Buzzwords and tortuous impact studies won’t fix a broken aid system

Curated on Posted on by Stefaan Verhulst

The Guardian: “Fifteen leading economists, including three Nobel winners, argue that the many billions of dollars spent on aid can do little to alleviate poverty while we fail to tackle its root causes….Donors increasingly want to see more impact for their money, practitioners are searching for ways to make their projects more effective, and politicians want more financial accountability behind aid budgets. One popular option has been to audit projects for results. The argument is that assessing “aid effectiveness” – a buzzword now ubiquitous in the UK’s Department for International Development – will help decide what to focus on.

Some go so far as to insist that development interventions should be subjected to the same kind of randomised control trials used in medicine, with “treatment” groups assessed against control groups. Such trials are being rolled out to evaluate the impact of a wide variety of projects – everything from water purification tablets to microcredit schemes, financial literacy classes to teachers’ performance bonuses.

Economist Esther Duflo at MIT’s Poverty Action Lab recently argued in Le Monde that France should adopt clinical trials as a guiding principle for its aid budget, which has grown significantly under the Macron administration.

But truly random sampling with blinded subjects is almost impossible in human communities without creating scenarios so abstract as to tell us little about the real world. And trials are expensive to carry out, and fraught with ethical challenges – especially when it comes to health-related interventions. (Who gets the treatment and who doesn’t?)

But the real problem with the “aid effectiveness” craze is that it narrows our focus down to micro-interventions at a local level that yield results that can be observed in the short term. At first glance this approach might seem reasonable and even beguiling. But it tends to ignore the broader macroeconomic, political and institutional drivers of impoverishment and underdevelopment. Aid projects might yield satisfying micro-results, but they generally do little to change the systems that produce the problems in the first place. What we need instead is to tackle the real root causes of poverty, inequality and climate change….(More)”.

A roadmap for restoring trust in Big Data

Curated on Posted on by Stefaan Verhulst
Mark Lawler et al in the Lancet: “The fallout from the Cambridge Analytica–Facebook scandal marks a significant inflection point in the public’s trust concerning Big Data. The health-science community must use this crisis-in-confidence to redouble its commitment to talk openly and transparently about benefits and risks and to act decisively to deliver robust effective governance frameworks, under which personal health data can be responsibly used. Activities such as the Innovative Medicines Initiative’s Big Data for Better Outcomes emphasise how a more granular data-driven understanding of human diseases including cancer could underpin innovative therapeutic intervention.
 Health Data Research UK is developing national research expertise and infrastructure to maximise the value of health data science for the National Health Service and ultimately British citizens.
Comprehensive data analytics are crucial to national programmes such as the US Cancer Moonshot, the UK’s 100 000 Genomes project, and other national genomics programmes. Cancer Core Europe, a research partnership between seven leading European oncology centres, has personal data sharing at its core. The Global Alliance for Genomics and Health recently highlighted the need for a global cancer knowledge network to drive evidence-based solutions for a disease that kills more than 8·7 million citizens annually worldwide. These activities risk being fatally undermined by the recent data-harvesting controversy.
We need to restore the public’s trust in data science and emphasise its positive contribution in addressing global health and societal challenges. An opportunity to affirm the value of data science in Europe was afforded by Digital Day 2018, which took place on April 10, 2018, in Brussels, and where European Health Ministers signed a declaration of support to link existing or future genomic databanks across the EU, through the Million European Genomes Alliance.
So how do we address evolving challenges in analysis, sharing, and storage of information, ensure transparency and confidentiality, and restore public trust? We must articulate a clear Social Contract, where citizens (as data donors) are at the heart of decision-making. We need to demonstrate integrity, honesty, and transparency as to what happens to data and what level of control people can, or cannot, expect. We must embed ethical rigour in all our data-driven processes. The Framework for Responsible Sharing of Genomic and Health Related Data represents a practical global approach, promoting effective and ethical sharing and use of research or patient data, while safeguarding individual privacy through secure and accountable data transfer…(More)”.

