RNA stool test with 95% accuracy to increase colonoscopies (Interview)


RNA stool test with 95% accuracy to increase colonoscopies (Interview)

RNA stool test with 95% accuracy to increase colonoscopies (Interview)
In November 2021, a month after Dr. Haytham Gareer joined Geneoscopy as CMO, the company raised $105 million in funding. The company is developing an RNA analysis platform to detect colorectal cancer (to be launched in 2023).
A clinical study showed that when compared against the gold-standard colonoscopy, the platform demonstrated better sensitivity data in detecting advanced adenomas and colorectal cancer than other non-invasive tests.
Dr. Gareer says Geneoscopy is going to increase the number of colonoscopies being performed. However, it’s obvious to me that digital biology is disrupting not just GI but many other specialties that are diagnosing cancer.
I couldn’t hold my curiosity and asked quite directly. Should gastroenterologists be worried about them? Should Cologuard be worried? Should Medtronic with its AI-based polyp detection system be worried? Because when there’s a test that’s going to detect adenomas with a fair degree of accuracy, why bother with diagnostic procedures? Dr. Gareer had a different and interesting view.
As readers of Scope Forward, you already know my take. With more data, digital biology innovations such as RNA and DNA tests combined with machine learning would get extremely sophisticated. It’ll even be able to predict things that we just can’t with traditional approaches. Dr. Haytham completely agreed.
Watch this interview in full. Without doubt it’ll help you comprehend the future of GI.
◘  The journey of Geneoscopy
◘  The science of RNA biomarkers
◘  The thinking behind stool RNA test for detection of colorectal cancer
◘  What is the difference between RNA and DNA?
◘  Is the RNA test better than the stool DNA test?
◘  Availability of the test
◘  What is the business model?
◘  “Who do you see as competition for Geneoscopy?”
◘  Should gastroenterologists be worried?
◘  “We really think our test is actually going to add a lot of value to colonoscopies”
◘  “Our test will actually increase the number of colonoscopies being performed”
◘  How does the stool RNA test compare against other non-invasive tests?
◘  Will the test replace AI-based adenoma/polyp detection system?
◘  The role of machine learning in the product
◘  On digital biology as an exponential technology and the power of data
◘  Wider focus, wider opportunities
◘  What are the investors thinking?
◘  “The potential of the RNA platform for disease detection is very appealing to the investor community”
◘  What is the future of gastroenterology?

The Transcribed Interview:
Praveen Suthrum:  Dr. Haytham Gareer, thank you so much for joining the Scope Forward show. I’ve been looking forward to having this conversation for a long time now. We’re going to be chatting about RNA to test and I can’t be more excited to learn more. Thanks, I appreciate it.
Dr. Haytham Gareer: I appreciate you taking the time and I look forward to having our dialogue and our conversation this morning. So excited to be here.
Praveen Suthrum: Excellent.  Let me start by outlining your bio for everyone. Dr. Haytham Gareer is currently the chief medical officer of Geneoscopy. He’s responsible for leading clinical research efforts, collaborations with key medical advisors and professional societies, and providing critical insights to support commercialization and technology development across the company’s pipeline of products. Prior to joining Geneoscopy, Dr. Gareer served as VP Global Head of Medical and Clinical Affairs for Olympus. Dr. Gareer is an endoscopist with international experience. He’s received his MD in surgical oncology from Cairo University National Cancer Institute in Egypt, A PhD in surgical sciences and hepatobiliary and pancreatic illnesses from University of Verona, Italy. He holds a Masters in Minimal Invasive Surgical Technology from Italy as well an MBA from Hult International Business School and a Master’s in Applied Healthcare economics and outcomes research from Jefferson University. That’s quite a bit of an educational background and an expansive career spread and that to a global one. Is there anything remaining that you would be studying item from this point? Are you going to be studying more?
Dr. Haytham Gareer: Well, I’m considering law school. It’s a little bit of a stretch. No, I think this all kind of came together nicely. It’s just the medical experience combined with the business and the applications of medical knowledge and the medical domain and both the medical device and diagnostics, the education helped move this forward and drive this forward. So, my ability to contribute to some of the work that’s happening in the industry was supported well by this education. So it all came together nicely.
