In a previous post on this thread I drew attention to the fact...

In a previous post on this thread I drew attention to the fact that the Expert Report used an assumption of only 10% of visits by patients to clinicians being related to respiratory issues whilst at the same time referencing Australian documentation showing figures of around 4 times that percentage and also stating that in the US around 10% of visits resulted in an actual diagnosis of a respiratory disease.



This would mean that everyone who went to the GP because they thought they had a respiratory problem came out after being told they did in fact have one. This is obviously not correct.

The assumption is then made in the Expert Report that the clinician would use ResAppDx to assist in the diagnosis with only 1 to 2 percent of these ill patients.



That is, the clinician would not employ ResAppDx on any of the patients who thought they had a problem, only on those who it turned out did in fact have a respiratory disease.

It seems to me that, if anything, these other patients might be the ones where the Dx might be used more often, just to be sure of the diagnosis before sending them off without attention.

These two major assumptions then resulted in the calculated offer of 20.8 cents and those assumptions entirely dictate that price.

As I demonstrated in a previous post, just including the other patients who thought they had a problem but didn’t (if a total of around 40% is correct) would have resulted, using exactly the same method of calculation employed in the Report, in a ’preferred’ price offer of 41.3 cents.

This is before taking into account the accuracy of the assumption that ResAppDx would only be applied for 1 to 2 % of the ill patients, and thus 0.1 to 0.2 % of all patients (the Report actually calculates using a figure of 0.157% of all patients).

So lets look at this figure of around 0.157% of all patients visiting a GP/clinician used in the Expert Report.

One of the problems the Independent Expert would have had in making their assumptions is the paucity of actual data, according to various studies referenced in the Report, relating to the reasons why patients attend. There is obviously good international data on people with actual diagnosed illness but very little on those others who think they are ill and therefore attend a GP or clinic.

Reference No 45 on page 20 of the Report, being a 2018 study in the Canadian Family Physician, is described as -



The following quote from that study gives a good summary of its findings (RFV is reason for visit) -


Two tables from that study also give a good indication of the frequency with which ResAppDx could be relevant to a clinician’s diagnosis when a patient visits.



Table 2 gives a ranking out of a maximum score of 20 for clinician reported visits and patient reported visits. You will see on the right hand side that according to the patients the main reason why they visit is for a ’cough’. This scores 19.0 out of a possible score of 20 (they are ranks not proportions). As far as clinicians are concerned the largest reason for visits is “upper respiratory tract infection, unspecified”. So with both the patients and the doctors this was the most prevalent reason for visits (I have marked with an the ‘X’ various reasons of relevance to ResAppDx).

The division between developed and developing countries is also of particular interest. Table 3 gives again a rank score out of a maximum of 20 points for each condition as reported by the clinicians (and the figures can be read in combination with the left hand side figures in Table 2 above).



You will see that in developing countries in particular upper respiratory tract infection ranks at the top with 18.5 points out of a maximum of 20 points and it is then followed by two other very relevant conditions, pneumonia and tuberculosis.

Can you tie these figures into an assumption that only 0.1 to 0.2 percent of patient’s visits will involve the use of ResAppDx to assist?

I can’t.

In developing countries in particulay the Expert Report assumes only a 0.1% use (1% of the assumed “10%” of visits). Surely these are the circumstances, particularly remotely, where it could be expected to be used the most.

I am not able to accept as valid or relevant the assumptions that have been made in valuing the ResAppDx in the Expert Report.

Whilst the references given in the Report do make much of the “paucity of available data, particularly from developing countries” I can understand under those circumstances a very conservative position being taken by the Independent Expert in their assumptions, but those assumptions need to be themselves plausible.

I assume also that this is the reason why continents such as Africa and South America, let alone various other countries, were simply left out of the calculations.

I appreciate also that RAP only had a couple of days with the draft report before forwarding it on but I believe these matters, and those referred to in my previous posts, should have been taken into account. The Scientific Advisory Panel members should have themselves focused on such matters.

As I have said earlier I believe this has potential implications for the rest of the Australian university sector in the way in which they are seen as seeking to commercialise their research through the capital markets.

Again people, make your own assumptions and read the documentation fully. The short section relating to the valuation of ResAppDx should be all you need to read to form a view as to the appropriateness of the offer of 20.8 cents.

poorinvestor