{
  "docId": "019dd923-622c-750b-8b98-916758668d1f",
  "docSlug": "34401c2968d1",
  "documentTitle": "Dexcom, Inc. (DXCM)",
  "authorId": "54_Spruce_Point_Capital",
  "authorName": "Ben Axler",
  "documentKindSlug": "activist-deck",
  "documentKindLabel": "Activist deck",
  "sourceTypeSlug": "short_seller",
  "sourceTypeLabel": "Short seller",
  "presentationDate": "2019-03-21 00:00:00",
  "orientation": "landscape",
  "aspectRatio": 1.3333334,
  "pageNumber": 25,
  "pageCount": 83,
  "prevPage": 24,
  "nextPage": 26,
  "slideType": "preempt_rebuttal",
  "function": "preempt_rebuttal",
  "density": "dense",
  "nDataPoints": 3,
  "notes": "Uses a combination of clinical study citation and expert testimony to undermine the bull case for Dexcom's technical superiority.",
  "elementsJson": [
    "headline_text",
    "paragraph",
    "callout_box",
    "quote_block"
  ],
  "metadataConfidence": 1,
  "imagePath": null,
  "slideHref": "/slides/019dd923-622c-750b-8b98-916758668d1f/25",
  "deckHref": "/decks/019dd923-622c-750b-8b98-916758668d1f",
  "deckJsonHref": "/decks/019dd923-622c-750b-8b98-916758668d1f.json",
  "deckAnchorHref": "/decks/019dd923-622c-750b-8b98-916758668d1f#slide-25",
  "components": [
    {
      "bbox": null,
      "kind": "callout",
      "text": "With the Libre set to add an alarm, and with differences between Dexcom's and Abbott's accuracy not significant, the medical professionals with whom we spoke see little room for material differentiation between the Libre 2 and the G5/G6.",
      "attrs": null,
      "subkind": null,
      "toolName": "Visual emphasis",
      "toolSlug": "visual-emphasis",
      "confidence": null,
      "componentId": "019dd952-f5d2-7501-bd89-f090b138b526",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.15,
        "w": 0.48,
        "x": 0.02,
        "y": 0.45
      },
      "kind": "framework",
      "text": "Assessing Sensor Accuracy for Non-Adjunct Use of Continuous Glucose Monitoring",
      "attrs": null,
      "subkind": "instance",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "c30db94e-aff7-4d8b-9fa3-897c85f91c4c",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.22,
        "w": 0.96,
        "x": 0.02,
        "y": 0.16
      },
      "kind": "paragraph",
      "text": "Dexcom bulls point out that Dexcom's CGMs take more accurate readings than the Libre. A CGM's accuracy is measured by its mean absolute relative deviation (MARD)...",
      "attrs": null,
      "subkind": "paragraph",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "077d26bf-e0a6-480e-9124-e593636be7ac",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.15,
        "w": 0.96,
        "x": 0.02,
        "y": 0.79
      },
      "kind": "paragraph",
      "text": "Below MARDs of 10%, medical professionals view improvements in a CGM's MARD as less important than its sensitivity to rates of change...",
      "attrs": null,
      "subkind": "paragraph",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "6d565d78-8f04-4007-8bd9-52adff131659",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.15,
        "w": 0.47,
        "x": 0.51,
        "y": 0.45
      },
      "kind": "quote",
      "text": "Research into automated insulin delivery... any sensor with a MARD below 10 will be suitable for use in closed loop systems...",
      "attrs": null,
      "subkind": "pull-quote",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "66b48005-9da7-48a1-9d96-0f827a90472e",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": null,
      "kind": "quote",
      "text": "\"Research into automated insulin delivery - both ours and academic - has demonstrated that any sensor with a MARD below 10 will be suitable for use in closed loop systems, which means that all four commercially available sensors (Senseonics, Medtronic, Dexcom, Abbott) operate in an acceptable range for closed loop, effectively rendering the conversation about MARD moot.... Any concerns about bias in any particular sensor can be accounted for in software....\" — Current Employee, Diabetes-Related Medical Tech Company",
      "attrs": null,
      "subkind": null,
      "toolName": "Authority citation",
      "toolSlug": "authority-citation",
      "confidence": null,
      "componentId": "019dd952-f5d2-7501-bd89-f6579eef7817",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.05,
        "w": 0.65,
        "x": 0.315,
        "y": 0.05
      },
      "kind": "title",
      "text": "Dexcom Accuracy Advantage Is Overblown",
      "attrs": null,
      "subkind": "headline",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "c348fc62-3227-4131-838b-26c507e2c47f",
      "frameworkName": null,
      "frameworkSlug": null
    }
  ],
  "metrics": [],
  "tools": [],
  "frameworks": [
    {
      "name": "authority-citation",
      "slug": null,
      "matchId": "67a05ccb-9c07-4895-824b-2f10de33c3b4",
      "evidence": "Cites Diabetes Technol Ther study and anonymous medical tech employee to validate the argument.",
      "confidence": 0.9
    }
  ],
  "arcBeats": [],
  "loops": [],
  "imagePathAlt": null,
  "thumbSrc": null,
  "thumbSrcAlt": null,
  "locked": true
}