Praveen Suthrum: So you joined Geneoscopy as it’s a Chief Medical officer in October 2021. And the next month the company raised $105 million from various investors to advance stool-based RNA tests. So tell us about it, tell us about the company and about the product pipeline. How did it get started and how did you end up joining them?
Dr. Haytham Gareer: Yeah, absolutely. So Geneoscopy was founded in 2017 by Barnell siblings, Dr. Erica Barnell and Andrew Barnell. They really were the ones that started the company and helped develop and build it to where it is today. Erica was a PhD student at the time, and she uncovered the potential of RNA and really the proprietary technology behind being able to isolate the human RNA from stool and isolate that from all the bacterial noise and bacterial RNA and be able to harness that power to interrogate the RNA and be able to identify several disease states. And the primary focus they decided at the time would be on colorectal cancer screening to be able to identify the RNA biomarkers in stool and really be able to detect Colorectal cancer at an early stage. And we can certainly talk a little bit in more detail, but the company started with funding from family and friends as they called it at the time and didn’t really have a lot of capacity. There was no facilities or anything like that. They were really at the time it was Erica, Andrew and Yemen who was the software engineer or the range behind developing the algorithm that feeds into or. This essay helps feed into the company’s growing since and there’s a lot of progress. And as you mentioned, after going through a series A and series B, they were able to raise about $150 Million with a lot more recognition from key investors, strategic investors and also most recently they were able to certify some labs. Clear certified it’s over 11,000 square foot lab in St. Louis, Missouri where the company is based, where both founders Erica and Andrew grew up. And this is the headquarters for now for the company.
Praveen Suthrum: That’s awesome. Let’s start with the science. Tell us about what exactly the product is about, what does it do? And you mentioned one of the first people to come aboard was a technical person. So, what exactly did he or she will tell us a little more about the platform.
Dr. Haytham Gareer: So, as I mentioned, I think the essay is focused around being able to harness and identify RNA biomarkers in stool. RNA plays an integral role in tumor adjusts, the development of cancer, it’s role in cellular processes including proliferation, differentiation and apoptosis which allows for the development of proteins that then would be identified as part of the cancer development process is really the power behind RNA and how it is able to detect cancer and precancerous allegiance at an early stage. While the analysis of RNA stool has been extremely challenging in the past due to the nature of RNA being extremely easily degraded and being masked by the high bacterial burden and stool, the ability to identify and isolate those biomarkers are any biomarkers is really what this technology is about. And so this essay, the first test that the company is developing and we’re currently close to bringing to market is focused around isolating or combining the eight stool derived human RNA biomarkers, combining them with certain patient demographics like the smoking status of a patient as well as the people immunochemical test results. And that combination based on an algorithm would then help with a high degree of sensitivity, detect colorectal cancer, advanced anomalous and also precancer said no.
Praveen Suthrum: Did the founders go after stool RNA test for colorectal cancer, or did it just come about whether researching for something else and did this come about?
Dr. Haytham Gareer: I think the potential, as I mentioned of RNA is very vast. The focus on colorectal cancer is just the beginning so there’s potential for additional applications and it was felt because of the potential. As you know, colorectal cancer is a disease that is preventable if diagnosed early and treated. So, the social impact of this test, the potential application of this test and the indicated target population that would be best served by a colorectal cancer screening essay seemed like the ideal first step to move forward with this. There are other applications certainly and we can also briefly touch on that if you’d like. But really the colorectal cancer essays seem like the ideal first test for this technology.
Praveen Suthrum: If you have to explain as you would to a ten-year-old, how would you define RNA and what is the difference between RNA and DNA?
