Biotech Investing

Long/short equity, deep value, growth, research analyst
Biotech Investing
Long/short equity, deep value, growth, research analyst
Contributor since: 2013
Great article. Thank you.
Since you are picking only selective things from the article, let me fill it in. Unfortunately, there is always going to be a incompetent doctor with the "Go ahead, order a CT scan attitude".
Right after your selected "quote" (Did you even bother reading the article? It is showing that doctors comment as one of the types and reasons CT scans are an issue...):
"Still, the findings are cause for concern, researchers say, because the number of CT scans done in the United States is soaring. The most recent data suggests that U.S. doctors perform at least 70 million scans each year, 5 percent to 10 percent of them in children. A CT scan—a computer-enhanced series of X-rays routinely used to identify brain trauma, cancer and other conditions that might be missed or take longer to diagnose by other means—delivers at least 10 times the radiation of a mammogram and up to 600 times the radiological punch of a single X-ray. Studies suggest that a third or more of CT scans may be unnecessary, says health physicist David Brenner, director of the Center for Radiological Research at Columbia University Medical Center. "
..The study...
"...demonstrates that the cancer risks from low-dose CT scans are statistically on par with those seen in atomic bomb survivors, says Andrew Einstein, a cardiologist and radiologist at New York-Presbyterian University Hospital of Columbia and Cornell."
"To avoid inappropriate scans—such as those for chronic headache, minor trauma, and low back pain—Swensen advises every person offered a CT scan—and every parent advised that their child might benefit from one—to ask the doctor:
• How could the test result change my (or my child's) care, if at all?
• Can you recommend an alternative, such as an ultrasound or MRI, that doesn't involve radiation?
• Can a dose at the low end of the scale be used?
• What is the accuracy of the test at the recommended center? Some operators are better at getting clear images than others, Swensen says.
• Do you have a financial interest in the scanner? Doctors that do, he says, have a greater incentive to refer patients for tests."
Here, the APPY test provides an alternative that can be used in conjunction with an Ultrasound to confidently make the right decision in the management of your patient.
If it were your child, would you consider it still low? Furthermore, studies are just now coming out showing the risks to be a lot higher and more will follow suit.
This is directly from the FDA:
"The imaging procedure should be judged to do more good than harm to the individual patient. Therefore, all examinations using ionizing radiation should be performed ONLY when necessary to answer a medical question, help treat a disease, or guide a procedure."
Again, if the APPY test tells you with 97% confidence that the patient is at extremely low risk for having appendicitis, you still send them for a CT scan? This will cost thousands for the patients over $50-$70 for the APPY test.
With all due respect, but I have a difficult time believing you are in fact a physician especially with the claims you make (and the fact you would order CT scans even for straight-forward diagnosis). If you are in fact a Physician, I would be terrified of trusting your judgement as a patient.
Let me see if I understand you correctly. You get a child in with abdominal pain. The APPY test tells you the patient is unlikely to have appendicitis (97% confidence), so instead of eliminating that from the list and proceeding to figuring out if its something else, you still order a CT scan?
Again, the test tells you with extremely high confidence that your patient is at extremely low risk of appendicitis, and that it is likely something else. Ordering a CT scan, especially knowing that it exposes the child to higher chances of cancer (see my citations of the highest ranked medical journals) seems like a the non-logical way to go and irresponsible.
I have to disagree with you on the second part as well, as we have numerous physicians in my family. They only resort exposing their patients to harmful radiation, especially children, as the last circumstance. If you can't figure out that it is an ovarian cyst, urethral stone, inflammatory bowel disease without a CT scan, then I would question your credibility as a physician.
Simple non-invasive tests will tell you if it is one these:
Ovarian Cysts: cancer antigen 125 (CA 125) (blood test)
Urethral Stone: simple urinalysis will give you the result you need, as urine pH and presence of calculi crystals should be good indicators
Inflammatory Bowel: Usually one of these will tell you if it is IB,
1. Blood Test,
2. Stool Sample
3. Colonoscopy
4. Flexible sigmodiosocopy
5. Barium enema (x-ray)
6. Then, only last resort CT scan
The problem in the U.S. is the fact that physicians, like yourself, order CT scans without much thought prior to the obvious clinical signs or just mere listening to the patient (all three above could be easily diagnosed by just listening to your patient as well, family history etc..)
Imaging is harmful to patients, something the EU has long realized and thus limited its use. We are slowly catching on in the U.S. as well, since unprecedented number of CT scans are ordered, even for the most routine of diagnosis. Not to mention the economical affects of ordering expensive CT scans. Cancer is rampant, and doing all we can to reduce it (especially in our children) should be a priority. As a physician, you have an obligation to protect your patients.
The APPY test is important, as it eliminates unnecessary CT scans.
If you rather not spend the time looking up my citations, visit this as well for more information:
@Jonnie, no way to know until the end of December or Q1/Q2 of next year. I would keep my ears open for the live webcasts at the conferences as well, as there might be a mention of it.
Thank you for your comment. Numerous other physicians who contacted me would find the test helpful, as the test determines how unlikely someone has appendicitis. Again, this is a preference thing, and from my personal experience most physicians would gladly have a test that allows them to manage patients more conservatively (esp children) and avoid sending them to CT scans. I won't even address your comment about how safe CT scans are..
Why exactly would it drop? Please don't give advice without any solid proof. These are investor conferences, and usually when an IPO goes to these, the stock goes up (because investors learn about the company etc..).
That is ultimately the goal behind SolarCity = charge at home. The next few years will be exciting for both SCTY and TSLA.
