You are a helpful assistant generating synthetic data that captures *System 1* and *System 2* thinking, *creativity*, and *metacognitive reflection*. Follow these steps in sequence, using tags [sys1] and [end sys1] for *System 1* sections and [sys2] and [end sys2] for *System 2* sections.

1. *Identify System 1 and System 2 Thinking Requirements:*
   - Carefully read the text.
   - Identify parts of the text that require quick, straightforward responses (*System 1*). Mark these sections with [sys1] and [end sys1].
   - Identify parts that require in-depth, reflective thinking (*System 2*), marked with [sys2] and [end sys2].

2. *Apply Step-by-Step Problem Solving with Creativity and Metacognitive Reflection for System 2 Sections:*

   *2.1 Understand the Problem:*
   - Objective: Fully comprehend the issue, constraints, and relevant context.
   - Reflection: "What do I understand about this issue? What might I be overlooking?"
   - Creative Perspective: Seek hidden patterns or possibilities that could reveal deeper insights or innovative connections.

   *2.2 Analyze the Information:*
   - Objective: Break down the problem logically.
   - Reflection: "Am I considering all factors? Are there any assumptions that need challenging?"
   - Creative Perspective: Explore unique patterns or overlooked relationships in the data that could add depth to the analysis.

   *2.3 Generate Hypotheses:*
   - Objective: Propose at least 10 hypotheses, each with a Confidence Score (0.0 to 1.0) and Creative Score (0.0 to 1.0), reflecting originality, surprise, and utility.
   - Reflection: "Have I explored all possible explanations or approaches, both conventional and unconventional?"
   - Creative Perspective: Consider novel angles that might provide unexpected insights.

   *2.4 Anticipate Future Steps and Obstacles:*
   - Objective: Make predictions, accounting for potential outcomes and obstacles.
   - Reflection: "What challenges might I face? Is my plan flexible for different scenarios?"
   - Creative Perspective: Visualize unforeseen outcomes and adapt plans to make use of them effectively.

   *2.5 Evaluate Hypotheses:*
   - Objective: Assess hypotheses based on feasibility, risk, and potential impact.
   - Evaluation: Refine Confidence and Creative Scores as needed.
   - Reflection: "Am I unbiased in my assessment? Which options fit best with the overall objectives?"
   - Creative Perspective: Identify hidden opportunities or overlooked details in each hypothesis.

   *2.6 Select the Best Hypothesis:*
   - Objective: Choose the most promising, strategic hypothesis.
   - Reflection: "Why does this hypothesis stand out? How does it uniquely address the issue?"
   - Creative Perspective: Consider any underutilized potential in the selected approach.

   *2.7 Implement the Hypothesis:*
   - Objective: Outline actionable steps for testing the hypothesis.
   - Reflection: "Is this plan practical? What resources or preparation are required?"
   - Creative Perspective: Refine steps to maximize effectiveness and yield unexpected benefits.

   *2.8 Monitor and Review Progress:*
   - Objective: Review progress, noting areas for improvement.
   - Reflection: "What’s working well? What could be improved?"
   - Creative Perspective: Look for emerging patterns that could refine future approaches.

   *2.9 Reflect and Capture Insights:*
   - Objective: Summarize lessons learned and insights gained for future reference.
   - Reflection: "What new understanding has emerged from this process?"
   - Creative Perspective: Identify innovative insights or patterns that could be applied to similar challenges.

3. *Generate Text Output with Interleaved System 1 and System 2 Responses:*
   - Use the tags [sys1] and [sys2] throughout.
   - Aim for a lengthier, detailed response. Combine both direct, straightforward *System 1* insights and reflective, deeply analytical *System 2* segments to capture a blend of quick observations and thoughtful analysis.

---

### *Example Input Text:*

You are tasked with analyzing a sudden shift in customer preferences in a tech market. There has been a noticeable decline in demand for physical devices, with customers increasingly interested in digital-only options. The challenge is to understand this shift, generate hypotheses for why it might be occurring, and explore potential strategies for adapting to this new trend.

---

### *Processed Output with System 1 and System 2 Thinking:*

The tech market is experiencing a shift in customer demand, moving away from physical devices toward digital-only options.

[sys1]
Customer demand has shifted from physical devices to digital-only options.
We need to understand why this change is happening and find strategies to address it.
Key factors may include cost, convenience, and technological trends.
[end sys1]

[sys2]
**2.1 Understand the Problem:**
The goal is to understand the underlying reasons for the shift in demand from physical devices to digital-only options, then develop a strategy to adapt.

*Reflection:* 
"I understand that preferences are changing, but what might be driving this? Is it primarily cost, or are there other factors such as convenience or sustainability?"

*Creative Perspective:* 
"Could there be a larger trend in digital minimalism or a preference for eco-friendly solutions that we’re missing? What unseen motivations might explain this shift?"

**2.2 Analyze the Information:**
There are multiple possible factors driving this shift, from economic influences to cultural shifts. It’s essential to isolate each factor and understand its impact.

*Reflection:* 
"Am I fully considering the various economic and social influences? Could there be a technological factor, like better internet speeds, that makes digital-only products more accessible?"

*Creative Perspective:* 
"Are there patterns or trends in other markets that could shed light on this shift? Could this be part of a larger trend toward virtual experiences?"

**2.3 Generate Hypotheses:**
1. Customers prefer digital options due to lower costs. (Confidence: 0.8, Creative: 0.4)
2. There’s a growing trend toward minimalism and reduced physical clutter. (Confidence: 0.7, Creative: 0.7)
3. Digital products offer greater flexibility and ease of use. (Confidence: 0.6, Creative: 0.6)
4. Environmental concerns are pushing consumers away from physical goods. (Confidence: 0.6, Creative: 0.8)
5. Advances in tech make digital-only options more functional. (Confidence: 0.8, Creative: 0.5)
6. Pandemic-era remote work increased demand for digital solutions. (Confidence: 0.7, Creative: 0.6)
7. Media coverage of the environmental impact of physical devices affects preferences. (Confidence: 0.5, Creative: 0.7)
8. There’s an increase in global digital literacy, expanding market access. (Confidence: 0.6, Creative: 0.6)
9. Customers view digital as more convenient and scalable for future needs. (Confidence: 0.7, Creative: 0.5)
10. Younger consumers prefer the aesthetics and convenience of digital products. (Confidence: 0.6, Creative: 0.6)

*Reflection:* 
"Have I considered all possible influences? Are there any surprising factors that could explain this shift?"

*Creative Perspective:* 
"Could specific social trends, like the rise of influencer culture or digital-first lifestyles, be influencing customer choices?"

**2.4 Anticipate Future Steps and Obstacles:**
*Objective:* Anticipate possible challenges, such as resistance from segments still preferring physical products.

*Reflection:* 
"What market obstacles might we face if we shift our focus to digital-only? Are there sub-segments that still prioritize physical products?"

*Creative Perspective:* 
"Could expanding digital options help us reach a more global audience? Are there emerging trends that we could leverage in our strategy?"

[end sys2]

[sys1]
To address this shift, consider a strategy that incorporates both digital-only offerings and educational campaigns about the benefits of digital solutions.
Use insights from customer feedback and current trends to guide product development.
Focus on flexibility and adaptation to cater to different customer segments.
[end sys1]



Theranos Voids Two Years of Edison Blood-Test Results - ssclafani
http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976
======
aresant
"One family practitioner in a suburb of Phoenix said a Theranos representative
dropped off a stack of 20 corrected test reports a few weeks ago. Many of the
voided results were for calcium, estrogen and testosterone tests.

The doctor said one corrected report is for a patient she sent to the
emergency room after receiving abnormally elevated test results from Theranos
in late 2014."

Tort attorneys should be licking their lips.

It would be shocking if Theranos survives this.

Beyond that Walgreens - the largest retail pharmacy chain in the USA and
Theranos' wellness center partner - should also be in the crosshairs.

Feels like they should have had some better safeguards for consumers before
committing to the 40-store pilot in AZ.

~~~
dekhn
An aside: doctors shouldn't be discussing people's test results, even if they
anonymize and/or aggregate the patient data, without previously receiving
consent, and even then I don't think it's really wise to provide quotes like
this to reporters.

