Call it data liberation day: Patients can now access all their health records digitally  

Curated on Posted on by Stefaan Verhulst

Article by Casey Ross: “The American Revolution had July 4. The allies had D-Day. And now U.S. patients, held down for decades by information hoarders, can rally around a new turning point, October 6, 2022 — the day they got their health data back.

Under federal rules taking effect Thursday, health care organizations must give patients unfettered access to their full health records in digital format. No more long delays. No more fax machines. No more exorbitant charges for printed pages.

Just the data, please — now…The new federal rules — passed under the 21st Century Cures Act — are designed to shift the balance of power to ensure that patients can not only get their data, but also choose who else to share it with. It is the jumping-off point for a patient-mediated data economy that lets consumers in health care benefit from the fluidity they’ve had for decades in banking: they can move their information easily and electronically, and link their accounts to new services and software applications.

“To think that we actually have greater transparency about our personal finances than about our own health is quite an indictment,” said Isaac Kohane, a professor of biomedical informatics at Harvard Medical School. “This will go some distance toward reversing that.”

Even with the rules now in place, health data experts said change will not be fast or easy. Providers and other data holders — who have dug in their heels at every step  —  can still withhold information under certain exceptions. And many questions remain about protocols for sharing digital records, how to verify access rights, and even what it means to give patients all their data. Does that extend to every measurement in the ICU? Every log entry? Every email? And how will it all get standardized?…(More)”

Realistic Reasons to be Bullish on Nudging

Curated on Posted on by Stefaan Verhulst

Essay by Ed Bradon: “Nudges are a valuable, modestly resourced and, as we shall see, dramatically underused way of improving people’s lives. Abandoning them now would be like discovering aspirin then immediately shutting down production because it doesn’t cure cancer.

Nudging’s value stems from its modest but unusual success in solving two hard problems. One is changing people’s behavior, in a sustainable way, in challenging contexts such as health, crime, and education, in the messiness of the real world. The second is getting stuff done in large organizations, particularly government. Most attempts at either one of these fail: over 80 percent of social projects and programs don’t work; big reform efforts are generally stymied, or backfire.

By contrast, nudges do get implemented—albeit with a lot of hard work behind the scenes—and when they are they tend to do some good. Looking at trials from two nudge units, Stefano DellaVigna and Elizabeth Linos find that a sample of low-cost, light-touch nudges do better than their control groups by 8 percent on average. In a landscape littered with failures and overclaiming, small robust improvements that affect thousands of people are worth having…

But might we still be overinvesting in nudges? Perhaps they have proven so popular that the best opportunities have been exhausted, making it time to redeploy resources elsewhere?

Unfortunately, the opposite is true: we haven’t picked even the lowest hanging fruit. A back-of-the-envelope calculation for central governments can illustrate this opportunity. A typical government might have 10 large departments of state (a department for education, for example), each with 10 directorates (such as the organization in charge of apprenticeships and technical education). And each of these could easily have 20 nudge-able systems (a system through which young people can sign up for apprenticeships, say). Each system can accommodate multiple nudges: you could try boosting sign-ups by pre-filling parts of the form, for example, while also reminding students at a timely moment. One government × ten departments × ten directorates × twenty systems × three nudges each gets us a total of 6,000 possible nudges….(More)”.

How to stop our cities from being turned into AI jungles

Curated on Posted on by Stefaan Verhulst

Stefaan G. Verhulst at The Conversation: “As artificial intelligence grows more ubiquitous, its potential and the challenges it presents are coming increasingly into focus. How we balance the risks and opportunities is shaping up as one of the defining questions of our era. In much the same way that cities have emerged as hubs of innovation in culture, politics, and commerce, so they are defining the frontiers of AI governance.

Some examples of how cities have been taking the lead include the Cities Coalition for Digital Rights, the Montreal Declaration for Responsible AI, and the Open Dialogue on AI Ethics. Others can be found in San Francisco’s ban of facial-recognition technology, and New York City’s push for regulating the sale of automated hiring systems and creation of an algorithms management and policy officer. Urban institutes, universities and other educational centres have also been forging ahead with a range of AI ethics initiatives.

