4 ms·

Aside from whether their technology actually works or not, the central premise that cheaper, easier and more frequent testing will improve outcomes is unproven.

by Gatsky 11y ago

Aside from whether their technology actually works or not, the central premise that cheaper, easier and more frequent testing will improve outcomes is unproven. There are many potential downsides. It might increase health spending through extra doctor visits, the need for repeat testing and more invasive and expensive investigations. But will it actually make anyone's life better? Bear in mind that even a single, obvious test performed in a high risk population to screen for say breast cancer or ovarian cancer, either barely moves the needle in saving lives or ends up being useless. What effect does Theranos think indiscriminate widespread testing will have? With all these competing risks, this frequent testing strategy needs to be evaluated in randomised double blind clinical trials. Before that though, Theranos needs to submit their tests for independent validation in many thousands of patients, and publish the results. I note this single study which compared Theranos' CRP to a conventional method [1]. The Pearson correlation was 0.85, which I don't think is really good enough. [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091290/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091290/

OopsCriticality 11y ago
> Aside from whether their technology actually works or not, the central premise that cheaper, easier and more frequent testing will improve outcomes is unproven. There are many potential downsides. This is an excellent point. Nevertheless, it's very hard to convince patients, and the public, that more tests do not lead to better outcomes. Think on every time there are revisions to the recommended screening criteria for breast or prostate cancer---it's good evidence-based medicine, but there's an outcry from the public every time. In addition to your considerations of more testing being invasive and expensive, I'd also add that overtesting can lead to interventions that present a non-minimal risk to the patient and ultimately increase M&M.
gcanyon 11y ago
On the other hand you have things like blood glucose testing, which mid-twentieth century happened only in a doctor's office, when today diabetics do it several times daily. Obviously not all tests are going to be like that, and I haven't looked at the list of tests Theranos is performing, so all, some, or none of their tests might be similar.

by Gatsky 11y ago

OopsCriticality 11y ago

> Aside from whether their technology actually works or not, the central premise that cheaper, easier and more frequent testing will improve outcomes is unproven. There are many potential downsides. This is an excellent point. Nevertheless, it's very hard to convince patients, and the public, that more tests do not lead to better outcomes. Think on every time there are revisions to the recommended screening criteria for breast or prostate cancer---it's good evidence-based medicine, but there's an outcry from the public every time. In addition to your considerations of more testing being invasive and expensive, I'd also add that overtesting can lead to interventions that present a non-minimal risk to the patient and ultimately increase M&M.

gcanyon 11y ago

On the other hand you have things like blood glucose testing, which mid-twentieth century happened only in a doctor's office, when today diabetics do it several times daily. Obviously not all tests are going to be like that, and I haven't looked at the list of tests Theranos is performing, so all, some, or none of their tests might be similar.