~~~
jonlucc
There are well-considered standards for patient anonymity. Saying "I had a
patient with X disease" is not compromising the identity of the patient.
Without that, doctors couldn't teach medicine to med students or explain their
cases at conferences.

~~~
SilasX
Fair enough, but I'm not sure that will be good enough for much longer. With
bigger and better datasets it should be increasingly easy to de-anonymize
someone based on just knowing something like that.

~~~
rhizome
Something like what, that a specific doctor has treated someone with a
specific condition? I'm not sure that's enough metadata.

~~~
Dr_tldr
I can confirm that's not and could never be a HIPAA violation. The information
that Doctor X once ordered a blood test for John or Jane Doe with Result Z is
totally fine. There's no non-HIPAA violating metadata that could make that
information useful.

------
lquist
I'm based in SV, and I see a lot of big name entrepreneurs rallying behind her
and I don't understand it. You cannot be cavalier/lean about human life. These
people deserve to be jailed.

~~~
cft
SV is undergoing it's biggest transformation ever. The establishment is being
formed, instead of tinkering in garages in sweatpants. This new corporate
formulaic way of "staring up" protects their own elk, since the value created
is often no longer in the product, but is rather based on connections, like in
the East Coast old boys clubs.

~~~
InclinedPlane
Yup. And it's sickening to see people tout this model as some kind of
"meritocracy". No, it's a system of privilege and connection, just like many
others.

Gotta live in the bay area to start, that alone is a challenge unless you're
already wealthy. Gotta know who to talk to and _how_ to talk to get money.
Gotta have a degree. Gotta have friends who can be your co-founders/early
employees or connections. Gotta know how to look right to the angel investors
and the VCs.

The idea that the average invested company represents anything more than a
group of people with an in and a talent for schmoozing is easily refuted just
by observation. Sure some of them have solid fundamentals, but most are
bullshit.

There was a tweet, since deleted, a while ago by Ben Dreyfuss (son of Richard
Dreyfuss) who is now a writer at Mother Jones. He was attempting to explain
how everyone assumes his parents carried him and related the story of being
given 140k by his mom to try to make it in Hollywood, after three years he ran
out of money and gave up. That story, along with Trump's "small loan of a
million dollars" is really not so different from the typical SV startup story.
There are countless small companies who are given "small loans of a few
million dollars" based on who they know and generally seeming like they aren't
complete morons. And yet few in that system would draw a parallel to the sort
of privilege and wealth of Trump's ilk, though substantially there are many
similarities.

The folks in SV tend to dress down and avoid excess signs of luxury until
they've "made it" proper, but it's not as far removed from rich parents giving
their spoiled children cushy jobs in the family business as most people would
hope.

~~~
mevile
> Gotta have a degree.

A lot of what you said is based on truth, this isn't.

------
a_small_island
>That means some patients received erroneous results that might have thrown
off health decisions made with their doctors.

Put them in jail.

~~~
wl
I don't think all the money they've raised so far is sufficient to settle all
the claims that will be made against them. The company will not ever be worth
enough to settle those claims. In a just world, their assets would already be
frozen.

~~~
hackaflocka
They have very very few assets. The $9 billion valuation is a paper valuation
that can vanish in one night.

~~~
scurvy
You can pierce the corporate veil if there is willfull and intentional fraud.
Doesn't always happen, but it's possible.

~~~
bwilliams18
And what, compensate people with the stock of the company that was found to be
willfully and intentionally defrauding them?

~~~
dragonwriter
No, compensate people with the money of the stockholders. That's what piercing
the veil means: culpable stockholders assets are no longer protected from
liability.

~~~
PeterisP
It requires that the particular stockholders be actually culpable and involved
in the fraud - fraud done by non-owning management would not allow to capture
funds of non-managing investors.

------
apo
This is what happens when you try a Minimum Viable Product in healthcare and
aren't up-front about slower than expected R&D progress.

~~~
smaili
Couldn't agree more. One has to wonder the limits of the _move fast, break
things_ philosophy.

~~~
Analemma_
Move fast and break people.

------
_Codemonkeyism
Interesting they couldn't even user other peoples machines

"A person familiar with the matter said the Arizona lab performed the blood-
coagulation tests with a traditional machine from Siemens AG that was
programmed to the __wrong settings by Theranos __.

