Mad as Hell

Way back in 1976, long before the world of way cool whiz bang, there was great movie called Network. In the movie Peter Finch plays a struggling network anchor Howard Beale who basically loses it one day and goes on one of the greatest on-air rants ever. During the rant Beale encourages his audience to head to their windows and scream out loud that there as mad as hell and they aren’t going to take it anymore. Given the world we now live in we’re pretty sure this fabulous scene can be found on YouTube.

Well we’re going to do our own little Mad as Hell rant thanks to our friends at OneDrop who can’t seem to comprehend the concept of clinical trials. Yes, the folks at OneDrop rather than running real clinical trials have relied instead on fuzzy math to prove their way cool whiz bang toy works. OneDrop has a panache for using self-reported data, a major no-no, combined with fuzzy math to prove patients using their toy achieve better outcomes.

But OneDrop goes on step further as they are claiming they have amazing results and producing them quickly. Listen we have long known that OneDrop besides have a panache for fuzzy math has also taken chutzpah to new levels. We have no idea who writes their press releases or their numerous Facebook and Twitter posts but if you believe them you’d think besides helping patients with diabetes OneDrop has come up with a cure for the common cold.

Now for those of us who understand diabetes we can laugh off these many outrageous claims. We know that self-reported data combined with fuzzy math proves nothing. Or as Momma Kliff used to say; “These results aren’t worth the paper their printed on.” (Hey, keep in mind Momma Kliff didn’t have a computer.)

However, the problem comes when the main stream media who knows even less about diabetes than OneDrop picks up these stories. Rather than do even the slightest research they believe the manure OneDrop is spreading and report these results as if they were real, which they aren’t. Listen we have nothing against the main stream media but when it comes to diabetes they tend to be vastly under-educated.

Here is the most recent example of One Drop’s panache for bullshit. Last Thursday at the 39th Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine (SBM) the company unveiled a “peer-reviewed” study, which states the following;

“Method: We queried One Drop’s database for people with T2D and an ‘Expert’ for 3 months. Three mixed repeated measures models assessed 1st- to 12th-week change in average BG, percentage of high BGs, and percentage of in-range BGs by coach program (‘On Call’ vs. ‘On Track’). Unadjusted and adjusted logistic regression models tested the likelihood of a 12th-week average BG < 155 mg/dL if the 1st-week average BG was < 155 mg/dL.

Results: The sample (N=290) was 63% male with diagnosed diabetes for 7.1 ± 7.5 years. People (n=107) with a 1st-week average BG ≥169 mg/dL (eA1c ≥ 7.5%) had a -53.1 mg/dL lower average BG in week 12, p < .001, equivalent to a -1.9 lower eA1c. Average percentage of high BGs was -26% lower and in-range BGs +27% higher, p < .001. There was no interaction by coaching program. People with a 1st-week average BG < 155 mg/dL (eA1c ≤ 7%) had a higher likelihood (4.1 OR, 4.3 AOR) of maintaining an average BG < 155 mg/dL in week 12.

Conclusion: Among people with T2D paying for an ‘Expert’ and ‘Chrome’ meter with strips, average, objective BG improved among people with an initially elevated average BG, and was maintained for people with a low average BG at baseline. People paying for an in-app coach and meter with strips may be more motivated than someone not paying for these services. More studies employing different methods should evaluate the impact of apps with coaching for people with diabetes.”

So, let’s see if we’ve got this right;

1. “We queried One Drop’s database” – translation self-reported data

2. “equivalent to a -1.9 lower eA1c” – basically what this means is that IF these results were real these patients might lower their A1c -mind you there is no independent verification of this – think of it this way right now the Chicago Cubs are 7-7 right at the .500 mark – using OneDrop’ s fuzzy math this means if these results continue through the remainder of the season the Cubs will finish at 81-81 and likely miss the playoffs. Simply put OneDrop is extrapolating, yes, we know this is a big word even for us, this self-reported data into A1c results or put even more simply it’s BULLSHIT.

3. “More studies employing different methods should evaluate the impact of apps with coaching for people with diabetes.” Ya think. Like how about real clinical studies that do not use self-reported data, use blood tests to verify A1c results and can be replicated by others.

Ok how about some facts, now this where the folks at OneDrop will surly tune out as facts are not something they are well acquainted with;

1. We understand why OneDrop is doing this, as they know like everyone else does that for payors to adapt and pay for their way cool whiz bang toy they must prove their system produces results and does so quickly. They know as everyone else does that the average time a patient spends on a plan is between 24 to 30 months which is why it’s so important not just to produce results but produce them quickly.

2. Outrageous claims grab headlines and create free publicity. We have never claimed the people at OneDrop were stupid, they know what we explained earlier the main stream social media driven media will report whatever crap OneDrop states without doing even the slightest due diligence.

3. The one thing OneDrop does well is they know how social media works and they can manipulate social media. Just as the snake oil salesmen of old claimed they could turn sand into gold, OneDrop is claiming they take patients with diabetes to the promised land. Listen we’re not very religious but we seem to remember something about false prophets.

4. OneDrop in spite of what they claim is not the only company with this whiz bang way cool toy, just last week we reported on Livongo raising another $105 million and Livongo does the exact same thing as OneDrop. Thankfully Livongo does not make outrageous claims based on self-reported data combined with fuzzy math which are meaningless and complete and utter BULLSHIT.

This is the reason we are as Howard Beale said mad as hell and not going to take this anymore. Listen we have nothing against what companies like OneDrop are trying to do. However, we will not sit ideally by while OneDrop attempts to pawn off self-reported data combined with fuzzy math as the gospel. Or as Michael Bassey Johnson once said; “You can believe in whatsoever you like, but the truth remains the truth, no matter how sweet the lie may taste.”