Is a racially-biased algorithm delaying health care for one million Black people?

Curated on Posted on by Stefaan Verhulst

Jyoti Madhusoodanan at Nature: “One million Black adults in the United States might be treated earlier for kidney disease if doctors were to remove a controversial ‘race-based correction factor’ from an algorithm they use to diagnose people and decide whether to administer medication, a comprehensive analysis finds.

Critics of the factor question its medical validity and say it potentially perpetuates racial bias — and that the latest study, published on 2 December in JAMA1, strengthens growing calls to discontinue its use.

“A population that is marginalized and much less likely to have necessary resources and support is the last group we want to put in a situation where they’re going to have delays in diagnosis and treatment,” says nephrologist Keith Norris at the University of California, Los Angeles, who argues for retiring the correction until there’s clear evidence that it’s necessary.

On the flip side, others say that the correction is based on scientific data that can’t be ignored, although they, too, agree that its basis on race is a problem….(More)”.

Challenging the ‘Great Reset’ theory of pandemics

Curated on Posted on by Stefaan Verhulst

Essay by Mark Honigsbaum: “Few events are as compelling as an epidemic. When sufficiently severe, an epidemic evokes responses from every sector of society, laying bare social and economic fault lines and presenting politicians with fraught medical and moral choices. In the most extreme cases, an epidemic can foment a full-blown political crisis. Thus, Thucydides describes how the repeated visitations of plague to Athens in 430-426 BC provoked widespread social disorder and the breakdown of civic norms.

‘Men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane,’ writes Thucydides. ‘All the burial rites before in use were entirely upset and… many had recourse to the most shameless sepulchres.’

As the plague progresses, Thucydides describes how Athenians were swept up in a wave of hedonism and lawlessness, threatening the foundations of Athenian democracy: ‘Men now coolly ventured on what they had formerly done in a corner… fear of gods or law of man there was none to restrain them.’

The resulting crisis, Thucydides claimed, undermined Athenians’ faith in the rule of law and the democratic principles that underpinned the Greek city state, paving the way for the installation of a Spartan oligarchy known as the Thirty Tyrants. Even though the Spartans were later ejected, Athens never regained its confidence.

Covid-19 appears to have engendered a similar crisis in our world, the main difference being in scale. Whereas the crisis Thucydides describes was confined to Athens, the coronavirus pandemic has destabilized governments from Brazil to Belarus, not just that of a 5th century city-state. The political reckoning has been particularly rapid in the United States, where Donald Trump’s inability or unwillingness to check the spread of the coronavirus was a key factor in his recent election defeat. Now, the lockdowns and social distancing measures look set to plunge the world into the worst economic depression since the 1930s, raising the spectre of further political instability.

Given the wide-ranging social, economic and political impacts of Covid-19, it is natural to assume that the same must have been true of past epidemics and pandemics. But is this the case? Do pandemics really have the historical impacts that are often claimed for them or are these claims simply the product of particular narratives and readings of history? …(More)”.

Getting Everyone Vaccinated, With ‘Nudges’ and Charity Auctions

Curated on Posted on by Stefaan Verhulst

Richard Thaler at the New York Times: “The good news is that safe and effective vaccines from Moderna and Pfizer appear to be on the way soon and that more are likely to follow.

The bad news is an usual combination: There won’t be enough vaccine on hand to meet initial demand, yet there is also a need to urge everyone to get shots.

I have some suggestions: An unusual type of charity auction, a bit of technology and a few nudges can help….

Economic theory offers a standard method for dealing with shortages. It is, basically: Let markets work. This would mean that those willing to pay the most would get the vaccine first.

Wisely, policymakers are not following this course. Nurses, other frontline workers and most nursing home residents could not win a bidding battle with billionaires. And, to be clear, they should not have to!

Yet there is a small but useful role that prices might play in determining who gets priority in the second round of vaccines, after the first 20 million people have gotten their shots.

At that point, perhaps sometime early this winter, suppose a small proportion of doses are sold in what would amount to a charity auction.

Who might be the winning bidders? Very wealthy individuals and high-tech companies are likely to account for some of the demand, along with businesses that employ high-profile talent like professional athletes and entertainers.