Denialism: what drives people to reject the truth

Curated on Posted on by Stefaan Verhulst

Keith Kahn-Harris at The Guardian: “…Denialism is an expansion, an intensification, of denial. At root, denial and denialism are simply a subset of the many ways humans have developed to use language to deceive others and themselves. Denial can be as simple as refusing to accept that someone else is speaking truthfully. Denial can be as unfathomable as the multiple ways we avoid acknowledging our weaknesses and secret desires.

Denialism is more than just another manifestation of the humdrum intricacies of our deceptions and self-deceptions. It represents the transformation of the everyday practice of denial into a whole new way of seeing the world and – most important – a collective accomplishment. Denial is furtive and routine; denialism is combative and extraordinary. Denial hides from the truth, denialism builds a new and better truth.

In recent years, the term has been used to describe a number of fields of “scholarship”, whose scholars engage in audacious projects to hold back, against seemingly insurmountable odds, the findings of an avalanche of research. They argue that the Holocaust (and other genocides) never happened, that anthropogenic (human-caused) climate change is a myth, that Aids either does not exist or is unrelated to HIV, that evolution is a scientific impossibility, and that all manner of other scientific and historical orthodoxies must be rejected.

In some ways, denialism is a terrible term. No one calls themselves a “denialist”, and no one signs up to all forms of denialism. In fact, denialism is founded on the assertion that it is not denialism. In the wake of Freud (or at least the vulgarisation of Freud), no one wants to be accused of being “in denial”, and labelling people denialists seems to compound the insult by implying that they have taken the private sickness of denial and turned it into public dogma.

But denial and denialism are closely linked; what humans do on a large scale is rooted in what we do on a small scale. While everyday denial can be harmful, it is also just a mundane way for humans to respond to the incredibly difficult challenge of living in a social world in which people lie, make mistakes and have desires that cannot be openly acknowledged. Denialism is rooted in human tendencies that are neither freakish nor pathological.

All that said, there is no doubt that denialism is dangerous. In some cases, we can point to concrete examples of denialism causing actual harm. In South Africa, President Thabo Mbeki, in office between 1999 and 2008, was influenced by Aids denialists such as Peter Duesberg, who deny the link between HIV and Aids (or even HIV’s existence) and cast doubt on the effectiveness of anti-retroviral drugs. Mbeki’s reluctance to implement national treatment programmes using anti-retrovirals has been estimated to have cost the lives of 330,000 people. On a smaller scale, in early 2017 the Somali-American community in Minnesota was struck by a childhood measles outbreak, as a direct result of proponents of the discredited theory that the MMR vaccine causes autism, persuading parents not to vaccinate their children….(More)”.

Americans Want to Share Their Medical Data. So Why Can’t They?

Curated on Posted on by Stefaan Verhulst

Eleni Manis at RealClearHealth: “Americans are willing to share personal data — even sensitive medical data — to advance the common good. A recent Stanford University study found that 93 percent of medical trial participants in the United States are willing to share their medical data with university scientists and 82 percent are willing to share with scientists at for-profit companies. In contrast, less than a third are concerned that their data might be stolen or used for marketing purposes.

However, the majority of regulations surrounding medical data focus on individuals’ ability to restrict the use of their medical data, with scant attention paid to supporting the ability to share personal data for the common good. Policymakers can begin to right this balance by establishing a national medical data donor registry that lets individuals contribute their medical data to support research after their deaths. Doing so would help medical researchers pursue cures and improve health care outcomes for all Americans.

Increased medical data sharing facilitates advances in medical science in three key ways. First, de-identified participant-level data can be used to understand the results of trials, enabling researchers to better explicate the relationship between treatments and outcomes. Second, researchers can use shared data to verify studies and identify cases of data fraud and research misconduct in the medical community. For example, one researcher recently discovered a prolific Japanese anesthesiologist had falsified data for almost two decades. Third, shared data can be combined and supplemented to support new studies and discoveries.