Dr. Haytham Gareer: So the RNA is really again as I mentioned, it is really part of the regulatory or regulate the cellular processes. So it’s part of the pathway that is associated with the initiation progression of several cancers. While DNA is really an indicator of the presence of cancers the ability of RNA be detected in certain tissues like stool and primarily why stool is ideal here is because the colonic mucosa exfoliates colonocytes that would then be shed into the lumen and accumulated in stool and those human colonocytes this eukaryotic RNA president of cells. We are able to isolate and identify at what stage in the progression of cancer that patient is and so be able to differentiate whether this patient is at a precancer stage with much higher sensitivity and specificity to DNA. So currently our initial clinical study just to give an idea of what that means differentially or in a clinical setting. The known precursor for colorectal cancer in most cases is an adenoma, right? Or an advanced adenoma. With a higher degree of sensitivity, RNA is able to detect advanced adenomas in patients than DNA and our first study indicated that compared to DNA we have a sensitivity of about 62% versus 42% with current DNA stool test. So we’re able to detect more advanced, enormous and potentially detecting cancer or the precancerous lesions in an early stage so we’re able to impact the prevention of colorectal cancer more. This is really the power of RNA and the power of our essays to be able to detect more of these precancerous lesions than a DNA platform.
Praveen Suthrum: Are you saying that it is way better than stool DNA test and perhaps FIT test?
Dr. Haytham Gareer: At the end of the day, it’s really the clinical characteristics of the test and how it is able to detect and differentiate the different types of lesions. Right? And because of that the higher sensitivity of advanced rate of detecting those adenomas against both DNA and FIT is much higher. So there is a superiority element in that particular aspect of precancerous lesion detection.
Praveen Suthrum: Now, this clinical study that you’ve conducted and are conducting, CRC prevent, can you share what you’ve learned so far from it and what is the purpose of the study?
Dr. Haytham Gareer: The intent is to move this forward as part of our PMA submission to the FDA to get the product approved on the market. This is a 10,000-patient study that we’ve begun about a year ago and we’re close to completing now. It has a very relatively high rapid rate of enrollment. It also had a very high diversity inclusion of the target patient populations. The reason for that is it was a decentralized clinical study approach. I think we’re one of the very few initial companies to apply that. So as opposed to working in a traditional setting where we work with sites specifically to patients and follow up, we use the decentralized approach. We reached out to patients through social media to be able to recruit them and include them as part of the study. What that means is really reaching out to a very diverse and geographically spread patient population. So the study is very representative of the target, the intended target population of the United States, where we were able to include a very diverse racial and very racially diverse, socially economically diverse. We were able to include patients from several statuses, including low income. And what we learned from this is really being able to understand a little bit more about the demographics of who gets screened and how they get screened. We were also able to learn a little bit more about currently and how the process would work. And we can also talk about how we’re going to commercialize this, but this is more or less the same approach. The results were still unblinded to the results of this study. We won’t be able to speak until mid or late August, but we believe it will be as promising as our pilot study with the targets that I mentioned, the 9th and the 62% and 95% sensitivity for advanced abnormalism colorectal cancer, respectively.
Praveen Suthrum: So when is commercialization? When would the product launch and be available for patients to perhaps buy directly online or get a prescription from their doctors?
Dr. Haytham Gareer: The incentives for it to be commercially available in Q1 or Q2 of 2023.
Praveen Suthrum: What is the business model for the company? Are you going to be selling directly to consumers? What’s the plan?
Dr. Haytham Gareer: We’re currently really ironing out the full process, but it would be a very similar process to the non- invasive tests that are currently available on the market. It would be prescribed by the patient’s primary care physician or gastroenterologist. We would receive the order and ship out the kit to the patient’s home, where in the box would include the return label. So the patient would deposit the sample and then it would be shipped back to our certified laboratory where a test is conducted and the report is sent back out to the physician and obviously if the test is positive or there are normal findings on the test, the patient would be asked to schedule a follow up call on colonoscopy. We’re working to ensure that our test is we’re not just focused on the kit or the product itself, but also incorporating comprehensive solution that would include patient education, that would include patient navigation through the process to ensure that the two- step screening test is a non- invasive test and a potential colonoscopy is followed through as part of our process. So really the component of a comprehensive colorectal cancer solution. We’re also looking into potentially including a telemedicine approach. We’re still working on the details for that but that would potentially be another option.
Praveen Suthrum: Back to the business model. Who do you see as competition for Geneoscopy?