In the works. Stay tuned. There are some exciting IPOs coming up in the next few months.
Thank you.
Anticipate 20K untis by end of next year. This may result in a saturated market in terms of Model S sales (unless price drops), thus anticipate only an additional 10K units in 2015. This, however, may be conservative as they are expanding globally and demand may increase. Gen III will be the deciding factor, especially in terms of justifying Tesla's expected increase in valuation.
Thank you.
Thank you for the comment. I have submitted a correction to reflect a more accurate view in regards to the battery swap tech. It should have said "some", instead of "most".
4121, Thank you for noticing the error. A correction has been submitted.
Thank you for the advice. Yet, again I think an apology was necessary on my behalf for the comment.
I look forward to more discussions in the future. In the meantime, I will read through your previous articles to try and understand your side better.
John, my apologies for the for comment. I didn't mean make money of seeking alpha. Either way, the comment was unprofessional and served no purpose.
I understand your side of the argument, but I hope you see the other side as well, and refrain from calling sustainable alternatives "fairy dust solutions". Again, I hope we can continue to express our views in a more professional manner in the future.
Bob. Excellent article and I agree with you that institutional holdings are a great indicator of investment confidence. Venaxis is a great company to keep in the portfolio due to its unique product and long potential.
As they complete their last trial, I would expect the media coverage to increase, and subsequently the number of analysts covering $APPY.
Why don't people see that he only wrote this article to make $$ and aggravate people. Someone who tells me that "oil" is sustainable over "solar", has no validity in my book or is of a lost generation.
Thank you Carrix. The gross margin of the APP1 reader should be around $30-$50 and assuming that they reach 30% penetration of the potential market in Europe and U.S., which is 6.3M tests, will put them at a market cap around $150M+, with a stock price around $6. Again, this is all speculative and example given is a conservative outcome.
Wait, EVs are not sustainable, but oil guzzlers are? Please explain.
I agree with everything. Great article. However, what is wrong with what TSLA's stock is accomplishing? Elon Musk didn't invent the wheel, he made it cool and marketable. Without TSLA, the industry would not change. Now everyone knows about TSLA and EVs. The new generation wants a sustainable lifestyle, something the last few generations don't understand. Every major car manufacturer is scrambling now to build EVs and there is nothing the oil lobbies or the "old rich" can do about it. I praise TSLA for what it accomplished on a larger scale.
Every analyst out there can crunch numbers, but what it is really about is "change" which has no price tag.
I say keep running up the stock because it shows " what people want ". It is time to think green, and not the money kind.
What is wrong with the product they are producing and the movement they started? Is that something we all shouldn't get behind?
@ pedroom. I will have another article out soon with more details. My purpose here was just to share and introduce. Thank you for the kind comment.
@michaelpyles. The specificity is important, but not too critical because of the high sensitivity. It is better than current methods of diagnosing appendicitis. Ideally, we would want both to be in the 90+ range, however, not necessary for this test.
Specificity measures the number of healthy patients who are correctly identified as not having apendicitis. The goal of the test is to identify the "risk of appendicitis", and help physicians make a better decision. High sensitivity, that is number of sick patients who are correctly identified as having apendicitis, is still better than anything out there right now. Think of it this way, the test allows you to confidently identify a child with stomach pain to be at very low risk of appendicitis and continue to test for other factors, such as bacterial infections (which are common). Thus, a low specificity just tells you that it is something else other than appendicitis helping the physician avoid ordering a CT scan and protecting the child from unnecessary radiation exposure (risk of cancer, see articles I cite). Again, under European regulations this was enough to justify the test and protect patients from unnecessary radiation.
The second clinical trial of 2000 people will be important and should get those numbers even closer to accuracy (expected completion is end of the year). The FDA liked the test as well, but are seeking just higher sampling.
My apologies, I should have discussed this in the article. Thank you for pointing it out and the constructive comment. Please don't hesitate to PM me if you have other questions. Again, my goal was to share this information, not advice one way or another about the stock or the company.
I meant buy today before closing bell. Thank you. (Also, @PeterJA, newbie or not, stocks always fall harder than they go up. I prefer to play it smart and make money with right timing; TSLA is a great stock to own long term, but not at this price. Someone smart once said, if too many analyst are covering it, its not a buy anymore--everyone and their mother knows about this stock now).
I am not gloating. I am going long after today, once the fall is set. I think Musk has still some tricks up his sleeve and after tonight, this thing will skyrocket.
Well that is embarrassing. Day later after your article, stock goes into super dive mode. Very unfortunate.
The lawsuits were rejected by the judge. They are all in the clear. Recent break past 1.40 is just the beginning. I'm long with confidence. Easy $$ here.
..and the battle continues. Tftf I am with you on this one.
Finally a sensible article that is not based on fluff, as is the current rise in markets. My only questions is, why is it that when everyone, I assume, is in good profits, is not pulling some chips off the table? Markets are at all time highs. We want more, more, more, then when the correction kicks in, which it will, you see your profits gone. I agree, watch the Fed, don't listen. That being said, it is all to obvious what we will see in the coming months. Great article. I am going back to my lake side. Enjoy the roller coaster bulls!
Tesla is not just a car company. They are directly intertwined with SolarCity, which is another story. Just out of curiosity, is nobody concerned about the 10% market(s) correction that is on the horizon? Is TESLA exempt? I want Tesla to succeed, but some point rationality has to kick in. What goes up always comes down, the question is how hard? I want to go long really bad, but at 101 it's just to risky. Interesting article.
Great article and you are dead on. This company is bound for success.