This business, didn't pass a basic litmus test of objective criticism from people who work in the space.
There seems to be this bravado among founders who believe they're sticking it to all the people who say something's amiss. I think if there's an elephant in the room though, it probably should be assassinated with a huge body of transparent evidence.
1) There's disruption that's seen as impractical or insanely difficult (e.g. Tesla, SpaceX). Or technically feasible but with significant social or legal obstables (e.g. AirBnB, Uber).
2) Then there's another category, disruption that defies laws of physics. Kickstarter is replete with examples. This includes things like pocket-size underwater rebreaters, self-filling water bottles, and solar-powered motorcycles.
I'm no expert in the subject matter but Theranos tech seems to be in the latter.
> The blood you get from a prick will be a mixture of blood from small venules, small arterioles, capillaries and lymph vessels, mixed with whatever loose tissue and cells have been cut by the prick and carried over into the blood. No way you could ever get a reliable CBC from such a sample. Since the kind of general blood tests that this company is targeting are usually CBC + chem panel, even if you could get your chem results from the prick, you still need a normal blood draw for the CBC, so the competitive advantage that they are trying to push (quick sampling by patient at pharmacy, without need for phlebotomist) is lost. On top of that, the variability inherent in chem results from prick blood will be significant for several analytes, like CK and AST (present in muscle so could be raised from prick injury), glucose and lipids (different levels in venous or arterial blood or lymph), etc…
In short, while it might be possible to reliably use only µL of blood for tests, using µL of blood for dozens of tests seems questionable, and the chosen blood source is likely to be mostly worthless.
That the uncertainty produced by the source chosen exceeds the acceptable variability in the results is an impossibility proof for a testing method relying exclusively on a single sample from that source having acceptable accuracy, since the accuracy of the test result cannot exceed the accuracy of the source used in representing the underlying measure.
For comparison, there is tremendous variation in the sound waves that humans recognize as the word "apple", but there are still systems that can filter out the relevant noise and identify the critical dimensions of variation.
Simply saying that the source is messy is not a proof that it's impossible to work around that.
This is a fundamental problem. You might luck into roughly correct results most of the time, but the basic nature of statistics is against you.
My point is only that there is no hard theory decrying this to be impossible in the same way that, say, computer scientists can prove that a problem is NP-complete.
Extreme to the point of being nonsensical in its impracticality (cost of installation, cost of replacement, current PV efficiencies, etc), but not fundamentally impossible.
Tesla built a very expensive sports-car, before they advanced towards cheaper products for the masses.
Disclaimer: I don't know much about how SpaceX or NASA's finances work. But I assumed that, due to their tighter coupling with a government, NASA has less leeway in their decisions of which technologies to research compared to SpaceX.
There are videos of the Autopilot feature attempting to swerve into oncoming traffic. It does have the potential to kill people, it likely will in wide usage just by raw statistics, and it's likely to eventually fall under regulation of some sort. That doesn't mean it's necessarily a bad feature, but pushing self-driving car functionality as a "beta" to the public is, by at least some definitions and to some extent, "Elon Musk playing with people's lives".
This is not born out by the currently available facts.
Tesla quoted deaths-per-autopilot-mile versus overall deaths-per-mile for all cars on the road. This is very misleading information, for a number of reasons.
1. Teslas are high-end luxury cars and thus have better safety features than the lower end of the market.
2. Teslas are likely to be newer and better maintained than the average car on the road. The average age of a car on the road is 11.4 years (https://www.google.com/search?q=average+age+of+cars+on+the+r...) - there are ZERO Tesla cars that old.
3. Autopilot is disabled on residential streets and those with no center divider (http://www.newsmax.com/TheWire/tesla-autopilot-videos-restri...), which means it's driving in more predictable situations than average. You're also unlikely to have it on when there are things like icy/snowy conditions.
4. Autopilot will hand over control when it can't handle something. If it does this suddenly, the subsequent crash may not count in Musk's "autopilot miles" statistic.
Most drivers will take over and disengage Autopilot in doing so, so your point remains, but I wanted to make it clear that the car isn't just doing a "Jesus^H^H^H^H^HDriver take the wheel!" thing.
Is it when the alarm sounds? When it begins to slow? When it turns on the hazards? When it has come to a complete stop? How would being rear-rended during this process be counted?
