{ "docId": "019dd923-622c-750b-8b9a-ad0811d3e80d", "docSlug": "dfcef8f28a20", "documentTitle": "Accelerate Diagnostics (AXDX)", "authorId": "61_White_Diamond_Research", "authorName": "White Diamond Research", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2019-09-16 00:00:00", "orientation": "portrait", "aspectRatio": 0.77272725, "pageNumber": 6, "pageCount": 41, "prevPage": 5, "nextPage": 7, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 2, "notes": "The slide uses a Q&A format to highlight technical and operational weaknesses in the AXDX Pheno system.", "elementsJson": [ "paragraph", "numbered_list" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-ad0811d3e80d/6", "deckHref": "/decks/019dd923-622c-750b-8b9a-ad0811d3e80d", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-ad0811d3e80d.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-ad0811d3e80d#slide-6", "components": [ { "bbox": null, "kind": "callout", "text": "The AXDX rep confirms above that the Pheno system doesn't replace cell culture, thus it is an adjunct to standard of care, not a replacement.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-78b4-70ad-b39f-b0957dd97e1b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.8, "x": 0.1, "y": 0.65 }, "kind": "list", "text": "1. If two people gave their blood samples with an interval of less than 7h, the sample from the second patient must wait until the first sample is analyzed. This effectively negates the advantage of a shorter test time using Pheno system.\n2. Another issue is having multiple samples from the same patient. It is a common practice to collect several blood samples from the same patient*, because of", "attrs": null, "subkind": "numbered", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b3cc072e-761e-4e4b-833d-4271a386d619", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.06, "w": 0.8, "x": 0.1, "y": 0.51 }, "kind": "paragraph", "text": "The PhenoTest analyzes only one sample at a time. If two samples need to be tested, the second testing module needs to be acquired, which is an additional expense and lab space", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "130c2851-1592-49c4-af98-34dbb731ec25", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.1, "y": 0.58 }, "kind": "paragraph", "text": "One Pheno system module is capable of processing only one sample at a time. This is a significant limitation, because of two reasons:", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "1d663f9e-6806-42ad-bdea-6f60b2f2712a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.1, "y": 0.45 }, "kind": "paragraph", "text": "The AXDX rep confirms above that the Pheno system doesn't replace cell culture, thus it is an adjunct to standard of care, not a replacement.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "34762fb3-59ce-4a8b-9a6e-a005ef3e0dbd", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.1, "w": 0.8, "x": 0.1, "y": 0.33 }, "kind": "paragraph", "text": "A. 15% is about accurate. Our panel covers about 85% of organisms. Our panel does not cover 100% of bug/antibiotic combinations, so you still need cell culture. It is not easy to cover 100%, because we use FISH probes and they may not be available for some bugs. Because of the FISH method we are somewhat limited.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "aae670e6-0652-42b3-9341-50ff5999e868", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.1, "y": 0.09 }, "kind": "paragraph", "text": "major limitation is that it does not cover all the pathogens that may be responsible for sepsis", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b8058a10-911d-48ed-948e-74fefbe12a78", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.8, "x": 0.1, "y": 0.24 }, "kind": "paragraph", "text": "Q. In your German study reported here, in 15% of cases the PhenoTest panel was either not broad enough or the number of cells were insufficient. How are you planning to address this limitation of your test system?", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "c85c93eb-02d7-42c7-aecb-539b9c7afc59", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.8, "x": 0.1, "y": 0.15 }, "kind": "paragraph", "text": "At ECCMID 2019 we interviewed an AXDX rep to better understand the reasons for a narrow coverage of their test. It appears that it is linked to a fundamental limitation of the FISH method, used in Pheno system for ID testing.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "eb85920d-3086-4cc7-b2ec-df28f43e26e4", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "A. 15% is about accurate. Our panel covers about 85% of organisms. Our panel does not cover 100% of bug/antibiotic combinations, so you still need cell culture. It is not easy to cover 100%, because we use FISH probes and they may not be available for some bugs. Because of the FISH method we are somewhat limited. — AXDX Representative", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-78b4-70ad-b39f-b52abc721ef0", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 9, "from": 3, "beatId": "c35db6aa-1659-4676-9230-380b8888605a", "arcName": "Problem-Agitate-Solution", "arcSlug": "problem-agitate-solution", "beatName": "Problem (Identify pain)", "beatSlug": "problem-agitate-solution-problem-identify-pain", "evidence": "The document highlights several issues with the Pheno system, including its narrow coverage of microorganisms and antibiotics, contamination risks, and the over-hyped criticality of AST testing for blood infection.", "position": 0, "confidence": 0.8, "parentBeatName": "Complication", "parentBeatSlug": "complication" } ], "loops": [ { "to": 9, "from": 5, "name": "Zoom In", "slug": "06-zoom-in", "bestFor": "Technical deep-dives, case studies, detailed analysis", "matchId": "4b8bad5d-bf36-4c0a-9c1e-2294d891556c", "evidence": "The document zooms in on several specific limitations of the Pheno system, including its narrow coverage of microorganisms and antibiotics.", "position": 0, "objective": "What are the limitations of the Pheno system?", "structure": "The Big Picture -> Key Area of Focus -> Specific Detail -> Implication", "confidence": 0.8, "description": "Start broad, then progressively focus on specific details that prove your point" } ], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }