5 ms·

If this study is correct, and blood drops have a high variability in certain important clinical features, then, no matter how accurate the instruments are, it's

by Fede_V 11y ago

If this study is correct, and blood drops have a high variability in certain important clinical features, then, no matter how accurate the instruments are, it's impossible to actually get a clean measurement from low volumes of blood. This is one of the most obvious tests that should come to mind for anyone who wishes to create a blood diagnostic company. How could Theranos not know about this?

JonFish85 11y ago
I'm sure they do/did, and hope(d) that they could work around it in some way. Unfortunately for them, it sounds like they're going to have to pay the piper before they wanted to.
- Fede_V 11y ago
  The best they can do is measure the sample with zero measurement noise - but that's no panacea if the variation is in the sample itself, and not the measurement.
Plough_Jogger 11y ago
Additionally important is the fact that the minimum required volume varies based on the feature that is being measured. This seems incongruent with Theranos' focus on a few standardized sample containers.
- IanCal 11y ago
  That depends on the sizes. The article says > Only when the authors tested upwards of five drops combined (60 to 100 microliters) were they able to get accurate results. That still sounds pretty low volume to me. I can't read the actual article, so I can't comment in much more detail (also, I'm not a biologist).
danieltillett 11y ago
More importantly how did their sophisticated investors not know this? This issue has been known in the industry for years. The whole Theranos fiasco would not matter except for the damage it does to other biotech startups - when sentiment turns it does not matter if what you are doing is real or not, everyone is frozen out.
- robbiep 11y ago
  Hype always beats science and reality, at least in the short term
- JonFish85 11y ago
  If you look through their BoD, there's not a lot of biomed representatives as I recall...
  - danieltillett 11y ago
    That must be the understatement of the year. The board looks like the board you would put together if you were planning a coup of some central american country.
- FireBeyond 11y ago
  I highly doubt their sophisticated investors are any more clued in than their board / executive management, which included prominent military figures, industrial complex powerbrokers, politicos, but zero or nearly zero medical expertise.
  - danieltillett 11y ago
    I need to be a little less subtle with my snark I think. If there ever was a company you could have avoid investing in by looking at their board it is Theranos [1]. 1. https://www.theranos.com/leadership https://www.theranos.com/leadership
    - deleted 11y ago
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    - deleted 11y ago
      [deleted]
    - mkehrt 11y ago
      Kissinger?!
Jerry2 11y ago
>How could Theranos not know about this? They probably did know but willfully ignored it because the monetary upside was great.
such_a_casual 11y ago
The study states that they got accurate measurements once they started taking 5 drops of blood which is less than 0.1 ml. A blood sample could vary from 3-10 ml according to the first thing I found on google. So it seems like all they have to do is take a few more drops to be accurate (which will still be an order of magnitude from the volume of traditional blood tests). first thing on google: https://ethnomed.org/patient-education/blood/how-much-blood-is-taken-spanish-english https://ethnomed.org/patient-education/blood/how-much-blood-...
- danieltillett 11y ago
  To get 100 µl out you need more than a finger prick. Once you go this way you might as well cannulate. There might be some special cases where you can get 100 µl but not 3 mL, but this market is not going to support the weight of a unicorn.
  - such_a_casual 11y ago
    Are you claiming that 5 drops of blood cannot be obtained via finger prick?
    - thescriptkiddie 11y ago
      If he is, he's generally right. You get 1.5, maybe 3 drops out before it seals back up. Finger lancets are very tiny needles, even smaller than those used for insulin injections.
      - replicatorblog 11y ago
        I worked in diabetes where finger stick tests are the lingua franca. 3 microliter sample sizes were common about 10 years ago for home use systems using relatively fine lancets. Using something just a bit larger would pretty easily get you 5 drops of blood.
    - danieltillett 11y ago
      Not out of one - well not easily or consistently.
jacquesm 11y ago
It's not so much the volume that is the problem from what I understand it is the way in which it is drawn. So if that same volume were drawn from a vein then the variability would be substantially less. > How could Theranos not know about this? Who says they did not know about this? Maybe they did but it did not agree with their plans, maybe they thought they could overcome it.

by Fede_V 11y ago

JonFish85 11y ago

I'm sure they do/did, and hope(d) that they could work around it in some way. Unfortunately for them, it sounds like they're going to have to pay the piper before they wanted to.

