Four products, zero to one.
Most roadmaps are a list of guesses nobody wrote down as guesses.
I try to sell it before I build it. Karyo’s demand was proven by a fake-door test — 472 visitors, 66 signups — before a line of code existed. When the answer cannot be bought that cheaply, I go and ask: 100+ discovery interviews in 40 days on Relate XR, which is slow and unglamorous and where the actual answer usually is.
Then I write down what the product is allowed to claim. In regulated work that is literal — the intended-use and indications-for-use language in an FDA submission sets the ceiling on everything the product can ever say. Outside regulated work the discipline still holds: if I cannot state the problem in one sentence a stranger would understand, I do not understand it yet, and neither does the team about to build for it.
The rest is keeping that sentence honest while engineers, clinicians, investigators and regulators all pull on it — across eight clinical sites, under three separate oversight regimes.