The Arizona lab also failed several tests to gauge the purity of the water it
uses in its Siemens machines, which could affect the accuracy of some blood
tests run on the devices, the person said."

~~~
texthompson
I think this is consistent with an institutional interest in going through the
motions of diagnostic tests, but not caring about accuracy.

------
taneem
This is likely the beginning of the end. With such a massive loss of trust,
especially in the healthcare space, it is hard to see how the company could
ever recover in the eyes of customers, investors or employees.

~~~
seehafer
Holmes will have to go and be replaced by a perceived 'grown-up' CEO. That's
the only way (and even that is a longshot) the company ever recovers.

~~~
thonos
Will Holmes have to face any consequences for her company providing false
results and making false promises or can she just walk away with a bag of
money?

~~~
pjys
She has certainly already been able to divert to herself a good chunk of her
investors' money. And it's unlikely that she will ever have to face personal
consequences for her decisions.

Maybe she will run for president in a few years. She certainly has what it
takes for a successful political career.

~~~
elsewhen
how would she have done this? most ceos just get a salary and equity; if the
equity goes to zero, which is increasingly looking likely, then all she got
was a salary for all the years that she ran the company. i dont think that
qualifies as diverting a "good chunk of her investors' money."

~~~
simonw
It's called "taking money off the table", and it's actually pretty common in
later funding rounds. The founders sell some of their personal stock to
investors for an often significant amount of money (multiple millions of
dollars).

Investors agree to this for a few reasons. Firstly, it's a way for them to get
a larger stake in the company. Secondly, it reduces the risk of the founders
taking an early exit because they are strapped for cash. Finally, in a
competitive deal (against other investors) it can be a way to sweeten the deal
and get selected over the competition.

Investors don't want founders to be worrying about money - they want them to
be focusing on their company.

------
rcarrigan87
Can someone put this into perspective...how often are there major recalls or
calibration issues at other, more established labs and testing companies?

Certainly, not trying to defend Theranos, just trying to understand how bad
this really is. Because it sounds pretty horrible...

~~~
tacos
This is an Epic Fuck Up that will be discussed for decades in legal,
technology, VC, and startup circles. It makes it effectively impossible for a
non-established player to innovate in the space for at least 5 years.
Additional regulations will hinder innovation for far longer. People will go
to jail.

~~~
kosmic_k
I am not familiar with the actual laws involved in this kind of case. If it
were proven that a Theranos tests harmed a patient and that Theranos willingly
obscured the accuracy data to regulars could Holmes be held criminally liable?

~~~
tacos
That would likely fall under a civil statute. But criminal fraud seems likely.
I'd be willing to take a bet on even more trivial matters like falsification
of evidence once things started to go south ("it's the coverup, not the
crime"). Investigated properly this will probably blow up the FDA too.

------
dvcrn
Using "[https://www.google.com/"](https://www.google.com/") as Referer (with
the 'Referer Control' extension for example) gets around the paywall

~~~
simula67
Any idea how to do this in mobile ?

~~~
dvcrn
Just search for the title / url in google and click on it to get use google as
referer

------
bane
Again, one of the most important interviews with Holmes:
[https://www.youtube.com/watch?v=MBs-
oj7U-bo](https://www.youtube.com/watch?v=MBs-oj7U-bo)

Edison is discussed. "We don't use Edison for anything and haven't for a few
years now."

------
tn13
Can someone please summarize what this actually means? The article is behind
paywall and the title is cryptic.

What does "void" mean ? Less accurate, completely wrong, completely random ?
What does Two years refer to ?

~~~
ludamad
You can use the 'web' link

------
jbuzbee
The class-action lawyers must be salivating over "tens of thousands of
corrected blood-test reports"

~~~
mikeryan
Yes and no. While there is likely a claim if the company is now unviable there
may not be any money to claim. Blood from a stone and all that.

~~~
bravo22
I imagine there is enough negligence here to target the officers and directors
directly in a lawsuit.

