nothing about Science: - make bold claims - avoid going into details ("trade secrets", sheesh) - make investors believe in your "vision" - give talks about successful entrepreneurship to polish one's image And still nothing reliably demonstrated. What amazes me the most is how clueless investors are. If they don't care about Scie…

> What's next, a new take on homeopathy ? Not too far off, actually: http://blogs.sciencemag.org/pipeline/archives/2015/12/04/and...

Hehe, I really like Derek's sense of humor:

> A few billion years of blind evolutionary tinkering gives you a mass of insane, irrational, tangled interwoven systems with no documentation in sight. Crazy new things keep getting uncovered all the time (siRNA! Who knew!), and the number and scope of the crucial things we have no clue about is just another one of the things that we have no clue about. If your worldview has been formed by using human tools to make human-designed applications for humans, you are in for quite a shock.

Re: At Theranos, Many Strategies and Snags

#74

Post by firasd »

onewaystreet wrote: post #11
rdlecler1 wrote: post #5

The key questions that needs to be addressed, is how homogenous or heterogenous are blood markers at the level they want to measure at? The machines may be reporting results accurately, but a pin-prick-sized droplet may simply not be a large enough sample size for the tests they want to run.

>prick-sized droplet may simply not be a large enough sample size for the tests they want to run This was always the main criticism of Theranos. Finger-stick blood tests have never been considered reliable for clinical diagnostic tests because you don't get enough blood and the blood you do get can be contaminated.

I wonder if you could apply some substance on the skin or needle so that after the prick it doesn't heal up instantly? Keeps the blood flowing for a few seconds.

Re: At Theranos, Many Strategies and Snags

#75

Post by beagle3 »

ThomPete wrote: post #7

No matter how this story ends (whether they eventually ends up with having a fully functioning product or not) this should be a cautionary tale to anyone wanting to actually change the world in healthcare. Science speaks for itself and does not care how much you raised at what valuation. It requires a rigorous approach to testings and facts and data or it will be merciless if you aren't living up to your own claims.…

It is a common, romantic view of how science works - but it is only compatible with reality on a 30-50 year timescale, and probably only because of survivor bias.

The science of Dan Shchetman, J. Robin Warren, Barbara McClintock and many others spoke for itself, and for a long time "science" essentially didn't listen. I put "science" in quotes because "science" doesn't speak or listen - scientists do - and the scientists shunned those luminaries (eventually to recognize them with one of the highest honours - the Nobel Prize).

Warren had to use himself as a test subject for others to notice. Shechtman was a cast out for years (and then it turned out that he wasn't the first to notice 5-fold symmetry - he was just the only one for a long time to insist it's real; the other "scientists" who noticed it cared too much about their status, rather than the science). McClintock was shunned by her peers and essentially lost her job -- though evidence for how badly she was treated by "science" for her radical ideas (now mainstream and assumed true) is being whitewashed.

I keep wondering how much progress we have lost because "scientists" (unlike "science") does care how much you've raised, how much you've published, and who your friends are.

> anyone wanting to actually change the world in healthcare ... Science speaks for itself

The belief that modern healthcare is nothing but the application of science is also romantic and misguided. In the US, healthcare is a business and not even a free-market one. It is informed by science, most definitely. But e.g. no doctor will recommend the single most effective treatment for type 2 diabetes early in the disease[0] (calorie restriction whether directly, by direct fasting or intermittent fasting). In fact, it turns out that the American Diabetic Association recommendations are the everything but science, and possibly the worst you could do.

[0] - http://www.theguardian.com/lifeandstyle/2013/may/12/type-2-d..., see http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm for references

Re: At Theranos, Many Strategies and Snags

#76

Post by learc83 »

enraged_camel wrote: post #71
learc83 wrote: post #44

Earlier quoted context omitted.

The needle breaks the skin and moves through any contaminants that were on the skin's surface--potentially mixing the contaminants with the sample regardless of whether the blood sits on the surface of the skin or not.

Isn't it common practice to wipe the skin with a disenfectant to prevent this very thing? A 60-70% alcohol-based solution will kill the vast majority of germs on the skin.

Contaminants don't have to be alive to confuse results. Also many contaminants we're talking about were never alive in the first place.

Re: At Theranos, Many Strategies and Snags

#78

Post by randycupertino »

GabrielF00 wrote: post #36

Does the composition of Theranos' board strike anyone else as very weird? It seems much more like the board of a foreign policy think thank than a biotech start up. There are three former cabinet secretaries (state and defense), two former very senior military officers, two former senators (one regarded as a foreign policy expert), a bigshot DC lawyer, and the former CEOs of Bechtel and Wells Fargo. The only physicia…

I think they wanted a bunch of Washington power players because their real money grab was pushing regulation changes so that patients could go and do their blood tests themselves, without a doctor's order. Surprisingly, they were actually successful in getting this passed in 1 state already- Arizona. If they were able to push that through it would be a HUGE gamechanging cash cow, because people could either self pay or even try to get Medicare to pay for it if they wanted to run their own bloodwork without seeing a PCP and getting an order.

Physicians groups, insurance companies and biomedical ethics groups aren't really hip to this idea because patient self-testing bloodwork may open pandoras box to a lot of unnecessary expenses, especially if the patient is trying to bill this through their insurance. False positives can and do happen, and they lead to unwarranted appointments, specialist visits, exploratory surgeries, etc. Other reasons physician groups are opposed to it is because they view it as profiting off people who are hypochondriacs, and a huge amount of the customers would probably be drug abusers and steroid users. Most likely, people who would go and do their own blood work are the system's "super ultilizers" and they are the ones who are already costing the insurance companies and the states $3-4 million per patient per year in healthcare expenses. It's not uncommon to have a fibro/rheumatoid arthritis/hypochondriac patient who bills $10 million per year. If these people go to the ER and cost 3k per visit every time they can't fall asleep and have anxiety (~12x per month), imagine how often they might want to go and run their own bloodwork.

Not being able to order our own labs as patients is the reason there are moral objections to for-profit hospitals selling "full body scans" and dermatologists doing unwarranted full body mole checks. Generally the proper guidelines is to only administer testing when you suspect that something is wrong.

Re: At Theranos, Many Strategies and Snags

#79

Post by danso »

Cyberdog wrote: post #41
blakeross wrote: post #37

I wrote a parody of Theranos as a TV pilot that is increasingly becoming true: http://www.pricks.com/ (I'm sharing this here because the Hacker News community seemed to enjoy my Season 3 premiere of Silicon Valley [ https://news.ycombinator.com/item?id=10179894 ], but apologies if others feel it detracts from the discussion.)

Well, if nothing else, congrats on acquiring that domain name.

It definitely wins my award for Most Esoteric, Timely Use of a Six-Letter .com Domain Name that Can Be Found in an English Dictionary.

Re: At Theranos, Many Strategies and Snags

#80

Post by bookbok »

GabrielF00 wrote: post #48
hackaflocka wrote: post #43

Earlier quoted context omitted.

I suspect that Holmes is the "front" for someone connected to her father (who is a "civil servant" -- dunno why the article isn't more specific). Probably someone connected to military, government, etc.

Her father has a high-level job at USAID. https://www.usaid.gov/who-we-are/organization/christian-holm...

> Holmes worked in the field with USAID missions in Pakistan, Bangladesh, Indonesia, Egypt, Yemen, Ghana, Haiti, Liberia, Kenya, and Ethiopia

> Holmes served in the U.S. Army, Second Lieutenant, Civil Affairs, receiving the U.S. Army Soldier’s Medal for Heroism.

Want to guess who he really works for?

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