6 ms·

The lack of factual scrutiny for such potentially life-changing technology is a shame on both ends of this story. I mean there are 2 Theranos centers smack in

by aresant 11y ago

The lack of factual scrutiny for such potentially life-changing technology is a shame on both ends of this story. I mean there are 2 Theranos centers smack in the middle of SV (Palo Alto and Redwood City) - the WSJ's exposé centered largely on actually trying the tech and finding others with disparate results - where were the SV / SF / Oak proper journalists on either end of this story actually scrutinizing a $10b monster? "Watching the media build up and tear down Theranos feels the same with the sign bit flipped. Little data, and lots of hyperbole, both times." c/o Sam Altman's twitter and he's spot on. (1) https://twitter.com/sama/status/655492875073884160 https://twitter.com/sama/status/655492875073884160

annnnd 11y ago
I don't have much experience with FDA, but it looks like they are arguing with technicalities. They are not saying that product is not working, just that it isn't approved by them (for this purpose, if Theranos website is to be believed [0] - "The Nanotainer™ and our devices have already been cleared by FDA for use with our HSV-1 test"). It looks like this could be solved very quickly if all parties were interested. I am quite sure that Theranos has made some powerful enemies, many of whom probably have some influence within FDA... [0] https://www.theranos.com/news/posts/statement-from-theranos-2 https://www.theranos.com/news/posts/statement-from-theranos-...
- davak 11y ago
  I assuming hsv-1 was approved and successful because it's a pcr test requiring very little blood already. Most of the other tests require much more volume. It sounds like these tests were the ones that were supposed to be revolutionary but were not successful.
  - hga 11y ago
    Yeah, a PCR test can use a tiny sample, and and with a modicum of care it's not going to be subject to cross contamination in taking the sample (you do have to watch out for back-end contamination). But I can see how things like lipid panels would have contamination problems with finger-stick draws, although they say they use a combination of those and "venous blood draws using smaller needles and smaller tubes", which doesn't strike me as a big selling point. In my experience, pain is associated with not hitting the vein right the first time, and once you hit the vein, you might as well draw more than enough for the planned tests and any followup tests ordered once the first results come in.
    - jonknee 11y ago
      > although they say they use a combination of those and "venous blood draws using smaller needles and smaller tubes" That's new, they used to claim they could do it all from their Nanotainer sample. It was and still is a crock, but that's entirely what Theranos' claim to fame is.
      - hga 11y ago
        Yikes. And true per this cited on Wikipedia's intro page: http://www.wsj.com/news/articles/SB10001424127887324123004579055003869574012/ http://www.wsj.com/news/articles/SB1000142412788732412300457... Here's what they're saying right now on https://www.theranos.com/our-lab https://www.theranos.com/our-lab Our tests require less blood and less pain, regardless of whether we use our proprietary finger-stick technology or a venous draw. We do venous blood draws using smaller needles and smaller tubes. Now, I will say that when Quest does a venous draw they use a honking big tube ... well, the normal size since they stopped using syringes (you young whippersnappers are lucky, let me tell you!), and draw well more than a mL, but for the latter, who cares? Especially if that allows them to do followup tests without requiring another draw, as happened with me a couple of months ago. And for that matter, the larger the needle, the shorter the time is has to be in you to get a given sized sample.
omellet 11y ago
He's not a fan of two's complement, I guess.
patio11 11y ago
where were the SV / SF / Oak proper journalists on either end of this story actually scrutinizing a $10b monster? Most journalists are not capable of narrating how e.g. a Rails application works. They're equally not capable of walking an interlocutor through e.g. Phase N clinical trials. They rely on people who actually have domain expertise to tell them what the ground state of the world is like. One would hope that a good journalist goes around and checks those representations, but this is not always true. Every interaction I have ever had with a journalist attempting to use me as a source has decreased my confidence in the profession. I'm on like six organizations' internal lists as "Speaks English and can answer any Japan question." (My qualifications for this: I speak English, have a professional background which suggests bare minimum competence in a field which was once newsworthy regarding Japan, and then was in the NYT in that capacity. "Close enough!") They've asked me to provide my opinion of everything from e.g. Abe's economic policies to whether the man on the street thought that the Japanese women's soccer team was counteracting the national malaise after the Tokoku earthquakes. When I give them the honest answer, which is that I'm a small software entrepreneur who does not know anything useful about nation-level economics policies and is sufficiently politically apathetic that me knowing that Abe is prime minister actually means that I must be paying more attention than usual in 2015, that does not result in them stopping the interview or taking me off their list. Journalism is a high-prestige field which, to re-use Michael Creighton's observation, we understand is virtually never right about even the simplest consequential facts about things we actually understand, but we trust it to be accurate with regards to consequential facts about other fields, and this trust endures through every report that we have about journalists being catastrophically wrong. The alternative to trusting journalism is to believe that the New York Times and BuzzFeed hire the substantially same people to do substantially the same work for substantially the same reasons, and that the NYT is prestigious and BuzzFeed is not because the NYT has been BuzzFeeding for centuries. There is some threshold of evidence that causes us to accept the BuzzFeed hypothesis, right? Right? God help me, I know I sound crazy, but I think I'm there.
- PopeOfNope 11y ago
  Journalism is a high-prestige field which, to re-use Michael Creighton's observation, we understand is virtually never right about even the simplest consequential facts about things we actually understand, but we trust it to be accurate with regards to consequential facts about other fields, and this trust endures through every report that we have about journalists being catastrophically wrong. There is some threshold of evidence that causes us to accept the BuzzFeed hypothesis, right? Right? God help me, I know I sound crazy, but I think I'm there. Welcome to the ranks of conspiracy theorists. Anyone willing to admit difficult truths eventually winds up here. Is there a time in the history of journalism where journalists were ever right about even the simplest consequential facts? That would at least explain why they're still considered a high-prestige field. Anyway, I'd love to find out how such a worthless field earned and continues to maintain it's prestige.