Despite these benefits, researchers, research funders, and regulators have struggled to establish a norm for sharing clinical research data. In some cases, regulatory obstacles are to blame. HIPAA — the federal law regulating medical data — blocks some sharing on grounds of patient privacy, while federal and state regulations governing data sharing are inconsistent. Researchers themselves have a proprietary interest in data they produce, while academic researchers seeking to maximize publications may guard data jealously.

Though funding bodies are aware of this tension, they are unable to resolve it on their own. The National Institutes of Health, for example, requires a data sharing plan for big-ticket funding but recognizes that proprietary interests may make sharing impossible….(More)”.

The Democratization of Data Science

Curated on Posted on by Stefaan Verhulst

Jonathan Cornelissen at Harvard Business School: “Want to catch tax cheats? The government of Rwanda does — and it’s finding them by studying anomalies in revenue-collection data.

Want to understand how American culture is changing? So does a budding sociologist in Indiana. He’s using data science to find patterns in the massive amounts of text people use each day to express their worldviews — patterns that no individual reader would be able to recognize.

Intelligent people find new uses for data science every day. Still, despite the explosion of interest in the data collected by just about every sector of American business — from financial companies and health care firms to management consultancies and the government — many organizations continue to relegate data-science knowledge to a small number of employees.

That’s a mistake — and in the long run, it’s unsustainable. Think of it this way: Very few companies expect only professional writers to know how to write. So why ask onlyprofessional data scientists to understand and analyze data, at least at a basic level?

Relegating all data knowledge to a handful of people within a company is problematic on many levels. Data scientists find it frustrating because it’s hard for them to communicate their findings to colleagues who lack basic data literacy. Business stakeholders are unhappy because data requests take too long to fulfill and often fail to answer the original questions. In some cases, that’s because the questioner failed to explain the question properly to the data scientist.

Why would non–data scientists need to learn data science? That’s like asking why non-accountants should be expected to stay within budget.

These days every industry is drenched in data, and the organizations that succeed are those that most quickly make sense of their data in order to adapt to what’s coming. The best way to enable fast discovery and deeper insights is to disperse data science expertise across an organization.

Companies that want to compete in the age of data need to do three things: share data tools, spread data skills, and spread data responsibility…(More)”.

What’s Wrong with Public Policy Education

Curated on Posted on by Stefaan Verhulst

Francis Fukuyama at the American Interest: “Most programs train students to become capable policy analysts, but with no understanding of how to implement those policies in the real world…Public policy education is ripe for an overhaul…

Public policy education in most American universities today reflects a broader problem in the social sciences, which is the dominance of economics. Most programs center on teaching students a battery of quantitative methods that are useful in policy analysis: applied econometrics, cost-benefit analysis, decision analysis, and, most recently, use of randomized experiments for program evaluation. Many schools build their curricula around these methods rather than the substantive areas of policy such as health, education, defense, criminal justice, or foreign policy. Students come out of these programs qualified to be policy analysts: They know how to gather data, analyze it rigorously, and evaluate the effectiveness of different public policy interventions. Historically, this approach started with the Rand Graduate School in the 1970s (which has subsequently undergone a major re-thinking of its approach).

There is no question that these skills are valuable and should be part of a public policy education.  The world has undergone a revolution in recent decades in terms of the role of evidence-based policy analysis, where policymakers can rely not just on anecdotes and seat-of-the-pants assessments, but statistically valid inferences that intervention X is likely to result in outcome Y, or that the millions of dollars spent on policy Z has actually had no measurable impact. Evidence-based policymaking is particularly necessary in the age of Donald Trump, amid the broad denigration of inconvenient facts that do not suit politicians’ prior preferences.

But being skilled in policy analysis is woefully inadequate to bring about policy change in the real world. Policy analysis will tell you what the optimal policy should be, but it does not tell you how to achieve that outcome.

