The Ledger
Every statement that passed quotation and attribution checks. Mix any filter with any other: certainty 1/5, debate potential 5/5, or both at once.
why aren't all 197 resolved? a statement only gets an assessment when the public record can support or contradict it. opinions and what-ifs never can, and 3 checkable ones are still open, waiting for their date. predictions held up or didn't; assertions are supported or contradicted. on every card: ▮▮▮▮▮ certainty · ▮▮▮▮▮ debate potential. speakers are clickable
Pande: Cancer could easily not exist in 10 years
“Cancer could easily just not exist in 10 years, and that's due to this change in how we think about things, and there's all these things on the back end.”
Vijay Pande: Compute costs will fall a million-fold over 20 years
“The nice thing about the exponentials is that, you know, things will go down a factor of a thousand, like, every 10 years on the Moore's Law side, and we'll continue to see that. So, a thousand, maybe in 20 years, a million, you know, a thousand times a thousa…”
Pande: Healthcare AI needs a 10x improvement threshold to overcome stigma
“Yeah, so I think the bar is different. This might be the magic has to get to 10 X. Mm-hmm. Something where 10% is probably within noise and without doubt or something like that, but 10 X is kind of the thing where, like, okay, okay. We have to think of things …”
Pande: Healthcare service providers will eventually transition into AI companies
“Well, you can imagine a services company that's providing some sort of healthcare service. It's training AI with its workers. And then the easy things, which are probably the boring things anyways, AI starts to do. And then the more interesting, complicated th…”
Pande: FDA rejects new drugs that are cheaper but equal in efficacy
“If you had a drug that was as good as the best drug, but cheaper, That still can't get that won't go by the FDA because they actually has to be better than the last drug, even if it's not better scientifically, but it's better in other ways.”
Pande: The world's largest company will be in consumer health tech
“The biggest company in the world will be a consumer health tech company.”
Pande: AI is turning scientific discovery into an industrialized process
“Today, what I want to talk about is how AI is industrializing discovery.”
Pande: AI biomarkers achieve 90% accuracy compared to 50% for PSA tests
“Like a PSA test is roughly 50% accurate. These new AI discovered biomarkers are considerably more accurate, you know, with sensitivity and specificities in the nineties.”
Pande: Animal models will become machine learning inputs, not pass/fail tests
“We're not going to think about these models as some sacrosanct up or down vote. That they are basically going to be features into machine learning where you're going to have this as the inputs and label data in humans from previous experiments to be able to co…”
Pande: Machine learning will cut protein therapeutic costs by up to 90%
“If you could use machine learning methods to decrease the cost, and there's a lot of reason to think the cost could go down by half or a fifth or even a 10th, that would have a huge impact on drugs, as well as all the different proteins that are used in the bi…”
Pande: Real-world evidence will surpass clinical trials in utility
“And what I think we'll start to see is, especially as new statistical methods come online, that real world evidence will be very useful, in some ways will be more useful than what you can do in a clinical trial, both due to power and due to the fact of real li…”
Pande: Many students attend graduate school out of low risk tolerance
“A lot of people go to grad school because they're actually Not very risk tolerant. You know, that grad school is a comfortable thing to do.”
Pande: A dual-skilled generalist outperforms separate bio and CS experts
“And maybe I would just add, you know, what happens if you don't have this, and you try to substitute this with an A-plus computer scientist joined with another person who's an A-plus biologist. The problem there is they just do not know what the other one does…”
Pandey: Pharma companies will reframe themselves as data science companies
“Pharma companies will start to view themselves more as data generating companies and data science companies.”
Pandey: The future physical world will be engineered biology, not steel
“The future will not be steel and metal. It will be this sort of engineered biological thing that just grows, that has this function.”
Pande: AI early detection could be the missing link to curing cancer
“This is where AI could really be a part of the key missing link towards the cure to cancer.”
Pande: Genomic diagnostics scale across cancer types via repeatable engineering
“Science is something that you can't schedule creativity or the ability to come through a breakthrough. So if you have understood the science of colorectal cancer, what you've learned about a stool test probably is not going to be very useful for a breast cance…”
Pande: Data network effects never go off patent like biotech drugs
“Data network effects never go off patent. They just get stronger and stronger and help companies grow even after, even decades after.”
Pande: Biological engineering requires predictive accuracy, not 100,000 empirical guesses
“It's all about, can you make predictions? So if you think you can engineer something, you should be able to make 10 predictions and have three work, not making a 100,000 guesses and seeing what pans out.”
Pandey: Quantum computers will suddenly surpass classical computing at a specific threshold
“What will happen is a quantum computer at first will seem like it won't be all that useful. It will be below the number of qubits that you need. Maybe you need a hundred qubits to solve the problem and the existing machine only has 64. And so a classical compu…”
Pandey: Quantum computers do not need 100,000 qubits to deliver useful chemistry simulations
“Or enzymes. It's all the chemistry, you know, so, so this is something where a quantum computer could be able to do calculations that are either much bigger at much higher accuracy where actually would be essentially much bigger at higher, much much higher acc…”
Pande: Software will prove far more effective than small molecules for behavior
“I can imagine 10 years from now people would be like, well, what'd you expect? I mean, you wouldn't expect this small molecule that we didn't have like this Sense for how all of the human brain works and understanding behavior from a fomental molecular biologi…”
Pande: Digital therapeutics data moats outperform traditional pharmaceutical patents
“And you have an interesting barrier to entry that is far superior than something like patents.”