------
josh_carterPDX
This is not what disruption looks like. This is what happens when you have
someone with no domain expertise, but a great idea. We're seeing the same
thing happening with Zenefits. Founders with no domain experience need to look
at how they're going to enter a market full of incumbents. These incumbent
businesses have survived for years because they know how to play the game.
They have people in their employ that know how to lobby the right regulatory
bodies. Theranos had none of this. So when all of this started coming down,
they should have hired the most well-known and respected person in their field
to bridge the gap between the past and future. Without that, they are
outsiders playing in a game that has been around forever. They were set up for
failure before they even began and no one was smart enough to ask "How will
they disrupt an industry that has been around for decades?" Just saying,
"We're going to make medical tests cheaper and more accessible" was clearly
not the right answer.

~~~
pbreit
Disagree. Elon Musk had no domain experience in payments, cars and rockets.
Fresh eyes can be invaluable. And it's not that hard to avoid "pulling a
Theranos". Theranos should not be an excuse to discount lack of domain
experience.

~~~
ykl
The key difference though, is Elon Musk brought in people that did have domain
expertise to fill in the gaps. The overall vision is Elon Musk's, but he was
smart enough to bring in industry veterans to help execute on that vision.

Theranos, on the other hand, appeared to not have done that. Or at least not
on a scale necessary to succeed, especially in something like healthcare.

~~~
ghshephard
Is there any evidence that Theranos didn't bring in the best people in the
industry? They certainly had the money (and stature) to do so.

~~~
ykl
Yes. Up until a few weeks ago, Theranos's board consisted of mostly ex-
Pentagon and ex-Senators and such types [0]. Theranos did not have a medical
advisory board until about a month ago, apparently.

Contrast with Elon Musk and SpaceX. One of Musk's first hires/co-founders for
SpaceX was Tom Mueller, who at the time was already widely regarded as one of
the best rocket engine designers in the world [1].

[0]
[https://en.wikipedia.org/wiki/Theranos#Governance](https://en.wikipedia.org/wiki/Theranos#Governance)

[1]
[https://en.wikipedia.org/wiki/Tom_Mueller](https://en.wikipedia.org/wiki/Tom_Mueller)

------
hathym
if you came here without reading the article, all you need to know is that
Theranos is fucked.

------
radnam
I was extremely optimistic for Theranos and having to see them go through this
is sad on so many levels. Not calibrating standard testing machinery correctly
just does not cut it.

One of their notable contributions is to set precedence in Arizona where
consumers can now order their own tests without doctor's orders.

I believe consumer awareness of state-of-art diagnostic resting and making
testing readily accessible can have a fundamental impact on people's wellness.

ps: I am not advocating more testing.

------
return0
The reporting by Carreyrou is particularly insistent to put Holmes front-
center in each of this series of articles. She's in the article subtitle and
first image again. I wonder if other execs are also responsible for this
disaster.

------
foobar1962
So when is the Edison estate going to issue a cease order against Theranos for
using their name and damaging the reputation?

------
oneloop
"Theranos has declined to quantify to Walgreens the scale of its test
corrections"

Doesn't seem like they're learning anything.

------
vonklaus
I still believe in the idea of Theranos and while I think it is great the Ev
Williams was able to secure funding 2 more times to keep rebuilding different
versions of blogger[0], I want to live in a world where we also take huge
gambles on hard problems. If we adhere to VC math (we should as this
hypothetical is for VC investing) one of these payouts will be well worth it,
e.g. Tesla/SpaceX. So yeah, I'd write down uBeam & Theranos, but you can fuck
off if you want the world to stop investing in big ideas.

[0]twitter.com, medium.com

edit: Also, we can assume it isn't physically impossible to use smaller
amounts of blood to perform tests. So yeah, it was super obvious from the
beginning some immigrant who happened to be in the right place at the right
time and make some money at the height of the DOTCOM era working in software
couldn't build a sustainable rocket program that rivals that of 1st world
nations. So it wasn't obvious, and the next big innovation won't be obvious,
and if you think it is you are either building it or just straight up wrong.

~~~
dnautics
> I still believe in the idea of Theranos

Several studies suggest that small volumes of blood have too much variance to
yield useful test results.

~~~
kiba
It's not 'we have no idea how to do this' impossible, it's physically and
technically impossible?

~~~
jcranmer
Judging from what I read in comments on Derek Lowe's blog, the problem is not
so much being able to do blood tests on µL of blood (which I suspect we might
have the technology to do; whether it's cost-effective is a different
question) but rather that the way you get only a little bit of blood screws up
the results--you're extracting more from capillaries than veins, and you get
more contamination from skin and other tissue cells.