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Some important points from that article: > Current and former Safeway executives said Theranos missed deadlines for the blood-testing rollout. They also said s

by colmvp 11y ago

Some important points from that article: > Current and former Safeway executives said Theranos missed deadlines for the blood-testing rollout. They also said several Safeway executives questioned the accuracy of results Theranos gave to Safeway employees tested at a clinic in the supermarket chain’s headquarters in Pleasanton, Calif. > Theranos often drew the same employee’s blood twice, first with blood from a finger prick and then the traditional method of a needle in the arm, according to one former Safeway executive. > The former executive said he worried that Theranos’s finger-prick process was still a work in progress. “If the technology is fully developed, why would you need to do a venipuncture?” this person said, using the term for a traditional blood draw. > The concerns deepened when Theranos’s test results for several Safeway employees differed from the results the same employees got from other laboratories, according to the former executive. Another former Safeway executive confirmed those recollections. > One Safeway executive got a frighteningly high result from Theranos on a test to gauge his prostate-specific antigen, according to two former Safeway executives. They said the test suggested that the executive had prostate cancer. Retesting by another lab came back normal.

danso 11y ago
One of the most irritating things about Theranos's defenders is their argument about how Theranos should be given lesser scrutiny because of how important and noble its mission is...that's the exact opposite of how it should be, IMO. Using Facebook as the archetypical unjustifiably-rich-startup (not my opinion, just well-repeated), in which the goal is to lower friction between friend-network-contacts...even if FB's news feed algorithm was corrupt, users have multiple ways of assessing the quality of their experience -- including out-of-band assessments (um, hanging out with friends IRL) and being able to defriend/filter lists... The whole point of Theranos is to reduce the friction in personal health assessment...which is a great idea regardless of noble motives...but lowering friction essentially means being able to more frequently collect and analyze data about yourself. If the assessment process is bad, then using more of the product is fundamentally terrible for the person. But the bigger problem is that it isn't easy to compare health tests...if getting an old-fashioned blood draw test was trivial, then Theranos would have no purpose in the first place. So with Theranos, the easily imaginable bad-case scenario is literally that people die because of false positives and negatives, no matter the kind motives and ambitions of Holmes. But I have to admit...at least Theranos believes in their own product? Because if it were just snake oil, they probably would've worked out a way to not use their flawed procedures for the Safeway executives, who have much interest and motive (and money) to do comparative quality testing. (unless of course the Safeway execs conducted their own blind tests...which is obviously what they should do but obviously, not all big money executives have been that skeptical of Theranos)
- Pyxl101 11y ago
  > But the bigger problem is that it isn't easy to compare health tests... It ought to be relatively easy. I mean, not easy for the average Joe, but easy for anyone seriously interested in doing it. Draw blood twice: once with the finger prick, and once with a regular vein draw, and then test the two samples using the different methodologies. Compare the results. Seems like a fairly trivial experiment to run and reproduce.
  - danso 11y ago
    By "compare health tests", I'm including the process of going to the clinic, waiting for the appointment, getting blood drawn via the vein, etc. etc. Apparently that's enough of a wait time and process to discourage a non-significant number of people from even getting prescribed tests. For those of us who don't have a problem with needles and can make time for the office, easier testing may open new avenues of inquiry and awareness for our health, if testing is as easy as a needle prick. (yes, I'm leaving out the major issue of over-diagnosis...but that's an issue all kinds of testing and medical practice has to deal with)
  - PopeOfNope 11y ago
    > It ought to be relatively easy. ... Seems like a fairly trivial experiment to run and reproduce. That depends on what you're testing. "Blood test" and "health test" are ridiculously ambiguous terms. Something like red blood cell counts don't vary much from day to day, but some things, like blood sugar and cortisol, vary hour to hour.
- firebones 11y ago
  Never underestimate the collective self-delusion that can emerge in a situation like this. You have a wunderkind founder, the resident genius, who is telling everyone to believe and robotically dismissing critics--who is going to question her? You have insiders and investors who want to believe--keep your mouth shut! You have ex-employees who expressed doubt vilified. Mass willful suspension of disbelief seems much more likely. To do something like secretly changing the procedure for the Safeway execs would require someone to openly address the elephant in the room in a culture where the elephant isn't to be discussed. When are the insider stories about the culture going to start emerging?
sghodas 11y ago
The positive predictive value for the prostate-specific antigen test for prostate cancer is only 30%. This means that only 30% of people who test positive for elevated levels of prostate-specific antigen actually have prostate cancer. This is an intrinsic problem with testing for prostate-specific antigen not with Theranos' testing.
- sk5t 11y ago
  This would suggest that one cannot draw a definite conclusion from the test result. Not that the test result itself should fluctuate wildly.
- danieltillett 11y ago
  The issue is not how accurate the PSA test is for detecting prostate cancer, but that Theranos’ tests give wildly different results to everyone else’s FDA approved tests.
- srunni 11y ago
  A great book was published on this topic 2 months ago, called Risky Medicine: http://www.amazon.com/Risky-Medicine-Quest-Cure-Uncertainty-ebook/dp/B013LO4EL2 http://www.amazon.com/Risky-Medicine-Quest-Cure-Uncertainty-... Podcast interview of the author, released yesterday: http://www.econtalk.org/archives/2015/11/robert_aronowit.html http://www.econtalk.org/archives/2015/11/robert_aronowit.htm...

