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15 beagles, 4 cancers, 94% accuracy: my favorite AI workflow in health tech

with Shlomi Madar · SpotitEarly

September 11, 202601:08:46Englewood, NJ

15 beagles, 4 cancers, 94% accuracy: my favorite AI workflow in health tech

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Skillz from the Episode

Judgment Redundancy Audit

Audits a workflow where a single human judgment call is load-bearing, inventories the signals currently thrown away around that decision, and designs a redundancy and consensus layer so the call becomes reproducible instead of personal.

When to use it: Whenever a process depends on someone’s gut, intuition, or experience — a founder eyeballing which leads are real, a support lead who “just knows” a customer is about to churn — or a workflow that’s accurate but doesn’t scale past the one person doing it.

Benefits: You make an irreplaceable judgment call scalable without replacing the person doing it. Cheap redundancy and a ground-truth loop turn one person’s gut feeling into a system you can trust and eventually teach. Save the download as judgment-redundancy-audit/SKILL.md in your Claude or ChatGPT skills folder, then run it against your riskiest recurring decision.

Click to steal this skill 👇

Show Notes

Thirteen days from now, the FDA convenes a panel that has never convened before.

Funding stage: Series A Plus. SpotitEarly announced a $20.3M round in May 2025 on top of a 2022 seed, and is currently running a Regulation A+ public offering at $7.15 per share. Institutional Series A capital plus a live retail raise puts this well past seed.

On September 23, 2026, the FDA's Molecular and Clinical Genetics Panel sits down to vote on Grail's Galleri test, the first multi-cancer early detection test ever to reach an FDA advisory committee. Every founder building in early detection is watching. Shlomi Madar is watching too. He just is not building the same thing.

Madar is the CEO of SpotitEarly, an Englewood, New Jersey company founded in 2020 that screens for four cancers from a single breath sample collected at your kitchen table. Grail reads methylation patterns in cell-free DNA. SpotitEarly reads a mask you breathed into for a few minutes. And the sensor at the front of its pipeline is not a machine. It is a beagle.

This is the part where most people assume it is a gimmick. It is not. Madar has a PhD in cancer research from the Weizmann Institute of Science, and the reason the company landed on dogs is boring and rigorous: nothing built by humans comes close. The entire field of electronic noses, mass spectrometry included, keeps running into the same wall, which is sensitivity threshold. A dog detects at parts per trillion. Madar's favorite way to explain it: fill two Olympic swimming pools, stir half a teaspoon of sugar into one, and a dog will tell you which pool you tried to trick him with.

The problem with a dog is not the nose. It is that a dog cannot fill out a lab report. That is the entire engineering problem SpotitEarly set out to solve. Madar's team spent five and a half years turning an animal's opinion into a reproducible, scalable, auditable data output. You breathe into a surgical mask, seal it, and mail it. At the lab, the mask goes into a sniffing port, where cameras, a microphone, and accelerometer vests capture the dogs' behavioral and biological signals. Each sensor feeds its own trained machine learning model, and multiple dogs sniff each sample more than once, throwing out anything that deviates from an established behavioral pattern.

The company calls the platform LUCID. The Rainbow Study, run with medical centers in Israel including Sourasky, Hadassah, and Rambam, put 1,386 participants through it under double-blind conditions and reported 93.9% sensitivity and 94.3% specificity, published in Scientific Reports. Madar is careful, repeatedly and unprompted, about what the test is: a triage layer that routes people toward the full standard of care, not a replacement for it.

The go-to-market is the founder story underneath the science. Only about 14% of cancers in the US are caught through a recommended screening test, and Madar walks through why: invasiveness, distance, cost, testing fatigue, and scanxiety. SpotitEarly priced its panel at roughly $500, well under Grail's $950, after surveying physicians and patients on price tolerance directly.

Named Frameworks

The Three Layer Detection Stack (LUCID)

The founder translation: when your best sensor is a human or an animal, do not replace it. Instrument it.

  • ›Layer one, detection: the biological sensor, a trained canine operating at parts per trillion.
  • ›Layer two, verification: a multimodal sensor array capturing behavioral and biological signals from that sensor — overhead camera, in-port camera, microphone, accelerometer vest.
  • ›Layer three, interpretation: a dedicated ML model per sensor, trained on a labeled behavioral database, with consensus across multiple dogs and multiple sniffs.

The Five Barrier Audit

Madar's framing for why screening adoption stalls, useful for any founder in a category where the product exists and nobody uses it.

  • ›Invasiveness: the procedure itself is unpleasant enough to defer.
  • ›Accessibility: the customer does not live near where the service happens.
  • ›Cost: no insurance, or partial coverage with surprise exposure.
  • ›Fatigue: you make people repeat the same effort per category, one cancer at a time.
  • ›Fear: scanxiety, the emotional cost of waiting for the result.

Triage, Not Diagnosis

A positioning discipline that is also the moat.

  • ›SpotitEarly is a pre-screening layer that routes people into standard of care, not a replacement for it.
  • ›Madar never oversells the claim, and the restraint is the moat.
  • ›In regulated categories, the founder who overstates once loses the clinicians permanently.

Redundancy as an Accuracy Strategy

If you are automating anything fuzzy, buy accuracy with redundancy before you buy it with a better model.