The world is littered with optimal policies that don’t have a snowball’s chance in hell of being adopted. Take for example a carbon tax, which a wide range of economists and policy analysts will tell you is the most efficient way to abate carbon emissions, reduce fossil fuel dependence, and achieve a host of other desired objectives. A carbon tax has been a nonstarter for years due to the protestations of a range of interest groups, from oil and chemical companies to truckers and cabbies and ordinary drivers who do not want to pay more for the gas they use to commute to work, or as inputs to their industrial processes. Implementing a carbon tax would require a complex strategy bringing together a coalition of groups that are willing to support it, figuring out how to neutralize the die-hard opponents, and convincing those on the fence that the policy would be a good, or at least a tolerable, thing. How to organize such a coalition, how to communicate a winning message, and how to manage the politics on a state and federal level would all be part of a necessary implementation strategy.

It is entirely possible that an analysis of the implementation strategy, rather than analysis of the underlying policy, will tell you that the goal is unachievable absent an external shock, which might then mean changing the scope of the policy, rethinking its objectives, or even deciding that you are pursuing the wrong objective.

Public policy education that sought to produce change-makers rather than policy analysts would therefore have to be different.  It would continue to teach policy analysis, but the latter would be a small component embedded in a broader set of skills.

The first set of skills would involve problem definition. A change-maker needs to query stakeholders about what they see as the policy problem, understand the local history, culture, and political system, and define a problem that is sufficiently narrow in scope that it can plausibly be solved.

At times reformers start with a favored solution without defining the right problem. A student I know spent a summer working at an NGO in India advocating use of electric cars in the interest of carbon abatement. It turns out, however, that India’s reliance on coal for marginal electricity generation means that more carbon would be put in the air if the country were to switch to electric vehicles, not less, so the group was actually contributing to the problem they were trying to solve….

The second set of skills concerns solutions development. This is where traditional policy analysis comes in: It is important to generate data, come up with a theory of change, and posit plausible options by which reformers can solve the problem they have set for themselves. This is where some ideas from product design, like rapid prototyping and testing, may be relevant.

The third and perhaps most important set of skills has to do with implementation. This begins necessarily with stakeholder analysis: that is, mapping of actors who are concerned with the particular policy problem, either as supporters of a solution, or opponents who want to maintain the status quo. From an analysis of the power and interests of the different stakeholders, one can begin to build coalitions of proponents, and think about strategies for expanding the coalition and neutralizing those who are opposed.  A reformer needs to think about where resources can be obtained, and, very critically, how to communicate one’s goals to the stakeholder audiences involved. Finally comes testing and evaluation—not in the expectation that there will be a continuous and rapid iterative process by which solutions are tried, evaluated, and modified. Randomized experiments have become the gold standard for program evaluation in recent years, but their cost and length of time to completion are often the enemies of rapid iteration and experimentation….(More) (see also http://canvas.govlabacademy.org/).

This surprising, everyday tool might hold the key to changing human behavior

Curated on Posted on by Stefaan Verhulst

Annabelle Timsit at Quartz: “To be a person in the modern world is to worry about your relationship with your phone. According to critics, smartphones are making us ill-mannered and sore-necked, dragging parents’ attention away from their kids, and destroying an entire generation.

But phones don’t have to be bad. With 4.68 billion people forecast to become mobile phone users by 2019, nonprofits and social science researchers are exploring new ways to turn our love of screens into a force for good. One increasingly popular option: Using texting to help change human behavior.

Texting: A unique tool

The short message service (SMS) was invented in the late 1980s, and the first text message was sent in 1992. (Engineer Neil Papworth sent “merry Christmas” to then-Vodafone director Richard Jarvis.) In the decades since, texting has emerged as the preferred communication method for many, and in particular younger generations. While that kind of habit-forming can be problematic—47% of US smartphone users say they “couldn’t live without” the device—our attachment to our phones also makes text-based programs a good way to encourage people to make better choices.

“Texting, because it’s anchored in mobile phones, has the ability to be with you all the time, and that gives us an enormous flexibility on precision,” says Todd Rose, director of the Mind, Brain, & Education Program at the Harvard Graduate School of Education. “When people lead busy lives, they need timely, targeted, actionable information.”