Dr. Haytham Gareer: I mean, simply the prevalence of the other non- invasive stool tests is something to consider. We think of ourselves as a second generation non- invasive stool test. It’s something that would add definitely an incremental value to the non- invasive screening strategies that are out there in the market. It’s another option that physicians and patients could be offered with our improved sensitivity for advanced enormous. We think again, as I mentioned, there is a differentiator against other non- invasive stool tests, definitely much better than the Fit test and definitely there’s an incremental improvement over the DNA stool test. There’s also potential for what’s happening with the entrance for the blood tests. We think that overall, our cost effectiveness and navigation, the coral cancer screening solution that we’re offering will position us really well against those different noninvasive screening alternatives for colorectal cancer.
Praveen Suthrum: Let’s talk about that. So you’re saying that even if liquid biopsy, as they call it, to become a reality in the future, you don’t see that as coming in the way with what you’re building here? What I want to ask is if a single blood test or a blood sample can detect 15 different types of cancers as some of these companies are working on. Now here is your test working with stool RNA focused on one type of cancer. Don’t you see that as some kind of a business threat?
Dr. Haytham Gareer: There is definitely something to consider there and something to think through. So apart from the cost implications, and I’m not going to go into that in great detail, but there are associated costs with a lot of this unnecessary testing and this unnecessary screening and what it means beyond just that initial non- invasive test. The focus on one cancer or what our test offers really is again, because of the nature of the test, because of its ability to come close to the tumor and the pretumoral tissue in stool where at a very early stage before the cancer spreads beyond the walls or the layers of the colon to reach the bloodstream, it is still localized and limited to the colon. And because of the nature of the stool and how it allows for accumulating the exfoliated colonic cells. As I mentioned, it’s able to detect or pick up on these very early localized lesions much better than blood. So if blood is the option for treating this disease or managing and preventing this very preventable disease, there’s a very high chance that you will be missing on these three invasive precancerous lesions, right? So picking up on those in precancerous advanced or known as in the colon as an example, is really what would make this test a whole lot better. You would follow patients differently. You would follow patients and manage them in a much better and more focused approach than would a liquid biopsy.
Praveen Suthrum: So should Cologuard, be worried about you?
Dr. Haytham Gareer: I mean, there’s always a concern when you market entrance, right, if someone else is coming in, and in a general sense, there’s an opportunity for someone to challenge what’s been around for a while. There should be some thought around a new entrant, right? And to some degree there should be some consideration now that the market is and it’s just not just us. Again, we just talk about the luxury. So it will be more competition, obviously, and there’ll be more players in the market. So definitely there needs to be rethinking.
Praveen Suthrum: I’m taking away that gastroenterologists should definitely be worried about you. The stool DNA test, the liquid biopsy test and so on, shouldn’t they?
Dr. Haytham Gareer: We really think that our test is actually going to add a lot of synergies to colonoscopy and we’ll add a lot of value to the focus is really that there are, one that there’s a good percentage of patients that are eligible for colorectal screening that aren’t getting screened. That’s number one. So the compliance rate is about 60%. Right? There’s a lot of patients who would benefit from screening that aren’t getting screened. So introducing another noninvasive option onto the market that would allow patients an additional option, opportunity to get a noninvasive stool or noninvasive screening test. And those patients, those 40% or so would not have gone for a colonoscopy anyway. It’s just we’re targeting those patients, bringing them into the pool of patients that are going to get treated, that’s number one. Number two, because of, as I mentioned, our tests ability to detect advanced adenomas with a higher sensitivity, we have looked into modeling studies in health cost effectiveness, health economic models. We see that our test would actually increase the number of colonoscopies being performed. We’re going to increase the number of colonoscopies with a positive finding. So bring the patients and that aren’t getting screened today into the pool, but also the patients that would require a colonoscopy because they have some sort of positive finding will be the ones that are going through for a colonoscopy. The third value is really because of that, where it becomes a more targeted approach to some degree, where because of the COVID 19 and the backlog and the issues with getting patients adequately in for colonoscopy and time. You have a population of patients very well behind and you can’t screen everyone to bring everyone back at the right time. A test like ours, that would allow for more, I wouldn’t say selective, but at least making sure that the patients that are being offered a colonoscopy are the ones that are in need of a colonoscopy because of an abnormal finding, again, it adds value to the GI’s practice. So we think actually we’re here for the GI, we’re here for the patient, we’re here for the provider, the primary care. It’s not a test that’s going to take away from anyone who actually will add value to all the healthcare stakeholders from what we see. Right. And this is how we’re trying to position. I understand from a broader general perspective, but I want to read something from your website under the study, which I found quite interesting. You say it’s in a clinical study when compared against the gold standard colonoscopy. Our RNA based platform demonstrated better sensitivity data in detecting advanced diagnosis and colorectal cancer than that generated by any other available noninvasive test in their respective clinical studies, which is what you’ve been saying.