  • ›Multiple dogs, repeated sniffs, four sensor types, thousands of data points per sample.
  • ›None of the individual reads are trustworthy enough. The consensus is.
  • ›Borrowed idea, orthogonal confirmation: two completely independent methods agreeing raises confidence far more than the same method run twice.

Carry a Quota Once

Madar's advice to aspiring CEOs. He ran four VP roles before it clicked.

  • ›Sales forces honesty about the product, because you pay the price twice.
  • ›Once by not selling, and again by overselling and losing longevity with the account.

Focus Before Generalizing the Platform

LUCID could sniff Parkinson's, Alzheimer's, explosives, currency, or a missing person's shirt.

  • ›The dogs do not know they are smelling cancer. They are trained on a target scent, and the scent is swappable.
  • ›Madar knows the platform generalizes. He is still shipping four cancers first.
  • ›Resource planning and fundraising planning beat ambition.

Key Terms

VOC (volatile organic compound): Airborne molecules carried out of the bloodstream and exhaled. Human breath contains over 1,000 of them. Cancers produce characteristic patterns, which is the odor signature the dogs are trained on.
Bio-AI hybrid: SpotitEarly's term for a platform where a biological sensor sits at the front of the pipeline and machine learning handles interpretation and verification.
LUCID: SpotitEarly's proprietary platform combining the canine detection layer, the hardware sensor array, and the AI models.
Sensitivity: Of the people who actually have the disease, what share the test correctly flags. Misses show up as false negatives.
Specificity: Of the people who do not have the disease, what share the test correctly clears. Errors show up as false positives.
MCED (multi-cancer early detection): A single test screening for several cancers at once. Grail's Galleri and SpotitEarly's panel are both MCED products. No MCED test has FDA approval as of this recording.
Standard of care: The established diagnostic path for a given cancer, such as mammogram then biopsy for breast.
Scanxiety: Industry shorthand for the anxiety of waiting for a scan or test result. A real driver of screening avoidance.
CLIA: Clinical Laboratory Improvement Amendments. A federal certification program covering labs. A CLIA registered lab can develop and run a test in-house and sell the result, separate from FDA device approval. SpotitEarly's registration is 99D2307137.
LDT (laboratory-developed test): A test designed, made, and used within a single certified lab. This is the lane SpotitEarly is commercializing in ahead of FDA approval.
PMA (premarket approval): The FDA's most stringent device pathway. Grail's Galleri PMA is what the September 23 panel reviews.
Reg A+: A securities exemption allowing non-accredited investors to buy into a private company. SpotitEarly has one open at $7.15 per share.
Rainbow Study: SpotitEarly's double-blind clinical trial, 1,386 participants, published in Scientific Reports.

Q&A

Can dogs detect cancer accurately enough for clinical use?

In SpotitEarly's Rainbow Study of 1,386 participants, trained detection canines paired with AI verification reported 93.9% sensitivity and 94.3% specificity across breast, lung, prostate, and colorectal cancer. Per cancer sensitivity was 97% for lung and prostate, 94% for breast, and 86% for colorectal. Results published in Scientific Reports.

How does SpotitEarly's breath test work?

You breathe into a surgical mask at home, seal it, and mail it to the lab. Trained beagles sniff the sample in an instrumented port while cameras, a microphone, and accelerometer vests capture their biological and behavioral signals. Machine learning models trained per sensor convert those signals into a result, with multiple dogs and repeated sniffs used for consensus.

How much does an at-home multi-cancer breath test cost?

SpotitEarly has stated a single cancer test at about $250 and a four cancer panel at about $500. By comparison, Grail's Galleri is reported around $950 and full body MRI screening starts around $2,000.

Is SpotitEarly FDA approved?

No. The company is CLIA registered, which permits it to sell a laboratory-developed test in the US, and it is pursuing FDA approval separately. No multi-cancer early detection test has FDA approval as of September 2026.

When is the FDA deciding on multi-cancer screening tests?

The FDA's Molecular and Clinical Genetics Panel meets September 23, 2026 to review and vote on Grail's premarket approval application for the Galleri test. It is the first FDA advisory committee review of a multi-cancer early detection test.

Why do people skip cancer screening?

Invasiveness of procedures like colonoscopy and biopsy, distance from a clinic, cost and insurance gaps, screening fatigue from testing one cancer at a time, and scanxiety, the fear of the result. Only about 14% of US cancers are currently caught through recommended screening.

Does early detection actually change survival?

Cancer caught at stage one carries survival above 90% on average across cancers, and 99% for breast specifically. Stage three and stage four outcomes are substantially worse, along with treatment intensity, recovery burden, and cost.

How can founders use AI to automate judgment calls in their business?

SpotitEarly's approach generalizes: keep the human or biological sensor, instrument it with cheap sensors capturing behavioral signal, train a model per signal, and buy accuracy through redundancy and consensus rather than a single confident read.

What else can this platform detect besides cancer?

The canines are trained on a target scent, not on the concept of cancer, so the platform is swappable. Madar cites neurodegenerative diseases including Parkinson's and Alzheimer's as near-term possibilities, plus existing canine applications in explosives, currency, and search.

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