And who is busier than a parent? Text-based programs can help current or would-be moms and dads with everything from medication pickup to childhood development. Text4Baby, for example, messages pregnant women and young moms with health information and reminders about upcoming doctor visits. Vroom, an app for building babies’ brains, sends parents research-based prompts to help them build positive relationships with their children (for example, by suggesting they ask toddlers to describe how they’re feeling based on the weather). Muse, an AI-powered app, uses machine learning and big data to try and help parents raise creative, motivated, emotionally intelligent kids. As Jenny Anderson writes in Quartz: “There is ample evidence that we can modify parents’ behavior through technological nudges.”

Research suggests text-based programs may also be helpful in supporting young children’s academic and cognitive development. …Texts aren’t just being used to help out parents. Non-governmental organizations (NGOs) have also used them to encourage civic participation in kids and young adults. Open Progress, for example, has an all-volunteer community called “text troop” that messages young adults across the US, reminding them to register to vote and helping them find their polling location.

Text-based programs are also useful in the field of nutrition, where private companies and public-health organizations have embraced them as a way to give advice on healthy eating and weight loss. The National Cancer Institute runs a text-based program called SmokefreeTXT that sends US adults between three and five messages per day for up to eight weeks, to help them quit smoking.

Texting programs can be a good way to nudge people toward improving their mental health, too. Crisis Text Line, for example, was the first national 24/7 crisis-intervention hotline to conduct counseling conversations entirely over text…(More).

Big Data Is Getting Bigger. So Are the Privacy and Ethical Questions.

Curated on Posted on by Stefaan Verhulst

Goldie Blumenstyk at The Chronicle of Higher Education: “…The next step in using “big data” for student success is upon us. It’s a little cool. And also kind of creepy.

This new approach goes beyond the tactics now used by hundreds of colleges, which depend on data collected from sources like classroom teaching platforms and student-information systems. It not only makes a technological leap; it also raises issues around ethics and privacy.

Here’s how it works: Whenever you log on to a wireless network with your cellphone or computer, you leave a digital footprint. Move from one building to another while staying on the same network, and that network knows how long you stayed and where you went. That data is collected continuously and automatically from the network’s various nodes.

Now, with the help of a company called Degree Analytics, a few colleges are beginning to use location data collected from students’ cellphones and laptops as they move around campus. Some colleges are using it to improve the kind of advice they might send to students, like a text-message reminder to go to class if they’ve been absent.

Others see it as a tool for making decisions on how to use their facilities. St. Edward’s University, in Austin, Tex., used the data to better understand how students were using its computer-equipped spaces. It found that a renovated lounge, with relatively few computers but with Wi-Fi access and several comfy couches, was one of the most popular such sites on campus. Now the university knows it may not need to buy as many computers as it once thought.

As Gary Garofalo, a co-founder and chief revenue officer of Degree Analytics, told me, “the network data has very intriguing advantages” over the forms of data that colleges now collect.

Some of those advantages are obvious: If you’ve got automatic information on every person walking around with a cellphone, your dataset is more complete than if you need to extract it from a learning-management system or from the swipe-card readers some colleges use to track students’ activities. Many colleges now collect such data to determine students’ engagement with their coursework and campus activities.

Of course, the 24-7 reporting of the data is also what makes this approach seem kind of creepy….

I’m not the first to ask questions like this. A couple of years ago, a group of educators organized by Martin Kurzweil of Ithaka S+R and Mitchell Stevens of Stanford University issued a series of guidelines for colleges and companies to consider as they began to embrace data analytics. Among other principles, the guidelines highlighted the importance of being transparent about how the information is used, and ensuring that institutions’ leaders really understand what companies are doing with the data they collect. Experts at New America weighed in too.