Praveen Suthrum: I hang around a lot with gastroenterologists in private practice and all that they dream about is screening colonoscopies. At least the last 15 years that’s been the case. Productivity numbers, the quality metrics, everything is set on ADRs, adenoma detection rate and so on. Now here comes a test in 2023 that’s going to even do the ADRs. I mean, they don’t have to do this, right? They don’t have to do the screening. It’s about 25, 30, 40% of what typical private practice does, depending upon how interested they are in doing other stuff in GI. Again, just very openly and directly. But you’re an endoscopist, so I’m curious to know your views.
Dr. Haytham Gareer: Well, I think you’re absolutely right. I know the detection rates and there are certain quality metrics for colonoscopy that drive the outcomes of colonoscopy. We think our test, if there’s a positive noninvasive stool test, be it our test or any of the other tests out there, this is potentially going to impact the quality metrics of a colonoscopy, generally speaking. So this can improve a colonoscopy. If the physician is unblinded or is aware of the results of a positive stool test, there’s an opportunity to improve the colonoscopy procedure, potentially improving things like withdrawal times and potentially even at no detection rates, more meticulous examination, right. Test will allow for that. It’s offering to those patients that are not willing to undergo a colonoscopy. This other option, then, if they have normal finding, they’re going to come in for that colonoscopy, which is really what they need.
Praveen Suthrum: Right, so it’s avoiding the unnecessary colonoscopy, but it’s also ensuring that patients that aren’t getting screened or those that are actually benefiting from a colonoscopy, I get the point that it’s going to expand the number of people who would go through a test because it is noninvasive and now they have more options. I totally get that. Even as you’re narrating this, I’m thinking even someone like a Medtronic that has an AI product should be worried about tests like this. Because here’s the AI trying to compete with the GIs in trying to detect or classify polyps and identify polyps and the adenomas, right?
Dr. Haytham Gareer: Right.
Praveen Suthrum: So you don’t even have to do that if the test itself is identifying the adenomas with the fair degree of sensitivity, is my understanding correct?
Dr. Haytham Gareer: If the test is negative? Right. The patient will not require a colonoscopy. If the test is positive or abnormal, the patient will have to undergo a colonoscopy. The procedure itself would still benefit the colonoscopy procedure itself would still benefit from enhanced technologies like AI and the ability to detect and differentiate lesions. Right. Because at the end of the day, there’s going to be still some therapeutic element that polyp needs to be removed or that lesion needs to be respected. We’re not at a point where we can say one is taking away from the other. The way I see it is that it’s all adding value. You’re increasing the pool of patients that are getting screened. The patients that require screening are benefiting from a more focused approach and benefiting more from that colonoscopy. Adding enhanced imaging technologies and other technologies that would improve the colonoscopy procedure itself is still beneficial to the patient. So I think that all feeds into an enhanced continuum of care, better improvement for overall outcomes. Right? Again, we’re all focused on one thing, is detecting this disease early, treating and making sure that we’re managing it early to prevent it from developing into something that is going to be more burdensome.
Praveen Suthrum: Some endoscopists that I’ve spoken to when I asked this kind of a question, saying that wouldn’t your bread and butter be threatened, they very rightly compared the trend to ERCPs. Earlier, So, you don’t do any more diagnostic. It’s all therapeutic. And that’s what I heard you just say. So we don’t have to do diagnostic colonoscopy and that should be a good thing. If the market or the endoscopy market or gastroenterologists embrace that, then they scope forward, as I like to say. They move forward. If they don’t, then I can’t see how they will not be disrupted. It’s just not about you. Right. There are a flurry of companies in this space trying to take different approaches to solve this problem. Before I get to my next question, I’m curious. How do you use machine learning in the product, in the company? What role does it play? What do you do with this data? What does machine learning algorithms do with this data?
