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Comment by drcode | Hacker News Reader

Medical research is in great need of a major shakeup, because I feel like current research models have seriously underperformed in recent years...

...but now that isn't going to happen, primarily because of this debacle.

It's so sad that the "keystone cops" at Theranos have done so much damage to the reputation of the medical startup community- Possibly, they've set medical research back by several years with their bad behavior.

Every time from now on when someone dares suggest that medical regulation is stifling innovation, they will be asked to defend Theranos, which appears indefensible.

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I think the damage is largely limited to the reputation of the Silicon Valley medical startup community. The biomedical community (which doesn't have much overlap with the pg definition of "startup") has been very skeptical of Theranos (and I think to a lesser extent, SV) for a long time, well before the WSJ's recent articles. The fallout from Theranos might even help Boston and RTP firm up their positions.

>I feel like current research models have seriously underperformed in recent years...

The research models have performed as they always have, if not better.

The only thing that's changed is the introduction of know-it-all Silicon Valley VCs who think bio is the same as software.

> The research models have performed as they always have, if not better.

I'm not an expert on the history of progress in medical research... however, I do have a medical degree.

Bottom line, I have higher standards and think we could be doing a lot better. Regardless, without counterfactual data it's really a very subjective question.

If you haven't seen it, this a pretty interesting and controversial paper:

Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research http://www.pnas.org/content/112/36/11335.full

Basically, increased funding of biomedical research hasn't resulted in better output, and that we do, indeed, need to change the model. The current model is really inefficient.

I don't think that paper clearly shows that. It could also be that the low hanging fruit has been taken, and that, as we reach for ever more hard to reach fruits, the effort needed per unit of health improvement necessarily increases.

Another explanation could be that the money givers haven't gotten as much health improvements as they would want because they haven't directly asked for them, as this paper acknowledges:

"A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. [...] The efficiency of society’s investments in biomedical research, in terms of improved health outcomes, has not been studied."

Computer programmers do not produce more profitable programs if you pay programmers by lines of code, either.

Ah, maybe "better output" should have been "health improvement."

And yeah, I heard Casadevall speak at a conference and "used up low hanging fruit" was one of the theories. It's less likely that there'll be another penicillin moment.

It's all pretty depressing, and very true that it's all driven by Science/Nature/Cell publications, not by discoveries.

It's certainly not a recent phenomenon. Genentech was founded in the seventies, and Kleiner Perkins was one of the original investors.

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