These efforts point to an emerging paradigm that has been referred to as AI Localism. It’s a part of a larger phenomenon often called New Localism, which involves cities taking the lead in regulation and policymaking to develop context-specific approaches to a variety of problems and challenges. We have also seen an increased uptake of city-centric approaches within international law frameworks…

Below are ten principles to help systematise our approach to AI Localism. Considered together, they add up to an incipient framework for implementing and assessing initiatives around the world:…(More)”.

How Game Design Principles Can Enhance Democracy

Curated on Posted on by Stefaan Verhulst

Essay by Adrian Hon: “Gamification — the use of ideas from game design for purposes beyond entertainment — is everywhere. It’s in our smartwatches, cajoling us to walk an extra thousand steps for a digital trophy. It’s in our classrooms, where teachers use apps to reward and punish children with points. And it’s in our jobs, turning the work of Uber drivers and call center staff into quests and missions, where success comes with an achievement and $50 bonus, and failure — well, you can imagine.

Many choose to gamify parts of their lives to make them a little more fun, like learning a new language with Duolingo or going for a run with my own Zombies, Run! app. But the gamification we’re most likely to encounter in our lives is something we have no control over — in our increasingly surveilled and gamified workplaces, for instance, or through the creeping advance of manipulative gamification in financial, insurance, travel and health services.

In my new book, “You’ve Been Played,” I argue that governments must regulate gamification so that it respects workers’ privacy and dignity. Regulators must also ensure that gamified finance apps and video games don’t manipulate users into losing more money than they can afford. Crucially, I believe any gamification intended for schools and colleges must be researched and debated openly before deployment.

But I also believe gamification can strengthen democracies, by designing democratic participation to be accessible and to build consensus. The same game design ideas that have made video games the 21st century’s dominant form of entertainment — adaptive difficulty, responsive interfaces, progress indicators and multiplayer systems that encourage co-operative behaviour — can be harnessed in the service of democracies and civil society…

Fully participating in democracy today — not just voting, but getting involved in local planning and budgeting processes, or building and sharing knowledge — involves navigating increasingly complex systems that desperately need to be made more welcoming and accessible. So while the idea of gamifying democracy may seem to trivialize the deep problems we face today or be another instance of techno-solutionism, that’s not my intention. It’s a recognition that we already live in a digital democracy — one where deliberation takes place on social media that’s gamified to reward and promote the hottest takes and most divisive comments by means of upvotes and karma points; where people learn about the world through the warped lens of conspiracy theories that resemble alternate reality games; and where collective action is enabled and amplified by popularity contests on crowdfunding websites and Reddit.

“The same game design ideas that have made video games the 21st century’s dominant form of entertainment can be harnessed in the service of democracies and civil society.”…(more)”

Why Funders Should Go Meta

Curated on Posted on by Stefaan Verhulst

Paper by Stuart Buck & Anna Harvey: “We don’t mean the former Facebook. Rather, philanthropies should prefer to fund meta-issues—i.e., research and evaluation, along with efforts to improve research quality. In many cases, it would be far more impactful than what they are doing now.

This is true at two levels.

First, suppose you want to support a certain cause–economic development in Africa, or criminal justice reform in the US, etc. You could spend millions or even billions on that cause.

But let’s go meta: a force multiplier would be funding high-quality research on what works on those issues. If you invest significantly in social and behavioral science research, you might find innumerable ways to improve on the existing status quo of donations.

Instead of only helping the existing nonprofits who seek to address economic development or criminal justice reform, you’d be helping to figure out what works and what doesn’t. The result could be a much better set of investments for all donors.

Perhaps some of your initial ideas end up not working, when exhaustively researched. At worst, that’s a temporary embarrassment, but it’s actually all for the better—now you and others know to avoid wasting more money on those ideas. Perhaps some of your favored policies are indeed good ideas (e.g., vaccination), but don’t have anywhere near enough take-up by the affected populations. Social and behavioral science research (as in the Social Science Research Council’s Mercury Project) could help find cost-effective ways to solve that problem…(More)”.

A ‘Feminist’ Server to Help People Own Their Own Data

Curated on Posted on by Stefaan Verhulst

Article by Padmini Ray Murray: “All of our digital lives reside on servers – mostly in corporate server farms owned by the likes of Google, Amazon, Apple, and Microsoft.  These farms contain machines that store massive volumes of data generated by every single user of the internet. These vast infrastructures allow people to store, connect, and exchange information on the internet. 