Dr. Haytham Gareer: Don’t know if I can speak to the exact details, but I mentioned the algorithm that we’re utilizing. It said the information on the eight RNA biomarkers, the demographic status of the patients of smoking history, as well as the results of the Fit test. And what that does, it provides based on a threshold for all these inputs, it generates a binary report. Right. It’s either abnormal or negative, as we currently have it. So this is how this approach works. I don’t know if your next question is about AI specifically, but this is my kind of perspective. Just thinking ahead, maybe scoping forward the thought that maybe there are synergies there between a test like this and AI learning algorithms that are being developed for colonoscopy. Right? Could this add value? That’s something that if they play together, if you merge those two approaches, the positive noninvasive test with the procedure itself, can the results be merged? Potentially, but I don’t know currently if that’s an option. Today, our test just uses these inputs and the algorithm provides a binary output for test results.
Praveen Suthrum: Yes. No. The reason I asked that question first was because my assumption would be that with more data, the test would get more sophisticated. Broadly, the space comes under digital biology, and for me, digital biology would come under exponential technologies. And if you look back at any of the exponential technologies, for example, I sat in a self-driving car back in 2012, and at that time, it was a research project. I was in the Bay Area, and like, it was a Google car, and the laptop was connected to the steering wheel with wires going all around and the LiDAR scanner on top of this huge and it was all bulky. But now it’s more than a reality. So my take has always been that you give digital biology a few years, and because of more data, because of the number of tests that, for example, Cologuard has screened about 3.5 million plus people, the last time I took a look at that, I’m sure you would go down that path, you would get all this data, and with this data, there would be more analysis. And with the machine learning algorithms, it’s going to be able to predict I mean, I don’t think that it’s going to be remotely any competition with the ability of a human being to predict screening I can understand because it’s a sophisticated skill and an art, but this is a prediction. You would be able to predict things that I don’t think we’d be able to do in the traditional approaches. What do you think?
Dr. Haytham Gareer: No, I completely agree. I think you’re absolutely right. The more we learn about this, the more we learn about the power of RNA. And as I mentioned, this is not just a test. We consider this a platform because the potential for utilizing this test is different for even higher risk cancers, for other disease stays, for other GI too there’s always going to be an opportunity to learn how there will be different iterations of this test to begin with. So the ability to develop the test even further and enhance the sensitivity and specificity from where it is today, but also the applications with other disease states and how it interacts with different diseases and it can lead to cancer. So you’re absolutely right. I think the potential for it to grow and expand and evolve beyond where we are today, leveraging machine learning algorithms is definitely a possibility.
Praveen Suthrum: In your knowledge, how many such companies are there like broadly playing in the space? DNA testing, RNA testing, not just with GI, but medicine in general. Are we talking a hundred? Are we talking 1000? What would be your guess?
Dr. Haytham Gareer: In the hundreds of the space is evolving rapidly. The ability to focus on molecular biomarkers and tests in general is something that is advancing as the technology for sequencing and everything that feeds into this industry is improving and enhancing. There’s definitely an improved threshold for detecting at a much earlier stage, more advanced stage. I think the focus is also very broad across different diseases. So it’s not necessarily all focused on just GI or colorectal cancer specifically. I think there’s a place for lung cancer, bladder cancer, other disease states as well that are not necessarily immediate correlate to oncology as well as being able to follow up patients and predict. So the focus is not always on screening. There are companies out there, technologies out there that are focused on monitoring for residual disease, looking at prognostic indicators, monitoring therapies so there’s a lot that’s being done in this space and I think it’s expanding rapidly and it’s ultimately good for everyone. It’s good for patients, it’s good for therapeutic development, it’s good for the healthcare system in general that these technologies are being picked up and coming into play. But the focus is diverse, which is also good, right So we’re focused on GI health primarily and we think that our technology, the RNA technology will play a huge part in that space with DNA and proteins and the other biomarkers that are being utilized. There are opportunities for other things, but he’s out in the hundreds, which is good.
Praveen Suthrum: What are investors thinking? They’ve given you they’ve invested a significant sum of money. What are they thinking? What do they know?
