再加些更新 (需要强调的是lz没有这个专业学位也没经历过专业培训,资料都是来自public source)
1. 从运营一个商业化的 medical and diagnostic lab 的角度来阐述观点质疑这家公司
Wired 杂志在2014年2月发了一个标题为:“This Woman Invented a Way to Run 30 Lab Tests on Only One Drop of Blood”
放个著名的对比图在这里,对比Theranos家用的那个Nanotainer和常规血检用的存储容器。

原文链接
[url=http://www.wired.com/2014/02/elizabeth-holmes-theranos/]http://www.wired.com/2014/02/elizabeth-holmes-theranos/[/url]
当时文章出来后,然后著名的Reddit Technology 板块上大家狂吐槽这个公司(surprisely, nobody cared about all these questions, 毕竟女CEO各种大奖拿到手软基本上是2014年下半年开始的) ,这里贴一个高票的业内人士(答主就是管理lab的)回答,优缺点说的很清楚。(可以注意到指尖挤压这个问题,后面还会有文章提到,同时WellsFargo的分析师人肉去体验的时候,也在其报告里面提到了However, she needed to
provide a fair amount of pressure to my finger essentially milking it of blood.)

[url=https://www.reddit.com/r/technology/comments/28vb8q/this_woman_invented_a_way_to_run_30_lab_tests_on/cif0imc]https://www.reddit.com/r/technology/comments/28vb8q/this_woman_invented_a_way_to_run_30_lab_tests_on/cif0imc[/url]
看后大家一定对一些技术越发好奇。正好Wired昨天还写了一个比较技术流的文章
2. 从技术流角度来质疑这家公司
这就要涉及到一个现在非常热门的交叉学科:
Microfluidics 微流体学。 现在大量的生物检测技术,各种高大上的设备的研发都必须要考虑到微流体学问题。简单科普可以参考wiki
[url=https://en.wikipedia.org/wiki/Microfluidics]https://en.wikipedia.org/wiki/Microfluidics[/url]
Wired这篇文章不错,明确强调了microfluidics的重要性,对于Theranos来说,研究moving tiny volumes of liquid是核心问题。文章里的两段话贴在这里。大意就是说微小体积的液体(比如水)研究起来非常不容易,更何况当你研究的液体对象里面还含有血细胞这种大块头的家伙。解释的很生动,不需要背景知识就可以理解。
Microfluidics done right would have all kinds of implications for science—handheld sensors, tiny engines. If it worked for blood tests, it’d mean smaller needles and faster results, and by implication, better care. But liquids are difficult to deal with in small volumes. Think of trying to stir a drop of water with a toothpick. You’re more likely to smear it across the table, or break it into smaller drops. Shrink that volume down even further and bigger challenges emerge. At microscopic volumes, surface tension has more and more of an influence. The fluids get stickier and don’t want to flow without some kind of mechanical prodding.
Microfluids also have low Reynolds numbers, which means they are viscous—more like pudding than water. “One of the big challenges has been how you mix things in small volumes at a microscopic scale,” says Eugene Chan, microfluidics expert and head scientist at DNA Medical Institute in Cambridge, Massachusetts. Mixing pure liquids is hard enough, and it gets a lot harder when the liquids contain relatively large things, like blood cells.
文中提到的DMI Medical公司位于波士顿,同样是一家在指尖血液检测领域寻求突破的公司。
既然微流体研究还有很多难题,
目前的研究进展非常适合用于判断Yes-No一类的诊断,而很难在非常少量液体检测中给出一个非常准确的定量值。这是另一家位于圣地亚哥在也这个领域寻求突破的公司Genalyte的CEO给出的解释。
为什么FDA目前就给Theranos批准了Herpes诊断?这个诊断恰恰是Yes-No类型的。
为什么指尖血液定量研究很难?再选一段文字放在这里帮助理解。想想前面提到的为了采集到足够的血液样本,挤压手指,那么采集到的那几滴血液里有效信息的信噪比。。。
On their way to suck your blood, needles and pricks also slurp up a small volume of interstitial fluid—the stuff that makes up a lot of the 70 percent watery part of you. In a normal draw, this fluid gets diluted in four to nine vials of blood. But in the tiny volume a finger prick pulls, that signal-to-noise ratio gets blown up. Even minuscule quantities of interstitial fluid are enough to throw off sensitive assessments.
上面提到的两家公司都没有商业化呢,两家都在寻求FDA的审核批准。两家运作方式都更为公开透明,在两家的网站上(特别是Genalyte)详细列出了经过业内专业人士peer-reviewed期刊或会议文章,有明确介绍关于他们的技术。都有据可查。而对比来看Theranos,她家网上关于这些是空白,或者用文章里的词描述是个black box。
最后文章提到了没人能保证DMI和Genalyte就一定能成功,他们同样可能会遭受到失败,但是
Both Genalyte and DMI could fail, too. The difference is, those companies failures would be part of an open, scientific exploration—rather than headline news.
这和前面无数接受采访的科学家们的观点不谋而合
“Science is peer-reviewed,” Lakshman Ramamurthy, a former F.D.A. official and a vice-president at the consulting company Avalere Health, said, reacting to the Journal article this week. “The community, together, advances science, not one person working in a basement. It has to be transparent and reproducible, so that the peers in the scientific community go, ‘Oh, let me try that.’ No one else has done what Theranos claims to have done. They have to let people give it a try.”
[url=http://www.dnamedinstitute.com/company/team/]http://www.dnamedinstitute.com/company/team/[/url]
[url=http://www.genalyte.com/resources/]http://www.genalyte.com/resources/[/url]
[url=http://www.wired.com/2015/10/theranos-isnt-the-only-one-chasing-needle-free-blood-tests/]http://www.wired.com/2015/10/theranos-isnt-the-only-one-chasing-needle-free-blood-tests/[/url]