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  "documentTitle": "Tempus AI, Inc. (TEM)",
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  "authorName": "Spruce Point Capital Management",
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  "presentationDate": "2025-05-28 00:00:00",
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  "notes": "Uses a table to contrast pre- and post-2019 protocols and a quote to highlight the company's stated rationale.",
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      "text": "This policy prioritizes Ambry's operational preferences and business model over physician judgment and patient choice, while using compliance as a convenient excuse.",
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      "text": "We believe Ambry is steering doctors and patients into using +RNAinsight, rather than giving them a reasonable, flexible option. There is no technical barrier to simply collecting an extra RNA tube (e.g. RNA shield) at the initial blood draw and holding it for reflexive testing if the DNA results are ambiguous or inconclusive. This straightforward approach would eliminate the main compliance issue Ambry cites: patients failing to return for a second blood draw. Instead, Ambry insists on running RNA testing concurrently and refuses to offer reflex testing, effectively mandating +RNAinsight upfront regardless of clinical necessity. This policy prioritizes Ambry's operational preferences and business model over physician judgment and patient choice, while using compliance as a convenient excuse.",
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      "text": "We previously utilized retrospective RNA genetic testing for specific variants in Ambry's Translational Genomics (ATG) lab. With this approach, we observed two critical limitations. First, deep intronic pathogenic/likely pathogenic variants that were clinically actionable still remained undetected. Second, there was a 90% lost to follow-up rate for patients who were offered additional RNA studies due to the need to send in an additional sample. Therefore, it is more advantageous to offer RNA testing concurrently with DNA testing.",
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      "text": "We previously utilized retrospective RNA genetic testing for specific variants in Ambry's Translational Genomics (ATG) lab. With this approach, we observed two critical limitations. First, deep intronic pathogenic/likely pathogenic variants that were clinically actionable still remained undetected. Second, there was a 90% lost to follow-up rate for patients who were offered additional RNA studies due to the need to send in an additional sample. Therefore, it is more advantageous to offer RNA testing concurrently with DNA testing. — Ambry Genetic Blog",
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      "text": "Source: Alithea Genomics, Ambry blog and press release",
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      "text": "Ambry's RNA Testing Protocol Changes Prior and Post 2019",
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      "text": "Ambry's Policy: Forcing Upfront +RNAinsight Testing",
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