Just imagine how much the National Basketball Association, whose season will start around Christmas, would be willing to pay to ensure that none of its players or staff would be infected! The same goes for Hollywood studios and television production companies that are eager to go back to work.

The prospect of selling off precious vaccine to celebrity athletes and entertainers, hedge fund magnates and high-tech billionaires may strike you as utterly immoral, exacerbating the inequality this disease has already inflicted. But before you dismiss this idea as outrageous, let me make three points.

First, the very purpose of the charity auction would be to redistribute money from the rich to the poor….(More)”.

What the World’s First Medical Records Tell Us About Ancient Life

Curated on Posted on by Stefaan Verhulst

Essay by Robin Lane Fox: “The Hippocratic books now known as the Epidemics are entitled in Greek epidemiai. This title does not refer to epidemics as we now painfully recognize them, individual diseases which are spread widely through a population, whether by touch, inhaling, contact with wildlife, eating, drinking, kissing (which the elder Pliny, c. AD 70, recognized to be a means of transmitting diseases) or sex, while remaining one and the same disease. In the mid-fifth century BC, the amiable Ion, a poet and author from the island of Chios, composed Epidemiai which referred to his visits to the demos, or people, of individual city-states around the Greek world. His title has sometimes misled readers of the medical Epidemiai into thinking that their title, too, refers to traveling doctors’ visits to particular places. They refer to such visits, but their use of the verb epidemein shows that for them the word epidemia referred to the presence of a disease in a community. It was not necessarily a rampant disease in our sense of the word “epidemic,” and it was not contrasted with diseases which were endemic, a category the authors did not distinguish, but it was certainly a disease at large. This meaning was still correctly understood in later ancient commentaries on the Epidemic books.

By the mid-first century AD, seven books were grouped under this title: the grammarian Erotian referred then to “seven books of Epidemics” in the list of works which he considered, over-optimistically, to be by Hippocrates himself. The title went back to earlier editors, probably at least as early as the third century BC, but it may not have been used by any of the books’ original authors. All seven books share a distinctive feature. Whereas the other texts in the Hippocratic Corpus refer to patients in general, and only once, in passing, name an individual, the Epidemic books are quite different. They contain individual case histories, most of which specify the very place where the named patient lived, even the house or location. They are the very first observations and descriptions of real-life individuals during a number of days which survive anywhere in the world. In Babylonia written case histories of named individuals are unknown.

In China none survives until c. 170 BC, and even then they were presented for a different purpose, to defend their doctor-author’s reputation. In ancient Egypt, cases were discussed individually in the now-famous medical papyri whose contents date back into the second millennium BC, but they never name patients or describe observations of them day after day, let alone locate them at an exact address….(More)”.

People understand statistics better than politicians think

Curated on Posted on by Stefaan Verhulst

Sarah O’Connor at the Financial Times: “In 2015 I took my reporter’s notebook to Liverpool because statistics suggested it was enjoying a jobs boom. The unemployment gap between the northern English city and the national average had shrunk to the smallest in a decade. When I mentioned that fact to people I met, I might as well have said the grass was pink.

“It’s certainly not our experience, I would say I’ve never seen poverty at this level,” was the response from the director of the local Citizens Advice Bureau. A woman who ran a small cake business said: “My cynical side thinks straight away they’ve probably got zero-hours contracts somewhere — [they] are a great way of cooking the books.”

I thought of that trip when I read a newly published study that uses an in-depth survey and focus groups to delve into the British public’s understanding of economics. The headline findings are bleak. Large parts of the public have misperceptions about how economic concepts such as the unemployment rate are measured and they are “sceptical and cynical” about data.

One obvious response would be to blame inadequate education and worry that economic ignorance allows people to be duped by demagogues such as Nigel Farage in the UK and Donald Trump in the US.

Economic literacy classes in schools would certainly be a good idea, especially since most of those surveyed were “deeply interested” in the economy and regretted not understanding the details. But there’s more to this story. The public live and breathe the economy every day. If their first response to a statistic such as the unemployment rate is to say “that doesn’t feel right” (a common response in the focus groups) then perhaps it’s the economists who are missing something….(More)”.

Silicon Valley’s next goal is 3D maps of the world — made by us

Curated on Posted on by Stefaan Verhulst

Tim Bradshaw at the Financial Times: “When technology transformed the camera, the shift from film to digital sensors was just the beginning. As standalone cameras were absorbed into our phones, they gained software smarts, enabling them not only to capture light but also to understand the contents of a photo and even recognise people in it.

