Share to FacebookShare to TwitterShare to LinkedinBrigham Hyde, cofounder and CEO, Atropos Health.Atropos Health

分享给FacebookShare，推特分享给LinkedinBrighamHyde，Atropos Health的联合创始人兼首席执行官。Atropos健康

Doctors usually counsel people with diabetes not to abruptly switch or stop taking their regular medications before a surgery. That’s why David Klonoff, an endocrinologist who treats people with diabetes, was surprised when the American Society of Anesthesiologists issued guidance last summer saying patients should stop taking GLP-1 agonists, the new diabetes and weight loss drugs like Wegovy and Ozempic, before any scheduled surgery.

医生通常建议糖尿病患者在手术前不要突然改变或停止服用常规药物。这就是为什么治疗糖尿病患者的内分泌学家大卫·克洛诺夫（DavidKlonoff）感到惊讶的原因。去年夏天，美国麻醉医师协会（American Society of Anesthesiologists）发布了一项指导意见，称患者应在任何预定手术前停止服用GLP-1激动剂，即新型糖尿病和减肥药物，如Wegovy和Ozempic。

“I was concerned that the downside of that decision might be worse than the upside,” Klonoff, the medical director of the Diabetes Research Institute at Mills Peninsula Medical Center in San Mateo, California, told Forbes..

加利福尼亚州圣马特奥米尔斯半岛医学中心糖尿病研究所医学主任科洛诺夫告诉《福布斯》：“我担心这一决定的负面影响可能比正面影响更大。”。。

The drugs slow stomach emptying and the anesthesiologists were worried that patients on GLP-1 agonists might vomit during surgery, swallow some of it and end up with pneumonia, among other issues. The national anesthesiologist group decided the risks of potential complications outweighed the benefit of staying on the drugs.

这些药物会减缓胃排空，麻醉师担心服用GLP-1激动剂的患者可能会在手术过程中呕吐，吞下一些，最终导致肺炎等问题。国家麻醉师小组认为，潜在并发症的风险大于继续服用药物的益处。

But what irked Klonoff was that there was little evidence to support the position, aside from a handful of case reports. “There was no data,” he said..

但令克洛诺夫恼火的是，除了少数病例报告外，几乎没有证据支持这一立场。“没有数据，”他说。。

In medical school, doctors learn that randomized controlled trials are the gold standard to inform decision-making around how they should treat patients. But every day doctors have to make life-or-death decisions in situations that can’t be found in a clinical trial. They instead have to rely on training, intuition and experience to triangulate what’s best for an individual patient.

在医学院，医生们了解到，随机对照试验是告知他们应该如何治疗患者的决策的金标准。但医生每天都必须在临床试验无法发现的情况下做出生死攸关的决定。相反，他们必须依靠训练、直觉和经验来衡量对个体患者来说什么是最好的。

“There is not enough time and effort and money to do a randomized control trial for everything,” said Klonoff..

克洛诺夫说：“没有足够的时间、精力和金钱对所有事情进行随机对照试验。”。。

That’s why he joined the medical advisory board of Atropos Health, a startup Klonoff believes has come up with the next best alternative. Atropos is tapping into 200 million patient records to help doctors make decisions based on what’s happening in the real-world, outside of these carefully designed clinical trials..

这就是为什么他加入了Atropos Health的医疗顾问委员会，这是一家初创公司Klonoff认为已经想出了下一个最好的替代方案。Atropos正在利用2亿份患者记录，以帮助医生在这些精心设计的临床试验之外，根据现实世界中发生的事情做出决策。。

Say there’s a 45-year-old woman with bladder cancer – would she have fewer complications and better outcomes with radiation treatment or bladder removal? Atropos’ software combs through millions of those records to find similar patients and how they’ve fared and generates a statistical analysis in a matter of days – and, now with recent advances in generative AI – minutes..

假设有一位45岁的女性患有膀胱癌，那么放疗或膀胱切除术会不会减少并发症，改善预后？Atropos的软件梳理了数以百万计的这些记录，以找到类似的患者以及他们的表现，并在几天内（现在随着生成人工智能的最新进展）生成一个统计分析。。

On Thursday, Atropos announced a $33 million Series B round led by Valtruis, the venture growth arm of private equity firm Welsh, Carson, Anderson & Stowe. Forbes estimates the company’s valuation to be around $250 million; it has raised $54 million to date. Existing investors Breyer Capital, Emerson Collective and Presidio Ventures participated in the round, along with new strategic investors Cencora Ventures (formerly AmerisourceBergen), McKesson Ventures and Merck Global Health Innovation Fund..