by aresant 11y ago

annnnd 11y ago

I don't have much experience with FDA, but it looks like they are arguing with technicalities. They are not saying that product is not working, just that it isn't approved by them (for this purpose, if Theranos website is to be believed [0] - "The Nanotainer™ and our devices have already been cleared by FDA for use with our HSV-1 test"). It looks like this could be solved very quickly if all parties were interested. I am quite sure that Theranos has made some powerful enemies, many of whom probably have some influence within FDA... [0] https://www.theranos.com/news/posts/statement-from-theranos-2 https://www.theranos.com/news/posts/statement-from-theranos-...

davak 11y ago
I assuming hsv-1 was approved and successful because it's a pcr test requiring very little blood already. Most of the other tests require much more volume. It sounds like these tests were the ones that were supposed to be revolutionary but were not successful.
- hga 11y ago
  Yeah, a PCR test can use a tiny sample, and and with a modicum of care it's not going to be subject to cross contamination in taking the sample (you do have to watch out for back-end contamination). But I can see how things like lipid panels would have contamination problems with finger-stick draws, although they say they use a combination of those and "venous blood draws using smaller needles and smaller tubes", which doesn't strike me as a big selling point. In my experience, pain is associated with not hitting the vein right the first time, and once you hit the vein, you might as well draw more than enough for the planned tests and any followup tests ordered once the first results come in.
  - jonknee 11y ago
    > although they say they use a combination of those and "venous blood draws using smaller needles and smaller tubes" That's new, they used to claim they could do it all from their Nanotainer sample. It was and still is a crock, but that's entirely what Theranos' claim to fame is.
    - hga 11y ago
      Yikes. And true per this cited on Wikipedia's intro page: http://www.wsj.com/news/articles/SB10001424127887324123004579055003869574012/ http://www.wsj.com/news/articles/SB1000142412788732412300457... Here's what they're saying right now on https://www.theranos.com/our-lab https://www.theranos.com/our-lab Our tests require less blood and less pain, regardless of whether we use our proprietary finger-stick technology or a venous draw. We do venous blood draws using smaller needles and smaller tubes. Now, I will say that when Quest does a venous draw they use a honking big tube ... well, the normal size since they stopped using syringes (you young whippersnappers are lucky, let me tell you!), and draw well more than a mL, but for the latter, who cares? Especially if that allows them to do followup tests without requiring another draw, as happened with me a couple of months ago. And for that matter, the larger the needle, the shorter the time is has to be in you to get a given sized sample.

omellet 11y ago

He's not a fan of two's complement, I guess.

patio11 11y ago

where were the SV / SF / Oak proper journalists on either end of this story actually scrutinizing a $10b monster? Most journalists are not capable of narrating how e.g. a Rails application works. They're equally not capable of walking an interlocutor through e.g. Phase N clinical trials. They rely on people who actually have domain expertise to tell them what the ground state of the world is like. One would hope that a good journalist goes around and checks those representations, but this is not always true. Every interaction I have ever had with a journalist attempting to use me as a source has decreased my confidence in the profession. I'm on like six organizations' internal lists as "Speaks English and can answer any Japan question." (My qualifications for this: I speak English, have a professional background which suggests bare minimum competence in a field which was once newsworthy regarding Japan, and then was in the NYT in that capacity. "Close enough!") They've asked me to provide my opinion of everything from e.g. Abe's economic policies to whether the man on the street thought that the Japanese women's soccer team was counteracting the national malaise after the Tokoku earthquakes. When I give them the honest answer, which is that I'm a small software entrepreneur who does not know anything useful about nation-level economics policies and is sufficiently politically apathetic that me knowing that Abe is prime minister actually means that I must be paying more attention than usual in 2015, that does not result in them stopping the interview or taking me off their list. Journalism is a high-prestige field which, to re-use Michael Creighton's observation, we understand is virtually never right about even the simplest consequential facts about things we actually understand, but we trust it to be accurate with regards to consequential facts about other fields, and this trust endures through every report that we have about journalists being catastrophically wrong. The alternative to trusting journalism is to believe that the New York Times and BuzzFeed hire the substantially same people to do substantially the same work for substantially the same reasons, and that the NYT is prestigious and BuzzFeed is not because the NYT has been BuzzFeeding for centuries. There is some threshold of evidence that causes us to accept the BuzzFeed hypothesis, right? Right? God help me, I know I sound crazy, but I think I'm there.

PopeOfNope 11y ago
Journalism is a high-prestige field which, to re-use Michael Creighton's observation, we understand is virtually never right about even the simplest consequential facts about things we actually understand, but we trust it to be accurate with regards to consequential facts about other fields, and this trust endures through every report that we have about journalists being catastrophically wrong. There is some threshold of evidence that causes us to accept the BuzzFeed hypothesis, right? Right? God help me, I know I sound crazy, but I think I'm there. Welcome to the ranks of conspiracy theorists. Anyone willing to admit difficult truths eventually winds up here. Is there a time in the history of journalism where journalists were ever right about even the simplest consequential facts? That would at least explain why they're still considered a high-prestige field. Anyway, I'd love to find out how such a worthless field earned and continues to maintain it's prestige.