3 this is valid point, but it's significance is diminishing as autopilot is accumulating death-free miles. also does tesla not deal with icy/snowy conditions in Norway?
4 is pure speculation.
#1 and #2 are not at all irrelevant. This sort of technology will make its way into lower-end cars in time. Having actual data on how safe it is, with other variables accounted for, is going to be extremely critical.
It's like claiming racecar driving is really safe because not many people die doing it. That's not actually because it's safe - it's because the drivers are very well trained, with very good safety equipment so they survive crashes.
Teslas are safer than average cars. The autopilot may not be.
> 3 this is valid point, but it's significance is diminishing as autopilot is accumulating death-free miles.
It is certain statistically to have more fatal accidents as it accrues more miles. The underlying issue - that "autopilot miles" are safer miles than "all miles" - will remain. Its accident tallies need to be compared statistically with miles with human drivers in similar road conditions. This will likely require a research study.
> also does tesla not deal with icy/snowy conditions in Norway?
I couldn't say for certain, but it apparently will shut down in moderate rain (http://www.teslarati.com/tesla-autopilot-limitations-heavy-r...) so I'd guess snow would have similar impact on its visibility and functionality.
> 4 is pure speculation.
#4 is an important question.
http://www.iihs.org/iihs/ratings/TSP-List
Per http://www.torquenews.com/1083/why-tesla-s-2014-model-s-cann... - has some interesting comments, too.
Even then, he almost failed.
http://www.businessinsider.com/how-elon-musk-learned-rocket-...
In an engineering culture, there's solid respect for reality.
In a political culture there's respect for caste, status, and power, but not so much for reality.
Political people believe their own PR. They believe all they have to do is throw money at something and bang the table enough and they can get whatever they want.
Engineers know it doesn't work like that. Sometimes they throw money at things and bang the table too, but ultimately if reality says "No" - or "Not yet" - they accept that and move on.
If the product don't actually work in the first place, you can't call that innovation and it appears that Holmes failed to do her due diligence.
which ideas? Is there really that much innovative stuff by elon musk?
My impression is, that it was always more about economic feasibility than technical feasibility. Competitors to Tesla and SpaceX existed before those were founded but they lacked the investment.
Don't get me wrong, they're fantastic and innovative, but the basic technological underpinnings have been long established.
Sure, but not something that critics said was technically impossible (not likely to be viable as a business model, sure, but that's a different class of complaint.)
While it is difficult I would say much of this is due to the infrastructure and capital requirements to get to this point. No one doubted that an electric supercar could be made, rather that it would be very difficult to achieve scale.
Had Theranos opted for a mass produced microfluidics chip and instrument based on existing chemistries people would have said it would be difficult to compete with the large industry players (Bio-Rad, Roche, Thermo Fisher etc). This would be deemed difficult or "ridiculous" for reasons relating to capital, infrastructure and potential market share rather than the actual science and functionality of the system.
This is where Theranos differs from Tesla, not only trying to achieve scale but do so with a unproven scientific method.
It's a shame that Theranos has played out like this because a system that uses a small amount of blood is a great end goal but should have been a 10-15-20 year goal; just as Musk didn't intend to produce a $30,000 mass market car from the beginning. If Theranos built their own instrument based on existing qPCR research/design and used existing chemistry they could get "in the door" and begin really understanding the market. They would need to differentiate but could do so by attempting build a single benchtop automated unit that removed the need for manual sample preparation. While their solution may be a premium offering and a smaller market this would lead them towards their ultimate goal. Over time they could begin to look into chemistries, chip designs and instruments that would bring them closer to their ultimate goal of low cost and low blood requirement testing.
There were no scientific and few engineering objections to most of Musk's projects, mostly social/business objections that the time window was uncertain, the risks were high, and it would be difficult to build a viable business to bridge the gap it would take to get to the objectives.
There's a difference between projects not making sense to the risk tolerances of current incumbents and projects operating in an area where the science is well-established and demonstrates clear reasons why what is proposed cannot work.
http://i.imgur.com/NjvUGXh.png
Deciding to build a company that aggressively rides the edges of those curves is a lot different than building a company around a completely new technology that aims to beat anything in existence by a huge multiple (which is the claim for Theranos, that they would do accurate tests with vastly smaller amounts of blood).