周四，Atropos宣布了由私人股本公司Welsh，Carson，Anderson＆Stowe的风险增长部门Valtruis领导的3300万美元的B轮融资。《福布斯》估计该公司的估值约为2.5亿美元；迄今为止，它已经筹集了5400万美元。现有投资者Breyer Capital、Emerson Collective和Presidio Ventures以及新的战略投资者Cencora Ventures（前AmerisourceBergen）、McKesson Ventures和Merck Global Health Innovation Fund参与了这轮投资。。

Atropos has a radically different approach from most other health data companies. It doesn’t move healthcare data around to create one massive dataset. Instead, it runs separate queries on each data pile, or node, individually, which is known as a federated data model.

Atropos的方法与大多数其他健康数据公司完全不同。它不会移动医疗数据来创建一个庞大的数据集。相反，它分别对每个数据堆或节点运行单独的查询，这被称为联邦数据模型。

The uniqueness of the approach appealed to billionaire venture capital investor Jim Breyer, an early investor in Facebook, who’d realized how hard it is for doctors to share data across different hospitals when navigating both of his parents’ cancer diagnoses. “There are huge challenges in allowing medical professionals, be they great doctors or nurses, to have access to a full suite of data, which currently is as siloed as any industry that I know,” he told Forbes.

这种方法的独特性吸引了亿万富翁风险投资家吉姆·布雷耶（JimBreyer），他是脸书（Facebook）的早期投资者，他意识到医生在浏览父母的癌症诊断时很难在不同医院共享数据。他告诉《福布斯》：“让医疗专业人员，无论是伟大的医生还是护士，都能访问全套数据，这是一个巨大的挑战，目前，这些数据与我所知道的任何行业一样孤立。”。

Breyer joined Atropos’ seed round and board in 2020 and has participated in every financing since..

Breyer于2020年加入Atropos的种子轮和董事会，并参与了此后的所有融资。。

The startup is named for one of the three fates in Greek mythology whose scissors have the power to end or extend the lives of mere mortals. The hope is that by generating evidence to help clinicians make better decisions, the company can also help improve outcomes and extend people’s lives.“Every time we try and aggregate all the world's data into one place ...

这家初创公司是以希腊神话中三大命运之一命名的，它的剪刀有能力终结或延长凡人的生命。希望通过产生证据来帮助临床医生做出更好的决定，该公司还可以帮助改善结果并延长人们的寿命。“每次我们试图将世界上所有的数据汇总到一个地方。。。

the largest dataset always wins.”.

最大的数据集总是获胜。”。

Brigham Hyde, cofounder and CEO, Atropos Health

Atropos Health联合创始人兼首席执行官Brigham Hyde

Before starting Atropos, its CEO Brigham Hyde had spent a decade building and running companies that worked to aggregate healthcare data to sell to pharma companies for research. Companies pull this data together with the goal of creating a complete patient record, which is crucial to helping develop new drugs.

在启动Atropos之前，其首席执行官布莱根·海德（BrighamHyde）花了十年时间建立和运营公司，这些公司致力于汇总医疗保健数据，并将其出售给制药公司进行研究。公司将这些数据汇集在一起，以创建完整的患者记录为目标，这对于帮助开发新药至关重要。

For example, if a patient got a drug from one doctor’s office and surgery at a different hospital and a cancer diagnosis at another hospital, the data is only valuable if all the pieces of the puzzle are together..

例如，如果患者从一个医生的办公室获得药物，并在另一家医院进行手术，并在另一家医院进行癌症诊断，那么只有当所有拼图都在一起时，数据才有价值。。

But as Hyde discovered, the status quo, where companies simply buy up more and more data, is expensive and time-consuming. There’s risk to patients’ privacy, too — the more healthcare data that’s shipped around, the more risk there is for all of the parties involved under the federal privacy law known as HIPAA.

