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" ... Compared to our transportation choices—which define much about the physical realities of our lives—these examples are, frankly, apples and oranges. Predicting the adoption of mobile tech took about as much prognostic genius as predicting that homeowners would switch from candles to electric lights a century before. In short, it was, and always had been, inevitable. We all knew it at the time; we just needed the tech to ramp itself up. Transportation, on the other hand, simply cannot be mentioned in the same breath as her examples. In fact, a more appropriate comparison would be suggesting we’re going to migrate from having homes of our own to picking a new hotel, apartment, or random house every night, just because some app makes it possible and there’s an available cube across the street from your office. Nevermind the comfort and satisfaction of having a place of your own, which can be personalized, which welcomes you every night, and which, of course, holds all your stuff. ... "
" ... Small is certainly here. It's my sense that Confirm Rx is an initial step toward smaller and smaller devices that will resemble the microchip we see in labs and science fiction movies today. Further, the opportunity to evaluate real-time, real-world, at-home data can establish the chance for big data and artificial intelligence chance to scrutinize cardiac rhythms to reveal new insights into prognostic information. From R-R variability to morning catecholamine surges, these new data can be very powerful tools for care and research. ECGs will only be part of the tracking, as new biomarkers and analytics combine with sensitive microchip technology to advance cardiac care and save lives. ... "
" ... The prognostic utility for genotype testing is not substantial or consistent. The outcome most strongly associated with CYP2C19 loss of function genotype is stent thrombosis (hazard ratio of 3 to 4), a rare but potentially life-threatening event. However, given the rare occurrence of stent thrombosis, the positive predictive value of genotype is only 3-4%, too small to be clinically directive. A randomized controlled trial to definitively address the role of genotype is currently lacking. Given the paucity of thrombotic events, a trial with a sample size of 20,000-30,000 would be required to adjudicate the clinical utility of genotype testing, a number that might be understandably viewed as being prohibitive. With a sample size of around 1500 and a follow-up up to 6 months, the TARGET-PCI is woefully underpowered to address this. Not surprisingly, and given the null results of GRAVITAS and premature stopping of TRIGGER-PCI for futility, the decision to suspend TARGET-PCI does not seem unwarranted. ... "
" ... “We are now working on solutions for additional tissue types, expected to hit the market later this year, as well as for new applications for additional workflows in pathology that have already demonstrated significant productivity gains. Finally, we are engaged with several partners on projects for the development of AI-markers for prognostic and predictive applications used in cancer management and drug development,” adds Laifenfeld. ... "