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But that's not what is being disputed! Are you unaware that Theranos is a private lab that does all kinds of tests, and this whole finger prick thing is taken out of context and spinned as if that's actual core business?

Look at their website:

https://www.theranos.com/test-...

They are researching ways to get more tests per blood sample, and they invented procedures and equipment for that. The "detect cancer from a drop of blood" is not what they do on a daily basis, it's part of their R&D program. But the WSJ made it look like they claim to do all their tests with that experimental technology, then ridicule them when they try to explain why they do tests with "normal" equipment.

No doubt a future episode of American Greed will be featuring Theranos. Ms. Holmes is an interesting character as all such individuals are at some level. What I would like to know is how she convinced a rather stellar list of individuals to become involved with her company.

https://www.theranos.com/our-l...

We are voluntarily submitting all our tests to FDA even though we don’t need to – opening up to regulators like no lab before. We received our first FDA clearance this summer.

http://fortune.com/2015/07/02/...

it has not been, and still isn’t, required to seek FDA approval because of the way its business model works, which differs from those of incumbent diagnostic labs, like Quest Diagnostics DGX 0.67% and Laboratory Corporation of America

Holmes has voluntarily submitted voluminous data and validation studies to the FDA on more than 120 of her tests so far—without any legal obligation to do so—in an effort to persuade that body to grant formal clearance to her methods. She has done so, she says, because she regards the FDA’s imprimatur as the “gold standard” for safety and effectiveness.

In an interview, Holmes says that, because the FDA has today approved the basics of her system in the context of HSV-1 test, she is hopeful that clearances of her other tests will now be occurring at a faster pace.

So you are now saying that HSV is a simple test to get approved, but you don't believe any other tests will be? It takes time to get FDA approval, but funny, this company doesn't need any approvals, they are doing them voluntarily, which no other lab is required to do, hospitals don't have to get their tests approved by the FDA, so why is Theranos any different?

TFA is just bad reporting by the WSJ repeated by the rest of the press. It is made mostly from interviews with a few ex-employees.

You can read the company's written responses here

You can also see Elisabeth's response on Cramer .

Might be nice to get more info before expressing an opinion here.

In general, aggressive screening has been extremely useful: pretty much everyone gets screened for PKU, sickle cell anemia, cystic fibrosis, MCAD, hypothyroidism, and another ~20 conditions at birth.

Funny you should choose neonatal screening as an example in support of your argument. Firstly, the things that *are* screened are a carefully curated list of unambiguous genetic defects that 1) have immediate deleterious effect on the development of the child and 2) have an intervention that will alter the trajectory of the disease. This is why, for example, no one screens the population for Tay Sachs. In fact, the ~30 tests that are part of the standard panel now are all that's left after *hundreds* of candidate disorders were considered for screening and rejected by the American College of Medical Genetics.

Secondly, the positive predictive value of these neonatal screenings is incredibly low. That means that for every true positive result (i.e. a disorder detected correctly) there are 50 to 100 false positive results, which are subsequently ruled out by a different, more specific confirmatory test. However, this same problem (low PPV) is endemic in the mammogram/pap smear/PSA tests, and these result in deleterious effects on many people who have false positive results compared to the number of lives saved from true positive results.

Also, it's worth noting that they still perform the neonatal screening because the human cost of missing a diagnosis in an infant for these *treatable* diseases is so profound, but many parents are put under serious stress due to the false positive results.

Overall medicine is increasing the use of screening, not decreasing it.

Going back to the BRCA example: ask any medical geneticist what is the single most important screening tool. Every one of them will tell you it is "family history". If family history indicates a specific risk, they may counsel further testing such as BRCA. This is different than en masse population genetic screening for "cancer risks".

Recall the original poster was citing cancer risk. Have any examples of a trend toward expanded *cancer* screening? I gave two widely known examples of the trend moving in the opposite direction for cancer screening (in fact, these are probably the two most publicly visible/prevalent types of cancer screening), and correlated this to the issue of laypeople misinterpreting GWAS "cancer risk" data such as was provided by 23andme.

Tangentially, I hope that Theranos actually manages to pull off their plans for microfluidics testing. Look at their projected pricing, and the fact that they want this to be available at every corner Walgreens.

Uh, they have a licensed pharmacist right there to analyze the results, in the rest of the world a pharmacist can basically do everything an NP can do because they have to know medicine and pharmacology to do their job.

If you look at the Theranos website it make it cleat that the test are still ordered and interpreted by physicians. you are also misinformed about the scope of practice of pharmacists in most of the world. In may places pharmacists have been given limited prescribing power. But prescribing is only part of the role of medical practitioners, and pharmacists are not broadly trained in methodology of diagnosis and laboratory evaluation. This is not hating on pharmacists, pharmacists are fantastic and their knowledge of pharmacology and medication management is key to good patient care, but no self respecting pharmacist would claim that their role in healthcare is similar to that of an NP.

What test are you taking?
http://www.theranos.com/test-menu?ref=our_solution

I imagine that Walgreens is going to run only a few tests - cholesterol, pregnancy, HIV antibody.

Well, it looks like a few more than that:
http://www.theranos.com/test-menu?ref=our_solution

I didn't bother to count; maybe 200 in that list? Heavily tilted towards drug detection and STDs, but still a pretty good variety.

Why would I make an appointment with my doctor for 4 weeks from now, drive over, get a referral to a testing center, drive over, get stuck and drained, drive home, make another appointment for 4 weeks to get the results, drive over, and have someone read me results with no background info, when I could go to Walgreens, walk out with the results 10 minutes later, and spend 20 minutes on Google finding out what they really mean?

I would say that the fact that I can get results from Walgreens changes everything.