但正如海德所发现的那样，公司只需购买越来越多的数据，这种现状既昂贵又耗时。患者的隐私也有风险-运送的医疗数据越多，根据联邦隐私法（HIPAA）涉及的各方的风险就越大。

But crucially, Hyde realized there was one major flaw. “Every time we try and aggregate all the world's data into one place,” he told Forbes, “the largest dataset always wins.” Essentially, the dataset will be biased towards the entity that supplied the most data..

但至关重要的是，海德意识到存在一个主要缺陷。他告诉《福布斯》：“每次我们试图将世界上所有的数据汇总到一个地方，最大的数据集总是会获胜。”从本质上讲，数据集将偏向于提供最多数据的实体。。

Hyde cofounded Atropos with two experts in healthcare informatics: Nigam Shah, chief data scientist at Stanford Health Care, and pathologist Saurabh Gombar. The trio built software that runs its analyses on each individual data source, in this case, each healthcare institution, and then combines the results in what’s known as a meta-analysis.

海德与两位医疗保健信息学专家共同创立了Atropos：斯坦福医疗保健首席数据科学家尼格姆·沙阿（NigamShah）和病理学家索拉布·贡巴（SaurabhGombar）。三人组构建了一个软件，该软件对每个数据源（本例中为每个医疗机构）进行分析，然后将结果合并到所谓的荟萃分析中。

Using this technique, the company can provide doctors and researchers with retrospective studies based on how real people responded to different therapies. And because there’s no moving data around, there are fewer privacy concerns. Now, a researcher or company who wants to conduct a retrospective analysis doesn’t need to buy the data, said Hyde: “They can just buy the answer.”.

利用这项技术，该公司可以根据真实人群对不同疗法的反应，为医生和研究人员提供回顾性研究。而且由于没有移动数据，因此对隐私的担忧更少。海德说，现在，想要进行回顾性分析的研究人员或公司不需要购买这些数据：“他们只需要购买答案。”。

So far Atropos has generated more than 10,000 of these retrospective studies. This includes working with Klonoff, the endocrinologist, to figure out if there were increased risk of complications for people on GLP-1 agonists who had nine common surgeries. An analysis of over 13,000 patients with diabetes – around 2,200 of them on GLP-1s – published this month in Diabetes, Obesity and Metabolism journal, found no evidence to support stopping the drugs before surgery..

到目前为止，Atropos已经产生了超过10000项这些回顾性研究。这包括与内分泌学家克洛诺夫（Klonoff）合作，以确定接受过9次常见手术的GLP-1激动剂患者的并发症风险是否增加。本月在《糖尿病、肥胖和代谢杂志》上发表的一项对13000多名糖尿病患者（其中约2200名患者服用GLP-1s）的分析发现，没有证据支持在手术前停用药物。。

Klonoff said he was swayed by the results, but he’s not the one in the operating room ultimately responsible for whether the patient lives or dies. And Girish Joshi, an anesthesiologist and vice chair of the committee that came up with the recommendation, said this particular study is flawed. There are too few patients, especially patients who died, to suggest meaningful correlations.

科洛诺夫说，他被结果所左右，但他并不是手术室里对病人的生死负有最终责任的人。提出该建议的麻醉师兼委员会副主席GirishJoshi表示，这项特殊研究存在缺陷。很少有患者，尤其是死亡患者，无法提出有意义的相关性。

Around 1 in 3,000 patients under anesthesia will aspirate, or inhale their own vomit. And Joshi said the study used medical diagnosis codes that were too broad, so it couldn’t correctly drill down on this specific phenomenon. Joshi said he’s not opposed to the general idea of using retrospective analysis to inform guidance, but the study needs to be better designed and include many more patients..

大约每3000名麻醉患者中就有1名会吸出或吸入自己的呕吐物。乔希说，这项研究使用的医学诊断代码过于宽泛，因此无法正确深入研究这一特定现象。乔希说，他不反对使用回顾性分析为指导提供信息的总体想法，但这项研究需要更好的设计，并包括更多的患者。。

Ultimately, that’s what Hyde hopes he’ll be able to provide. Even if there may not be enough data to convince Joshi now, Atropos will keep adding new patients and new medications. “What you need is new evidence,” said Hyde. “And that's what we generate.”

最终，海德希望他能做到这一点。即使现在可能没有足够的数据说服Joshi，Atropos也会不断增加新患者和新药物。海德说：“你需要的是新的证据。”。“这就是我们产生的。”

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