I asked Kurzweil what he makes of the use of Wi-Fi information. Location tracking tends toward the “dicey” side of the spectrum, he says, though perhaps not as far out as using students’ social-media habits, health information, or what they check out from the library. The fundamental question, he says, is “how are they managing it?”… So is this the future? Benz, at least, certainly hopes so. Inspired by the Wi-Fi-based StudentLife research project at Dartmouth College and the experiences Purdue University is having with students’ use of its Forecast app, he’s in talks now with a research university about a project that would generate other insights that might be gleaned from students’ Wi-Fi-usage patterns….(More)

Open Data Use Case: Using data to improve public health

Curated on Posted on by Stefaan Verhulst

Chris Willsher at ODX: “Studies have shown that a large majority of Canadians spend too much time in sedentary activities. According to the Health Status of Canadians report in 2016, only 2 out of 10 Canadian adults met the Canadian Physical Activity Guidelines. Increasing physical activity and healthy lifestyle behaviours can reduce the risk of chronic illnesses, which can decrease pressures on our health care system. And data can play a role in improving public health.

We are already seeing examples of a push to augment the role of data, with programs recently being launched at home and abroad. Canada and the US established an initiative in the spring of 2017 called the Healthy Behaviour Data Challenge. The goal of the initiative is to open up new methods for generating and using data to monitor health, specifically in the areas of physical activity, sleep, sedentary behaviour, or nutrition. The challenge recently wrapped up with winners being announced in late April 2018. Programs such as this provide incentive to the private sector to explore data’s role in measuring healthy lifestyles and raise awareness of the importance of finding new solutions.

In the UK, Sport England and the Open Data Institute (ODI) have collaborated to create the OpenActive initiative. It has set out to encourage both government and private sector entities to unlock data around physical activities so that others can utilize this information to ease the process of engaging in an active lifestyle. The goal is to “make it as easy to find and book a badminton court as it is to book a hotel room.” As of last fall, OpenActive counted more than 76,000 activities across 1,000 locations from their partner organizations. They have also developed a standard for activity data to ensure consistency among data sources, which eases the ability for developers to work with the data. Again, this initiative serves as a mechanism for open data to help address public health issues.

In Canada, we are seeing more open datasets that could be utilized to devise new solutions for generating higher rates of physical activity. A lot of useful information is available at the municipal level that can provide specifics around local infrastructure. Plus, there is data at the provincial and federal level that can provide higher-level insights useful to developing methods for promoting healthier lifestyles.

Information about cycling infrastructure seems to be relatively widespread among municipalities with a robust open data platform. As an example, the City of Toronto, publishes map data of bicycle routes around the city. This information could be utilized in a way to help citizens find the best bike route between two points. In addition, the city also publishes data on indoor, outdoor, and post and ring bicycle parking facilities that can identify where to securely lock your bike. Exploring data from proprietary sources, such as Strava, could further enhance an application by layering on popular cycling routes or allow users to integrate their personal information. And algorithms could allow for the inclusion of data on comparable driving times, projected health benefits, or savings on automotive maintenance.

The City of Calgary publishes data on park sports surfaces and recreation facilities that could potentially be incorporated into sports league applications. This would make it easier to display locations for upcoming games or to arrange pick-up games. Knowing where there are fields nearby that may be available for a last minute soccer game could be useful in encouraging use of the facilities and generating more physical activity. Again, other data sources, such as weather, could be integrated with this information to provide a planning tool for organizing these activities….(More)”.

Identifying Healthcare Fraud with Open Data

Curated on Posted on by Stefaan Verhulst

Paper by Xuan Zhang et al: “Health care fraud is a serious problem that impacts every patient and consumer. This fraudulent behavior causes excessive financial losses every year and causes significant patient harm. Healthcare fraud includes health insurance fraud, fraudulent billing of insurers for services not provided, and exaggeration of medical services, etc. To identify healthcare fraud thus becomes an urgent task to avoid the abuse and waste of public funds. Existing methods in this research field usually use classified data from governments, which greatly compromises the generalizability and scope of application. This paper introduces a methodology to use publicly available data sources to identify potentially fraudulent behavior among physicians. The research involved data pairing of multiple datasets, selection of useful features, comparisons of classification models, and analysis of useful predictors. Our performance evaluation results clearly demonstrate the efficacy of the proposed method….(More)”.