I don't mean to draw parallels, but I remember when Jobs announced the iPhone, everyone was very skeptical. Some called it the "Jesus Phone". I heard that when the iPhone was finally launched, Blackberry engineers went out and bought a few to see how he had done it.
Of course, just because there are skeptics it does not mean that the product is good. E.g., all the "perpetual motion" machines out there...
It's for hiding the failure and pushing the failed technology to patients outside the scope of an experiment.
Isn't this just elementary statistics and completely independent from the domain?
One reason that assertion might not hold is if the 5 being tested come from a special interest group, knowing if that could be the case or not depends on domain knowledge.
http://www.bd.com/vacutainer/labnotes/Volume17Number1/compos...
So, it is known that small samples of blood taken from capillaries will have a different composition than large samples taken from veins. Is it possible to write a test that compensates for the known differences? Or is it just known that they are so different that one can't be inferred from the other? Hard to tell, needs cutting edge domain knowledge.
The second example includes bias as a lead-in to the actual problems that tests of capillary blood need to handle.
To which companies of you refer?
That said, your "litmus test" is dangerous and should not be used. If you had talked to 100 cab drivers about Uber, how many would have said it's a viable idea?
Uber is actually WAY less viable than Theranos, because there are legal frameworks that made it literally illegal. Meanwhile Theranos is in a high-profit part of the medical industry, that is also (as you can see) regulated.
The issue is that Theranos is a scam. That's the only issue, not any of the stuff you mention.
Founder bravado exists because lots of parts of the world are stupid and wrong and done out of habit. Theranos isn't a scam due to bravado. It's a scam because it's not real.
If it "happened to be" real and not a scam, your comment could read exactly the same, except it would happen to be wrong instead of right. Your generalization about startups is entirely unjustified, and makes it that much harder for people who are not running scams to actually change the world.
Could I also venture a guess that you're not living in Silicon Valley? Your comment and others like it are the reason people don't change the world from the city you're living in, by creating a startup from scratch, but go and move to Silicon Valley to do it. If you have any examples of an Uber, an Airbnb, or a Tesla made in the city you're living in, go ahead and say it. These three companies have upended their respective markets (taxis, hotels, cars). You would have knifed them in their infancy, citing "founder bravado".
This literally impedes progress. People shouldn't have to move to Silicon Valley to be able to change the world.
None of this has ANYTHING to do with the fact that Theranos (and, to cite another example, that ultrasound charging company) are scams. They are scams ONLY because they're not real: not due to the opinions of the industries they're disrupting, and not because of bravado.
Don't conflate the two.
This person wrote:
>There seems to be this bravado among founders who believe they're sticking it to all the people who say something's amiss
which is a completely unfair generalization and hurts all founders, of all companies.
You raise irrelevant points. But to answer you, yes, there was a time in the past when taxi drivers would have argued that Uber is a scam, yes. I did a date-range Google search, and look at this:
http://observer.com/2012/10/uber-lawsuit-chicago-taxi-limous...
"Uber Sued for Consumer Fraud and Unlawful Practices by Chicago Taxi and Limo Companies". (2012)
Consumer fraud means scam.
So, please, jacalata, I would like you to say:
-> "All right, Taxi cab companies did accuse Uber of being a scam, i.e. of consumer fraud, in 2012. The only difference between this an Theranos is that Uber was real and Theranos is not real."
I want to hear you say this, because of the part of the comment that I quoted, stating "There seems to be this bravado among founders who believe they're sticking it to all the people who say something's amiss".
I'd love for you to agree that that signal or litmus test is irrelevant, and the only thing that matters is whether it's actually a scam.
Theranos was actually a scam - it didn't really do what it claimed at all, for which it is under criminal (criminal!) investigation. It has nothing, zip, zero, zilch, to do with Silicon Valley or founders, or bravado, or what the industry insiders were saying.
Whether that is a feature or a bug I suppose is a different question.
SV has advantages for startups, yes, but there is a world outside of your little pond, you know. Ola, Alibaba, Amazon, Tencent, Baidu. Even VW and Ford have excellent EV alternatives to Tesla. If change could only happen in SV, it would also be limited to SV.