Consequently, there is a massive distance between users and where and how the data is stored, which means that individuals have very little control over how their data is stored and used. However, due to the huge reliance on these massive corporate technologies, individuals are left with very little choice but to accept the terms dictated by these businesses. The conceptual alternative of the feminist server was created by groups of feminist and queer activists who were concerned about how little power they have over owning and managing their data on the internet. The idea of the feminist server was described as a project that is interested in “creating a more autonomous infrastructure to ensure that data, projects and memory of feminist groups are properly accessible, preserved and managed” – a safe digital library to store and manage content generated by feminist groups. This was also a direct challenge to the traditionally male-dominated spaces of computer hardware management, spaces which could be very exclusionary and hostile to women or queer individuals who might be interested in learning how to use these technologies. 

There are two related ways by which a server can be considered as feminist. The first is based on who runs the server, and the second is based on who owns the server. Feminist critics have pointed out how the running of servers is often in the hands of male experts who are not keen to share and explain the knowledge required to maintain a server – a role known as a systems admin or, colloquially, a “sysadmin” person. Thus the concept of feminist servers emerged out of a need to challenge patriarchal dominance in hardware and infrastructure spaces, to create alternatives that were nurturing, anti-capitalist, and worked on the basis of community and solidarity…(More)”.

Citizens can effectively monitor the integrity of their elections: Evidence from Colombia

Curated on Posted on by Stefaan Verhulst

Paper by Natalia Garbiras-Díaz and Mateo Montenegro: “ICT-enabled monitoring tools effectively encourage citizens to oversee their elections and reduce fraud

Despite many efforts by governments and international organizations to guarantee free and fair elections, in many democracies, electoral integrity continues to be threatened. Irregularities including fraud, vote buying or voter intimidation reduce political accountability, which can distort the allocation of public goods and services (Hicken 2011, Khemani 2015). 

But why is it so hard to prevent and curb electoral irregularities? While traditional strategies such as the deployment of electoral observers and auditors have proven effective (Hyde 2010, Enikolopov et al. 2013, Leefers and Vicente 2019), these are difficult to scale up and involve large investments in the training, security and transportation of personnel to remote and developing areas.

In Garbiras-Díaz and Montenegro (2022), we designed and implemented a large-scale field experiment during the election period in Colombia to study an innovative and light-touch strategy that circumvents many of these costs. We examine whether citizens can effectively oversee elections through online platforms, and demonstrate that delegating monitoring to citizens can provide a cost-effective alternative to more traditional strategies. Moreover, with growing access to the internet in developing countries reducing the barriers to online monitoring, this strategy is scalable and can be particularly impactful. Our results show how citizens can be encouraged to monitor elections, and, more importantly, illustrate how this form of monitoring can prevent politicians from using electoral irregularities to undermine the integrity of elections…(More)”.

All Democracy Is Global

Curated on Posted on by Stefaan Verhulst

Article by  Larry Diamond: “The world is mired in a deep, diffuse, and protracted democratic recession. According to Freedom House, 2021 was the 16th consecutive year in which more countries declined in freedom than gained. Tunisia, the sole democracy to emerge from the Arab Spring protests that began in 2010, is morphing into a dictatorship. In countries as diverse as Bangladesh, Hungary, and Turkey, elections have long ceased to be democratic. Autocrats in Algeria, Belarus, Ethiopia, Sudan, Turkey, and Zimbabwe have clung to power despite mounting public demands for democratization. In Africa, seven democracies have slid back into autocracy since 2015, including Benin and Burkina Faso.

Democracy is looking shaky even in countries that hold free and fair elections. In emerging-market behemoths such as Brazil, India, and Mexico, democratic institutions and norms are under attack. Brazilian President Jair Bolsonaro has made threats of an autogolpe (self-coup) and a possible return to military rule if he does not win reelection in October. Indian Prime Minister Narendra Modi has steadily chipped away at press freedoms, minority rights, judicial independence, the integrity of the civil service, and the autonomy of civil society. Mexican President Andrés Manuel López Obrador has attempted to silence critics and remove democratic checks and balances.

