⏭️Chris' Newsletter: No. 1
A weekly newsletter of what's noteworthy and what's next in digital health & hardware.
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🙏 Trials & Studies
Apple, Eli Lilly and Evidation presented results from their trial on monitoring cognitive decline in everyday life. They followed 113 people (31 with cognitive issues) for 12 weeks using an iPhone, Apple Watch, Beddit sleep sensor, and a questionnaire app. The paper discusses in detail how they overcome the challenge of missing data. Given the expense of these sorts of studies (in time and money) having a plan to deal with incomplete datasets is crucial, yet easily overlooked. Link
Ovia health developed a ML detection model for preeclampsia (a very serious pregnancy risk). The results were promising even though it relied to some degree on self-reporting. With all these kinds of predictive models it’s important to understand the savings and costs of associated with True Positives/Negatives vs False Positive/Negatives, only then can you determine if a technology is commercializable. In this case predictive value was 75% and sensitivity was 37%. Link
👩⚖️ Regulatory
The FDA will collaborate with Syapse on the use of “Real World Evidence” in regulatory decision making. The FDA has really been doing a commendable, if imperfect, job the past few years in trying to balance conservatism and embracing new technology, even . Link | Framework for FDA’s RWE Program
💸 Healthcare Economics
In An excerpt from Uwe Reinhardt’s book, Priced Out: The Economic and Ethical Costs of American Healthcare, he provides data to explore several hypotheses for what is driving exceptionally high health spending in the U.S. It’s administrative costs. Link
Price transparency in health care is having it’s moment in America. There have been a lot of well-meaning efforts at the state level for years, but most of them result in websites that don’t get the job done for everyday folks. I hope this time it’s different, but I suspect transparency will remain poor for some time. Link
The past few weeks have seen several digital health IPOs. Livongo is perhaps the most interesting. They partner with employers and health plans and use connected devices as a tool to narrow the chasm between their partners and their patients. Link
⌚ Wearables
The Wyss institute has a 5kg “soft-robotics” device that, on average, reduces the metabolic costs of walking by 9.3% and of running by 4%. So much wearable tech has been focused on monitoring, but actuators integrated in soft goods will increasingly enable us to perform better physically. Link
Google ATAP has submitted a patent application for a “Ergonomic Assessment garment”. Posture wearables (such as Lumo) have been around for some time, so the application isn’t novel, but the form-factor might be; ATAP is the team Project Jacquard, the Levi collaboration that produced a smart denim jacket. Link
Fitbit’s stock drops below $3 per share. This is after a steep 21% drop a few weeks ago It’s a symbolic milestone but one that’s emblematic of Fitbit’s slow but steady slide into irrelevance they IPO’d in June 2015. The hardware they’ve put out has been solid, but they’re hurting from being seen as a fashion brand with a million SKUs rather than a tech platform that people and/or firms can build things around. Link
Spire now brands themselves as Spire Health. They explicitly mention “Remote Patient Monitoring”, something the FDA has recently created additional billing codes for. A lot of erstwhile “wellness” and “lifestyle” wearables firms have been shifting toward more clinical applications as the realization sets in that organizations are more willing to pay for health than individuals. Perhaps Fitbit should move that way as well. Link. Spires’s old website
📖 Other Things
Investment in fertility companies is booming. Link
Fitz Frames is offering kids’ 3d printed glasses for $95/ea or $185/year for unlimited frames. Link
Elizabeth Yin of Hustle Fund published a google doc titled “Questions Early Stage VCs May Ask You”. Link
Best,
Chris
P.S. We should be better friends. Send me a note, I’ll buy you tea/coffee :)