Fede_V 11y ago
The best they can do is measure the sample with zero measurement noise - but that's no panacea if the variation is in the sample itself, and not the measurement.

Plough_Jogger 11y ago

Additionally important is the fact that the minimum required volume varies based on the feature that is being measured. This seems incongruent with Theranos' focus on a few standardized sample containers.

IanCal 11y ago
That depends on the sizes. The article says > Only when the authors tested upwards of five drops combined (60 to 100 microliters) were they able to get accurate results. That still sounds pretty low volume to me. I can't read the actual article, so I can't comment in much more detail (also, I'm not a biologist).

danieltillett 11y ago

More importantly how did their sophisticated investors not know this? This issue has been known in the industry for years. The whole Theranos fiasco would not matter except for the damage it does to other biotech startups - when sentiment turns it does not matter if what you are doing is real or not, everyone is frozen out.

robbiep 11y ago
Hype always beats science and reality, at least in the short term
JonFish85 11y ago
If you look through their BoD, there's not a lot of biomed representatives as I recall...
- danieltillett 11y ago
  That must be the understatement of the year. The board looks like the board you would put together if you were planning a coup of some central american country.
FireBeyond 11y ago
I highly doubt their sophisticated investors are any more clued in than their board / executive management, which included prominent military figures, industrial complex powerbrokers, politicos, but zero or nearly zero medical expertise.
- danieltillett 11y ago
  I need to be a little less subtle with my snark I think. If there ever was a company you could have avoid investing in by looking at their board it is Theranos [1]. 1. https://www.theranos.com/leadership https://www.theranos.com/leadership
  - deleted 11y ago
    [deleted]
  - deleted 11y ago
    [deleted]
  - mkehrt 11y ago
    Kissinger?!

Jerry2 11y ago

>How could Theranos not know about this? They probably did know but willfully ignored it because the monetary upside was great.

such_a_casual 11y ago

The study states that they got accurate measurements once they started taking 5 drops of blood which is less than 0.1 ml. A blood sample could vary from 3-10 ml according to the first thing I found on google. So it seems like all they have to do is take a few more drops to be accurate (which will still be an order of magnitude from the volume of traditional blood tests). first thing on google: https://ethnomed.org/patient-education/blood/how-much-blood-is-taken-spanish-english https://ethnomed.org/patient-education/blood/how-much-blood-...

danieltillett 11y ago
To get 100 µl out you need more than a finger prick. Once you go this way you might as well cannulate. There might be some special cases where you can get 100 µl but not 3 mL, but this market is not going to support the weight of a unicorn.
- such_a_casual 11y ago
  Are you claiming that 5 drops of blood cannot be obtained via finger prick?
  - thescriptkiddie 11y ago
    If he is, he's generally right. You get 1.5, maybe 3 drops out before it seals back up. Finger lancets are very tiny needles, even smaller than those used for insulin injections.
    - replicatorblog 11y ago
      I worked in diabetes where finger stick tests are the lingua franca. 3 microliter sample sizes were common about 10 years ago for home use systems using relatively fine lancets. Using something just a bit larger would pretty easily get you 5 drops of blood.
  - danieltillett 11y ago
    Not out of one - well not easily or consistently.

jacquesm 11y ago

It's not so much the volume that is the problem from what I understand it is the way in which it is drawn. So if that same volume were drawn from a vein then the variability would be substantially less. > How could Theranos not know about this? Who says they did not know about this? Maybe they did but it did not agree with their plans, maybe they thought they could overcome it.