Democratic prospects have risen and fallen in decades past, but they now confront a formidable new problem: democracy is at risk in the very country that has traditionally been its most ardent champion. Over the past dozen years, the United States has experienced one of the biggest declines in political rights and civil liberties of any country measured by the Freedom House annual survey. The Economist now ranks the United States as a “flawed democracy” behind Spain, Costa Rica, and Chile. U.S. President Donald Trump deserves much of the blame: he abused presidential power on a scale unprecedented in U.S. history and, after being voted out of office, propagated the “Big Lie” of election fraud and incited the violent rioters who stormed the U.S. Capitol on January 6, 2021. But American democracy was in peril before Trump assumed office, with rising polarization exposing acute flaws in American democratic institutions. The Electoral College, the representational structure of the Senate, the Senate filibuster, the brazen gerrymandering of House districts, and lifetime appointments to the Supreme Court have all made it possible for a political minority to exert prolonged outsize influence.

Can a country in the throes of its own democratic decay do anything to arrest the broader global decline? For many, the answer is no…(More)”.

The case for lotteries as a tiebreaker of quality in research funding

Curated on Posted on by Stefaan Verhulst

Editorial at Nature: “Earlier this month, the British Academy, the United Kingdom’s national academy for humanities and social sciences, introduced an innovative process for awarding small research grants. The academy will use the equivalent of a lottery to decide between funding applications that its grant-review panels consider to be equal on other criteria, such as the quality of research methodology and study design.

Using randomization to decide between grant applications is relatively new, and the British Academy is in a small group of funders to trial it, led by the Volkswagen Foundation in Germany, the Austrian Science Fund and the Health Research Council of New Zealand. The Swiss National Science Foundation (SNSF) has arguably gone the furthest: it decided in late 2021 to use randomization in all tiebreaker cases across its entire grant portfolio of around 880 million Swiss francs (US$910 million).

Other funders should consider whether they should now follow in these footsteps. That’s because it is becoming clear that randomization is a fairer way to allocate grants when applications are too close to call, as a study from the Research on Research Institute in London shows (see go.nature.com/3s54tgw). Doing so would go some way to assuage concerns, especially in early-career researchers and those from historically marginalized communities, about the lack of fairness when grants are allocated using peer review.

The British Academy/Leverhulme small-grants scheme distributes around £1.5 million (US$1.7 million) each year in grants of up to £10,000 each. These are valuable despite their relatively small size, especially for researchers starting out. The academy’s grants can be used only for direct research expenses, but small grants are also typically used to fund conference travel or to purchase computer equipment or software. Funders also use them to spot promising research talent for future (or larger) schemes. For these reasons and more, small grants are competitive — the British Academy says it is able to fund only 20–30% of applications in each funding round…(More)”.

Artificial Intelligence Needs Both Pragmatists and Blue-Sky Visionaries

Curated on Posted on by Stefaan Verhulst

Essay by Ben Shneiderman: “Artificial intelligence thinkers seem to emerge from two communities. One is what I call blue-sky visionaries who speculate about the future possibilities of the technology, invoking utopian fantasies to generate excitement. Blue-sky ideas are compelling but are often clouded over by unrealistic visions and the ethical challenges of what can and should be built.

In contrast, what I call muddy-boots pragmatists are problem- and solution-focused. They want to reduce the harms that widely used AI-infused systems can create. They focus on fixing biased and flawed systems, such as in facial recognition systems that often mistakenly identify people as criminals or violate privacy. The pragmatists want to reduce deadly medical mistakes that AI can make, and steer self-driving cars to be safe-driving cars. Their goal is also to improve AI-based decisions about mortgage loans, college admissions, job hiring and parole granting.

As a computer science professor with a long history of designing innovative applications that have been widely implemented, I believe that the blue-sky visionaries would benefit by taking the thoughtful messages of the muddy-boots realists. Combining the work of both camps is more likely to produce the beneficial outcomes that will lead to successful next-generation technologies.

While the futuristic thinking of the blue-sky speculators sparks our awe and earns much of the funding, muddy-boots thinking reminds us that some AI applications threaten privacy, spread misinformation and are decidedly racist, sexist and otherwise ethically dubious. Machines are undeniably part of our future, but will they serve all future humans equally? I think the caution and practicality of the muddy-boots camp will benefit humanity in the short and long run by ensuring diversity and equality in the development of the algorithms that increasingly run our day-to-day lives. If blue-sky thinkers integrate the concerns of muddy-boots realists into their designs, they can create future technologies that are more likely to advance human values, rights and dignity…(More)”.