What if Theranos was real?

3 minute read

Blood microsampling can reveal your CV risk profile about as well as a venous draw can. Sounds familiar, except plausible.

During the lead-up to the sensational trials of Elizabeth Holmes and Sunny Balwani, your Back Page correspondent became mildly obsessed with the Theranos story.

Besides the outrageous lies and fraud, everything about the saga was exquisitely infuriating: from the company’s name (an idiotic portmanteau of therapy and diagnose that sounds a lot like “death” in Greek) to the poseur turtlenecks and fake voice; from the way the medically untrained dropout seduced billions out of old and scientifically illiterate yet incredibly rich and powerful men, to the way media drank it up uncritically – barely stopping to ask whether the technology could plausibly physically work, let alone what less well-off or uninsured Americans were supposed to do with the information it yielded.

If you thought that bypassing the traditional research and publication stages and leaping straight to commercialisation might have rung alarm bells, you’re thinking like an academic, not a Silicon Valley spin merchant.

In all that gushing coverage, how many pathologists were interviewed about whether it was feasible to carry out hundreds of tests on a drop of capillary blood even in a lab, never mind accurately inside a small box, in 2003? Even the ultimately fierce media scrutiny was pretty quiet on that.

Anyway, the point of this mini-rant is that just this month, 20 years after the founding of Theranos, a paper has been published announcing the feasibility of using a capillary microsample to measure more than 100 lipoproteins and other parameters using metabolic phenotyping, with results on par with venous sampling.

The research, from a team at Murdoch University’s Australian National Phenome Centre, means it is possible to paint a portrait of cardiovascular risk using just a self-administered finger prick, no need to get the phlebotomists involved.

The sample can be collected at a pharmacy or at home in remote locations (and sent away – there’s no magic little box) and can be done relatively often to allow regular monitoring of lipoprotein levels and lifestyle adjustments as indicated.

The study was small, involving 20 healthy adults who gave both venous and capillary blood samples for comparison.

“Spectra acquired from both capillary and venous sampling sites were shown to be equivalent for all quantitative parameters … Importantly, markers such as total plasma triglycerides, apolipoprotein A1, and SPCs that have been identified as biomarkers of cardiovascular risk related to both acute and chronic inflammation were found highly correlated between the two sampling sites,” the authors write.

“These results indicate that self-administrable microcapillary blood collections are a suitable alternative to venous blood collections.”

They’re not promising “a world in which no one ever has to say goodbye too soon”, as Holmes nauseatingly did – just one where it’s easier to tell if you’re on the road to Heart Attack City and need to chuck a U-ie.

Send micro-story tips to penny@medicalrepublic.com.au.

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