by colmvp 11y ago

danso 11y ago

One of the most irritating things about Theranos's defenders is their argument about how Theranos should be given lesser scrutiny because of how important and noble its mission is...that's the exact opposite of how it should be, IMO. Using Facebook as the archetypical unjustifiably-rich-startup (not my opinion, just well-repeated), in which the goal is to lower friction between friend-network-contacts...even if FB's news feed algorithm was corrupt, users have multiple ways of assessing the quality of their experience -- including out-of-band assessments (um, hanging out with friends IRL) and being able to defriend/filter lists... The whole point of Theranos is to reduce the friction in personal health assessment...which is a great idea regardless of noble motives...but lowering friction essentially means being able to more frequently collect and analyze data about yourself. If the assessment process is bad, then using more of the product is fundamentally terrible for the person. But the bigger problem is that it isn't easy to compare health tests...if getting an old-fashioned blood draw test was trivial, then Theranos would have no purpose in the first place. So with Theranos, the easily imaginable bad-case scenario is literally that people die because of false positives and negatives, no matter the kind motives and ambitions of Holmes. But I have to admit...at least Theranos believes in their own product? Because if it were just snake oil, they probably would've worked out a way to not use their flawed procedures for the Safeway executives, who have much interest and motive (and money) to do comparative quality testing. (unless of course the Safeway execs conducted their own blind tests...which is obviously what they should do but obviously, not all big money executives have been that skeptical of Theranos)

Pyxl101 11y ago
> But the bigger problem is that it isn't easy to compare health tests... It ought to be relatively easy. I mean, not easy for the average Joe, but easy for anyone seriously interested in doing it. Draw blood twice: once with the finger prick, and once with a regular vein draw, and then test the two samples using the different methodologies. Compare the results. Seems like a fairly trivial experiment to run and reproduce.
- danso 11y ago
  By "compare health tests", I'm including the process of going to the clinic, waiting for the appointment, getting blood drawn via the vein, etc. etc. Apparently that's enough of a wait time and process to discourage a non-significant number of people from even getting prescribed tests. For those of us who don't have a problem with needles and can make time for the office, easier testing may open new avenues of inquiry and awareness for our health, if testing is as easy as a needle prick. (yes, I'm leaving out the major issue of over-diagnosis...but that's an issue all kinds of testing and medical practice has to deal with)
- PopeOfNope 11y ago
  > It ought to be relatively easy. ... Seems like a fairly trivial experiment to run and reproduce. That depends on what you're testing. "Blood test" and "health test" are ridiculously ambiguous terms. Something like red blood cell counts don't vary much from day to day, but some things, like blood sugar and cortisol, vary hour to hour.
firebones 11y ago
Never underestimate the collective self-delusion that can emerge in a situation like this. You have a wunderkind founder, the resident genius, who is telling everyone to believe and robotically dismissing critics--who is going to question her? You have insiders and investors who want to believe--keep your mouth shut! You have ex-employees who expressed doubt vilified. Mass willful suspension of disbelief seems much more likely. To do something like secretly changing the procedure for the Safeway execs would require someone to openly address the elephant in the room in a culture where the elephant isn't to be discussed. When are the insider stories about the culture going to start emerging?

sghodas 11y ago

The positive predictive value for the prostate-specific antigen test for prostate cancer is only 30%. This means that only 30% of people who test positive for elevated levels of prostate-specific antigen actually have prostate cancer. This is an intrinsic problem with testing for prostate-specific antigen not with Theranos' testing.

sk5t 11y ago
This would suggest that one cannot draw a definite conclusion from the test result. Not that the test result itself should fluctuate wildly.
danieltillett 11y ago
The issue is not how accurate the PSA test is for detecting prostate cancer, but that Theranos’ tests give wildly different results to everyone else’s FDA approved tests.
srunni 11y ago
A great book was published on this topic 2 months ago, called Risky Medicine: http://www.amazon.com/Risky-Medicine-Quest-Cure-Uncertainty-ebook/dp/B013LO4EL2 http://www.amazon.com/Risky-Medicine-Quest-Cure-Uncertainty-... Podcast interview of the author, released yesterday: http://www.econtalk.org/archives/2015/11/robert_aronowit.html http://www.econtalk.org/archives/2015/11/robert_aronowit.htm...