Let me give you an example. And let’s stick with diabetes, since that’s the time bomb. To diagnose diabetes, most doctors use a test called “fasting glucose.” It’s not very accurate. If you’ve got fancy health care, your physician would use a more expensive test for “glycated hemoglobin.” It’s a good test—it has some accuracy issues in edge cases. But if you want to detect diabetes before it happens—which is the goal here—you need these:
Fructosamine, Glycated albumin, 1,5-Anhydroglucitol, Adiponectin, Fetuin-A, alpha-ketobutyrate, L-alpha glycerylphosphorylcholine, Lipoprotein(a), Triglycerides, HDL-C, Ceramide, Ferritin, Transferrin, MBL-associated serine proteases, Thrombospondin 1, GPLD1, Acylcarnitine, miRNAs, CRP, IL-6, WBCs, Fibrinogen.
I put the list in small print because it’s the sort of thing you shouldn’t actually read. Unless you’re a doctor. But doctors cannot detect diabetes before it happens, because they can’t measure all those biomarkers. You can get at those details only in the world’s best research labs, and it would cost thousands of dollars to run all the varied tests.
This field of high-resolution biomarker detection is called multiomics. It’s just starting to show some incredible promise. For example, to detect nonsmall cell lung cancer, in the very early stage, physicians were measuring a molecule called pro-surfactant protein B. But then they found they could improve accuracy dramatically by also looking at the metabolite N1, N12-diacetylspermine.
I’m hitting these examples pretty hard, and with detail, to make my original point more convincing: Vital signs can’t do it. Basic blood workups can’t do it. Artificial intelligence can’t do it. To fix health care, we need to be able to measure trace compounds that we’ve never measured before.
Diagnosing patients is hard. Symptoms are just the first clue. For instance, let’s say a doctor knows a patient has something wrong with her pancreas. But is it pancreatic cancer, or just chronic pancreatitis? To make this diagnosis, physicians rely on a test to look for a cancer antigen called CA19-9. To do it earlier, with accuracy, you need CA19-9 and these nine other analytes:
Proline, Sphingomyelin s17:1, Phosphatidylcholine, Isocitrate, Sphinganine-1-phosphate, Histidine, Pyruvate, Ceramide, and Sphingomyelin d18:2.
It would take thousands of dollars to run the multiple tests to capture all that data. Most tests just capture a dozen or so analytes. We created a company, with a scientist out of UCLA, that found a unique way to hack testing equipment—using a combination of engineering and physics and computation—to get thousands of biomarkers out of a single low-cost test.
It opens the door to the possibility of a new era of medicine. For a low annual cost, physicians could diagnose disorders before symptoms appear. This would drastically reduce health care costs, and vastly improve the health of everyone.
We created several companies that can spy on cell-to-cell communications. They can read small RNAs, they can stratify and count the 4 billion immune cells in your body, and they can detect autism in a newborn baby. They’re part of a fleet of many new companies that are finally going to revolutionize health care.