A similar transformation is now starting to happen to maps — and it too is powered by those advances in camera technology. In the next 20 years, our collective understanding of a “map” will be unrecognisable from the familiar grid of roads and places that has endured even as the A-Z street atlas has been supplanted by Google Maps.

Before long, countless objects and places will be captured and recreated in 3D digital models that we can view through our phones or even, at some stage, on headsets. This digital world might be populated by our avatars, turned into a playing field for new kinds of games or used to discover routes, buildings and services around us. 

Nobody seems sure yet what the killer app for this “digital twin” of Planet Earth might be, but that hasn’t stopped Silicon Valley from racing to build it anyway. Facebook, Apple, Google and Microsoft, as well as the developers of Snapchat and Pokémon Go, are all hoping to bring this “mirrorworld” to life, as a precursor to the augmented-reality (AR) glasses that many in tech see as the next big thing.

To place virtual objects in our world, our devices need to know the textures and contours of their surroundings, which GPS cannot see. But instead of sending out cars with protruding cameras to scan the world, as Google did to build Street View over the past decade and a half, these maps will be plotted by hundreds of millions of users like you and me. The question is whether we even realise that we have been dragooned into Silicon Valley’s army of cartographers. They cannot do it without us.

This month, Google said it would ask Maps users to upload photos to Street View using their smartphones for the first time. Only handsets running its AR software can contribute.  As Michael Abrash, chief scientist at Facebook’s Oculus headset unit, recently told Fast Company magazine: “Crowdsourcing has to be the primary way that this works. There is no other way to scale.”…(More)”.

Lawmakers are trying to create a database with free access to court records. Judges are fighting against it.

Curated on Posted on by Stefaan Verhulst

Ann Marimow in the Washington Post: “Leaders of the federal judiciary are working to block bipartisan legislation designed to create a national database of court records that would provide free access to case documents.

Backers of the bill, who are pressing for a House vote in the coming days, envision a streamlined, user-friendly system that would allow citizens to search for court documents and dockets without having to pay. Under the current system, users pay 10 cents per page to view the public records through the service known as PACER, an acronym for Public Access to Court Electronic Records.

“Everyone wants to have a system that is technologically first class and free,” said Rep. Hank Johnson (D-Ga.), a sponsor of the legislation with Rep. Douglas A. Collins (R-Ga.).

A modern system, he said, “is more efficient and brings more transparency into the equation and is easier on the pocketbooks of regular people.”…(More)”.

COVID-19 Pushes Digital Services from Luxury to Necessity

Curated on Posted on by Stefaan Verhulst

Zack Quintance at GovTech: “So much of American life was pushed out of physical spaces and onto the Internet this year, including the vast majority of local government services. Following the outbreak of COVID-19 and resultant social distancing guidelines, seemingly overnight it became dangerous to wait in line at city hall, or to interact with a public servant in close proximity across the space of a traditional counter.

As a result, long-simmering governmental efforts to modernize and make services digital in 2020 were supercharged. For digital government services, the danger of the virus was like a turbo boost for a race car that had been lazily chugging along. Indeed, public-sector entities at state and local levels have sought to catch up to private companies online for years, struggling to offer a modern customer experience to constituents with projects that have ranged from online permit renewal to 24-hour chatbots. With the pandemic, providing digital services fast moved from luxury to necessity….

A great example of the former at the state level took place in Vermont, specifically within that state’s Department of Motor Vehicles (DMV). The Vermont DMV was already working to launch a new online driver’s license renewal platform, one that would enable residents there to avoid in-person trips to the office. The pandemic made the timing of that launch ideal, finally giving users a digital option they could use from home.

And the Vermont DMV is far from alone. There were others at the state level that worked on and debuted new online processes as well. Maryland, for example, managed to stand up a new online grant application in the early days of the crisis, doing so in just eight hours. Digitization efforts like this have traditionally taken far longer, but agencywide buy-in was fostered here by COVID-19. Armed with this, the Maryland Department of Information Technology (DoIT) was able to rapidly collaborate with the state’s Department of Commerce to add new small business grant application functionality to a platform the IT shop had launched for a different purpose back in early 2018.