Pande: AI will accelerate doctors long before replacing them
“And I think before we talk about replacing doctors at all, that doesn't make any sense when we could be accelerating them. Exactly. And having them do so much more. And I, I'm pretty sure we'll see that first. Just like you don't think a word processor with a …”
Pande: Developing countries will leapfrog the West in computational healthcare
“I can imagine leapfrogging in, in countries like this that don't have the infrastructure we have now, and that they would have an even greater benefit to moving quickly into this future.”
Vijay Pande: Data network effects offer a permanent moat unlike drug patents
“The intriguing thing is about, ah, data network effect never goes off patent.”
Pandey: 80% of cancers could be cured if caught early enough
“There is some really tantalizing possibilities here that 80% of all cancers could be cured with existing drugs if we caught them early enough and we knew to give them early enough”
Digital therapeutics can outperform traditional drugs for diabetes treatment, says Vijay Pandey
“And I believe actually Modis had done this, and in this case, one can show actually that, that digital therapeutic is not just comparable to the drug, but in, and generally can exceed the capabilities of the drug.”
A large fraction of published biological experiments are irreproducible, says Vijay Pandey
“It comes up all the time that a large fraction of biology experiments are just irreproducible.”
The cure for cancer will never be a single drug, predicts Pandey
“And it's never going to be that the cure to cancer looks like a single drug.”
Computational biology startups follow Moore's Law instead of Eroom's Law, says Pandey
“That traditional biotech is governed by Oom's law, and these are governed much more by Moore's law.”
Bio startups can reach clinical trials on $500,000 seed capital, says Pandey
“Basically half a million to a million dollars is all they really need to get the job done. And that could get you something through preclinical, which is what mouse studies are, such that you could have something go into phase one or phase two with that initia…”
Globivir computationally identifies repurposed drug candidates in just nine months, says Pandey
“Instead of taking 15 years and, you know, a hundred million dollars to do the first part, we could, in the case of our drugs for a lot of these areas, we could do it in nine months.”
Pande: Biotechs and pharma will eventually become data science companies
“People point to AI and machine learning, but really that's, I think, just a surrogate for the fact that data is being used very efficiently, and we have so much more data, and we do have techniques that actually didn't exist before, but in many ways it's, ah, …”
Pande: Pharma companies will transition into data generation and data science companies
“And I think we're seeing this more and more, where pharma companies will start to view themselves more as data generating companies. And data science companies as machine learning gets in,”
Pande: AI genomic analysis will outperform humans in cancer detection
“So the hypothesis here and the opportunity is that this is something that we could do considerably with AI considerably more accurate than people.”
Pande: Omada's digital therapy demonstrates greater diabetes efficacy than metformin
“AMADA has a behavioral therapy, which is in a sense similar to areas like cognitive behavioral therapy, or CBT, derived from the CDC's Diabetes Prevention Program. And AMADA can demonstrate efficacy that actually exceeds that of metformin.”
Pande: Freenome's genomic ML will drive cancer cure rates to 80-100%
“So a company like Freenome will use machine learning and deep learning with genomics to be able to tell whether you have cancer early enough, such that the cure rate, success rate could be 80%, a hundred percent.”
Pande: Software as a drug will revolutionize medicine like biologics
“You think about, like, Genentech in the early days of biologics. In the early days there, people may have said, you know, a protein can't be a drug. But now that's something that's well recognized. I think some people might say, software can't be a drug. But s…”
Pande: Bio-IT return multiples will look like software multiples
“The return multiples in this space I think will look like software multiples because these are software companies. These are companies that have software in their heart, they have high margins, they have all the things we like about software, we de-risk them t…”
Pande: Current healthcare technology is mostly just digitized user interfaces
“So in terms of technology, I think there is technology in healthcare, but it's largely in a user interface. So like MRI is really the same MRI from like the fifties just now with on a computer display. And so that's not really tech. That's actually, I would ca…”
Pande: Big Tech's healthcare initiatives will remain minor side experiments
“I suspect that for those reasons, it's something that The big tech companies will try, and we've seen Apple and Amazon and Google all dabble, but I think those experiments probably won't fit the way they want to build their company, and so I think they'll stay…”
Pande: 80% of late-stage drug failures stem from flawed biology
“What is it, like, 80% of drugs fail in phase two or three in trials, and that's not because it's toxic, it's because we screwed up the biology.”
Vijay Pande: Legacy Healthcare Data Advantage Is Overestimated
“The sort of spicy take on it is maybe not as much as they think. You know, because the temptation is the data's there, and this may be true for pharma too, may be true for pair of providers that, that data, there's a lot of it, but it might not be as good as t…”
Pande: Medicine will transition from a human problem to a data problem
“I think we'll get to that point where medicine will be about incorporating all this data. Data about me as a patient, data about everyone else that's like me to be able to draw the best conclusions. That's something that is just a computer problem. And that mu…”
Pande: AI adoption in medicine will progress from nursing to specialists
“We're gonna see it gradually, where first it's some bits of nursing, then more of nursing, then some bits of a GP, then maybe some bits of a specialist, and maybe certain specialists like neurology or something like that, where it's about prescribing drugs bas…”
Pande: FDA regulations would not have prevented the Thalidomide crisis
“Ironically, nothing that the FDA has done would have helped the phlegmide crisis because you don't test on pregnant women and so on”
Pande: Fee-for-service healthcare financially disincentivizes curing patients quickly
“If you know, you're just providing services, You may even want to be a therapist as an annuity. You know, the therapist is there for a long time. Curing someone quickly may not be what you're financially incentive for”