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This article points out the major issue in blood testing: it's not a panacea. So often, particularly outside the life-sciences press, the idea that we'll be abl

by entee 10y ago

This article points out the major issue in blood testing: it's not a panacea. So often, particularly outside the life-sciences press, the idea that we'll be able to test for everything and that it will be useful gets shouted from the rafters. The problem is, it's not that simple. Biological variation and lab procedure variation and just plain dumb bad luck makes it so that any lab test should only be considered a single datapoint. To be taken seriously, but not to be taken as "the answer" in and of itself. Technology can solve the lab procedure variation issue, but can't solve biological variation. Maybe it can alleviate the biological variation problem by making it feasible to test more frequently. However as you multiply the things you're measuring and multiply the frequency of testing you might end up testing too many hypotheses too frequently for your statistics to be reliable. I'd love to have more tests more frequently. I work in medical informatics after all. But We need to be cautious about what will come out of it and not over-promise. Much as we'd like it to be true, big squishy bags of water with bits of hardened calcium in them are not computers. Anything biological is hugely more noisy and far less deeply understood than anything we deal with in information technology.

JumpCrisscross 10y ago
Solution appears to revolve around getting more data. There are inherent limits in taking something out of the body to destructively test it. Remote imaging what can be imaged, and then relying on vessel-implanted data collectors may be the fruit the vision is in search of.
- entee 10y ago
  More data is more better. Imaging is nice, but it's really hard to do biochemical tests via imaging. It can be done but hasn't been much so far outside the lab. Implanted samplers are cool, but they get fouled up pretty easily and pose an infection risk, so there's still some progress to be made there.
MicroBerto 10y ago
I'm just starting to go down the blood testing route for myself and my startup (we're going to pay for before/after blood tests for certain supplement reviews), and I find it hugely fascinating. Others do too, and because of that, there's going to be continued growth. I am absolutely convinced that we'll someday get to where Theranos wants to go - possibly even better - but it's going to take more time and it's going to have to come far more slowly. Costs need to get down a lot more. You can't advertise and get funding for step 100 when we're still on step 3. This was their fatal sin. Either way, given the interest I'm seeing in our program, I know the future will push forward. We're clearly still on the very beginning part of the adoption curve with this one -- way earlier than Theranos led us to believe -- but someday I think we'll have the data we want, and in continuous fashion too. It's still all very reactive stuff though -- until we can read what our nervous system is communicating to the body, we're just playing an ugly, rudimentary form of catch-up. I don't see that really changing in my lifetime though.
- entee 10y ago
  I think you're right, it's someday possible, but it's quite early days. The danger of over-promising in medicine is that when you fall flat, in the best case you badly damage the pipeline of people trying to solve it, and in the worst case you injure people.
DanBC 10y ago
> The problem is, it's not that simple. Biological variation and lab procedure variation and just plain dumb bad luck makes it so that any lab test should only be considered a single datapoint. To be taken seriously, but not to be taken as "the answer" in and of itself. And even if the results are accurate it's often not useful. See the amount of over-diagnosis and over-treatment that results from too much testing.
- entee 10y ago
  Indeed, and never forget the false positive paradox: https://en.wikipedia.org/wiki/False_positive_paradox https://en.wikipedia.org/wiki/False_positive_paradox
- deleted 10y ago
  [deleted]

by entee 10y ago

JumpCrisscross 10y ago

Solution appears to revolve around getting more data. There are inherent limits in taking something out of the body to destructively test it. Remote imaging what can be imaged, and then relying on vessel-implanted data collectors may be the fruit the vision is in search of.

entee 10y ago
More data is more better. Imaging is nice, but it's really hard to do biochemical tests via imaging. It can be done but hasn't been much so far outside the lab. Implanted samplers are cool, but they get fouled up pretty easily and pose an infection risk, so there's still some progress to be made there.

MicroBerto 10y ago

I'm just starting to go down the blood testing route for myself and my startup (we're going to pay for before/after blood tests for certain supplement reviews), and I find it hugely fascinating. Others do too, and because of that, there's going to be continued growth. I am absolutely convinced that we'll someday get to where Theranos wants to go - possibly even better - but it's going to take more time and it's going to have to come far more slowly. Costs need to get down a lot more. You can't advertise and get funding for step 100 when we're still on step 3. This was their fatal sin. Either way, given the interest I'm seeing in our program, I know the future will push forward. We're clearly still on the very beginning part of the adoption curve with this one -- way earlier than Theranos led us to believe -- but someday I think we'll have the data we want, and in continuous fashion too. It's still all very reactive stuff though -- until we can read what our nervous system is communicating to the body, we're just playing an ugly, rudimentary form of catch-up. I don't see that really changing in my lifetime though.

entee 10y ago
I think you're right, it's someday possible, but it's quite early days. The danger of over-promising in medicine is that when you fall flat, in the best case you badly damage the pipeline of people trying to solve it, and in the worst case you injure people.

DanBC 10y ago

> The problem is, it's not that simple. Biological variation and lab procedure variation and just plain dumb bad luck makes it so that any lab test should only be considered a single datapoint. To be taken seriously, but not to be taken as "the answer" in and of itself. And even if the results are accurate it's often not useful. See the amount of over-diagnosis and over-treatment that results from too much testing.

entee 10y ago
Indeed, and never forget the false positive paradox: https://en.wikipedia.org/wiki/False_positive_paradox https://en.wikipedia.org/wiki/False_positive_paradox
deleted 10y ago
[deleted]