At the city level, Buffalo, N.Y., managed the similarly speedy task of transitioning its 311 infrastructure to be remote-operated as its city staff moved to work-from-home operations. In that instance, City Hall was vacated in the service of social distancing on a Friday, and by the following Monday, the IT shop had 311 up and running again via remote operation, doing so again with a collaboration, this time with the University of Buffalo and Cisco….(More)”.

Public Value Science

Curated on Posted on by Stefaan Verhulst

Barry Bozeman in Issues in Science and Technology: “Why should the United States government support science? That question was apparently settled 75 years ago by Vannevar Bush in Science, the Endless Frontier: “Since health, well-being, and security are proper concerns of Government, scientific progress is, and must be, of vital interest to Government. Without scientific progress the national health would deteriorate; without scientific progress we could not hope for improvement in our standard of living or for an increased number of jobs for our citizens; and without scientific progress we could not have maintained our liberties against tyranny.”

Having dispensed with the question of why, all that remained was for policy-makers to decide, how much? Even at the dawn of modern science policy, costs and funding needs were at the center of deliberations. Though rarely discussed anymore, Endless Frontier did give specific attention to the question of how much. The proposed amounts seem, by today’s standards, modest: “It is estimated that an adequate program for Federal support of basic research in the colleges, universities, and research institutes and for financing important applied research in the public interest, will cost about 10 million dollars at the outset and may rise to about 50 million dollars annually when fully underway at the end of perhaps 5 years.”

In today’s dollars, $50 million translates to about $535 million, or less than 2% of what the federal government actually spent for basic research in 2018. One way to look at the legacy of Endless Frontier is that by answering the why question so convincingly, it logically followed that the how much question could always be answered simply by “more.”

In practice, however, the why question continues to seem so self-evident because it fails to consider a third question, who? As in, who benefits from this massive federal investment in research, and who does not? The question of who was also seemingly answered by Endless Frontier, which not only offered full employment as a major goal for expanded research but also embraced “the sound democratic principle that there should be no favored classes or special privilege.”

But I argue that this principle has now been soundly falsified. In an economic environment characterized by growth but also by extreme inequality, science and technology not only reinforce inequality but also, in some instances, help widen the gap. Science and technology can be a regressivefactor in the economy. Thus, it is time to rethink the economic equation justifying government support for science not just in terms of why and how much, but also in terms of who.

What logic supports my claim that under conditions of conspicuous inequality, science and technology research is often a regressive force? Simple: except in the case of the most basic of basic research (such as exploration of other galaxies), effects are never randomly distributed. Both the direct and indirect effects of science and technology tend to differentially affect citizens according to their socioeconomic power and purchasing power….(More)”.

Intentional and Unintentional Sludge

Curated on Posted on by Stefaan Verhulst

Essay by Crawford Hollingworth and Liz Barker: “…Both of these stories are illustrations of what many mums and gym–goers may have experienced across the United Kingdom and United States as they tried to cope with the pandemic. We, along with other behavioral scientists, would label both as sludge—when users face high levels of friction obstructing their efforts to achieve something that is in their best interest, or are misled or encouraged to take action that is not in their best interest.

We can think of what the English mum goes through as unintentional sludge—friction due to factors like rushed design, poor infrastructure, and inadequate oversight. The mother is trying to access a benefit that will help her and which she has a right to claim, and which the government genuinely wants her to access. Yet multiple barriers prevented her from accessing the voucher that would help feed her children. Millions of parents found themselves in this situation as schools closed in England earlier this year. All over the country schools ended up paying for food parcels and gift vouchers out of their own budgets to help families who were going hungry.

What the New York gym-goer faces is different. It is intentional sludge—friction put in place knowingly to benefit an organization at the expense of the user. The gym doesn’t want him to cancel the membership, which would mean lost revenue. Even absent the pandemic, the policy would be considered unnecessarily difficult to cancel. The gym’s hope is that people forget, give up, or don’t bother canceling in person or over the phone, or that it takes them longer to do so. This translates into revenue for them, without any of the costs of providing a service. Stories like this have resulted in class-action lawsuits against companies that make it overly difficult or impossible to cancel gym memberships. One lawsuit alleged that one large gym company was stealing over $30 million per month from customers….(More)”.