Dr. Haytham Gareer: While colorectal cancer is really what we’re selling on our focus, there’s an opportunity for pipeline development as well. And this is really what we try to highlight, that there’s more than just colorectal cancer or potential for that with our RNA platform. But the promise of colorectal cancer itself is great, right? The ability to benefit this vast patient population that needs to be adequately screened, the gaps in compliance and being able to detect with a better sensitivity the precancerous lesions. I think this is all a great selling point to investors. The fact that we’re addressing this disease state is good and it’s very appealing. But also the potential of the RNA platform we believe is also going to be very appealing in its potential. For high risk patients, for other diseases I mentioned, like inflammatory bowel disease and others. And also the applications were being utilized as a companion diagnostic. So the utilization of this test to help even develop therapeutic drugs and other things, there’s a whole lot that we can offer with this platform that is potentially very appealing to the investor community.
Praveen Suthrum: If you were to advise GI fellow, what would you tell him or her? They are crossroads, right? What to do with their carrier over the next 40 years from that standpoint?
Dr. Haytham Gareer: Yes.
Praveen Suthrum: Given what you know about where things are going, about where things are and so on.
Dr. Haytham Gareer: I’ll try to be very broad because it’s very general, but I think medicine is now very interdependent on a lot of things the domain knowledge of medicine, understanding about diseases, pathologies and managing patients, and being able to be that bedside position where you’re caring for the patient directly and following up. But there is an opportunity now, I think, more so than ever, and I’ve been part of this kind of my career, is the technology component, right? And technology can have multiple avenues. It’s not necessarily just focusing on, for instance, the scope or imaging technologies, but things like what we’re discussing here now, the technologies that leverage even molecular genomics and being able to help predict where patients can be managed better. So just to be open minded about the practice of medicine, that it’s not just focused on what you can learn or it’s not just the medical and clinical knowledge, but there’s an opportunity to be more broadly focused on what’s next, what the technologies can bring and how they can benefit that. So nothing threatens the practice of medicine, but I think everything expands and improves outcomes ultimately. So to be focused on an open minded about what’s coming, what’s next, and be well informed on the advances and everything beyond just the practice of medicine, the technology around you, because everything’s coming together, right? We talk about AI, we talk about wearable technology, we talk about integrating patient information and data into cloud. So there’s a lot that needs to come together into play. And the more informed the physician, the more informed the GI, the better they’re able to stay up to speed and manage patients.
Praveen Suthrum: This naturally segues us into my final question, which is on the future of gastroenterology. So if you have to look ahead five years and then ten years, what do you see?
Dr. Haytham Gareer: I mean, we talked about it briefly, and again, this is my perspective. I think there’ll be more and more of the need of the advanced interventional therapy, the role of the Gist of this, talking about the endoscopy space, right? The colonoscopy endoscopy space. There’s definitely going to be more and more of a trend towards focusing on the therapeutic, the early stage management of diseases. The earlier you identify diseases, the more amenable are the early treatment and early cure better managing patients based on precision medicine or precision surgery approach. You focus more on what the disease is at what stage, and being able to manage that early on and control it. So I think we talked about it’s not going to be always the screen, right? We’re going to rely less and less on the ability to use invasive procedures in general. This has been like the trend over the past few decades, less invasive procedures for diagnosis and even less invasive procedures for therapeutics. Right? So I think to be able to stay on top of that and focus on technologies that would better serve the therapeutic component of the practice is going to be very important. That includes AI, that includes robotics, that include endoscopy suite ecosystem, integrating imaging, integrating information, integrating big data and all that into the endoscopy suite. Essentially, I see that heading in that direction. A more informed, precise, more precision focused management of patients and better care.
Praveen Suthrum: Dr. Haytham Gareer, thank you so much for spending your morning on the Scope Forward show. I learned a lot from this interview and it validated a lot of assumptions that I’ve been having. And thanks so much for sharing your perspective, being open about playing and going in the direction that I was going, but thoroughly enjoyed this conversation.
Dr. Haytham Gareer: Thank you so much. Thank you so much. I really enjoyed this too, and hope this is useful and look forward to staying in touch with you in the future. Thank you. I’m always interested in what you have to offer, so it was great to speak to you this morning.
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