Month: March 2013

Friday Fun Links 3-8-13

/ bs king / 4 Comments

Do you feel like getting away?  Got your passport handy?  How about those in other states?

Here’s some really pretty artistic gifs that kind of made my day.

Other amusing moments of the day include 17 kids who will change the world.

I guess I’m in a “kids are fun” mood today because I also liked this:

And I, I will survive…maybe

/ bs king / 1 Comment

Cancer Treatment Centers of America came under some serious fire today for their reporting practices around survival rates of their patients.  For those unfamiliar, CTCA is a for-profit cancer treatment center that advertises heavily on TV about their high survival rates and has multiple locations throughout the US.

The accusation of data manipulation include:
  • Not accepting patients whose prognosis is too bleak so that their death won’t count in their stats
  • Encouraging Medicare and Medicaid patients not to come there (approximately 14% of their patients are Medicare, your average oncology center is 50% Medicare)
  • Targeting richer patients whose added resources, better overall health and (likely) earlier detection will lead to better survival all on their own
  • Excluding large portions of the patients they do treat from their data
  • Reporting survival rates in terms of 4 year survival, not the industry standard 5 year survival
The charges are heavy, especially because the higher than average survival rate is a cornerstone of their advertising.  I took a look at one of their survival rate pages, and it does indeed only go through year 4, rather than the standard 5.  It also appears that they toss any patient who got any care anywhere else ever in the course of their diagnosis, and more strangely “excluded any patient whose medical records had missing information”.*  This left them with only 45 people to calculate prostate cancer survival rates from.

Apparently, CTCA has heard the criticism and is recalculating some of their stats:

Xiong said he is doing new survival calculations using more recent data from CTCA, trying to make sure the comparison to the national database is rigorous. The new results, Xiong said, are expected to be posted on CTCA’s website this month. 

For some cancers, CTCA will still have better survival rates, he said. For others, “the survival difference in favor of CTCA is no longer statistically significant” after adjusting for several differences between CTCA’s patients and those in the national database.

Now, I’ve talked before about hospital ranking and how difficult it is, but this story really got to me.   We’re living in a time in the US where hospitals are under increasing scrutiny to lower their costs, and rightfully so.  However, in our effort to achieve the triple aim (right treatment, right time, right price), we have to make sure we’re working honestly.  Increasing survival rate through innovation is awesome, increasing survival rates by only treating the population most likely to survive is atrocious.

This is why many hospitals are reluctant to release their statistics.  It’s easy to skew things if you try, and it’s even harder for the public to understand what this skewing means.  In education, teacher often complain their now “teaching to the test”…..do you really want a doctor who’s “treating for the stat”?

*Interestingly, when my workplace talks about our survival rates, we actually have a “lost to follow up” category we add in.  I’m curious what those numbers would be here….since I’m assuming that’s what “missing medical records” means.  Why not release the numbers of how many that is?  

Neurobunk and how to properly blame a journalist

/ bs king / 3 Comments

“When in doubt, blame the journalist” is one of my favorite explanations for bad science.  So often the science behind the headline is actually good (or at least appropriately admitting of it’s shortcomings) and then a journalist comes along and mucks it all up.  I’ve often wondered how scientists feel about seeing their work so grossly misrepresented, and yesterday I stumbled upon this TED talk where a neuroscientist explains how it felt to see that done to her own work:

http://embed.ted.com/talks/molly_crockett_beware_neuro_bunk.html

It’s a good video, but if you don’t have time for it, here’s the low down:  Molly Crockett and her lab did a study on whether or not taking away tryptophan from the brain would result in worse decision making.  They did this by giving people a gross drink.  The headlines ended up blaring “eat cheese for better decision making”.  Apparently the fact that cheese contains tryptophan was enough for the writers to conclude that eating cheese would cause decision making getting better….something the study never claimed to say.

The rest of her talk is quite good.  Some interesting points:

  • People are more likely to believe scientific articles that have pictures of the brain in them
  • Most regions of the brain have multiple functions, so any study claiming that the area associated with a specific emotion lit up at stimulus x likely just picked the function of that part of the brain they liked best 
  • Oxytocin not only promotes good feelings (like is commonly reported) but also jealousy and bad feelings
I don’t know much about neuroscience, so I enjoyed seeing new ways of cutting through the hype.  
It also led me to this article from a few months ago, which is also good.

Will the real racist please stand up?

/ bs king / 9 Comments

For those of you who don’t follow the activities of the Supreme Court, you missed a good one last week.  Shelby County v Holder went up before the judges, and Scalia, Roberts, Sotomayor and Kagan all got in some commentary that made headlines.   The case is a challenge specifically to Section 5 of the Voting Rights Act, which requires that states with a history of discriminatory practices in voting must get any changes to their voting practices “precleared” before they can implement them.  

Other states, like the one I currently reside in, can change their practices willy-nilly, and then just get sued later under section 2 of the Voting Rights Act, which all states must uphold.
Shelby County is arguing that Section 5 infringes on states rights by holding some states to a different standard based on past history.  As of 2008, here’s who’s on the section 5 list:
Now I’ll admit I wasn’t following the case all that closely, but my Dad and I talked about it briefly this weekend, which led him to send me this link.  Apparently part way through the arguments, Chief Justice Roberts queried why Mississippi needs special clearance when Massachusetts has a lower percentage of registered black voters and lower turnout rates than Mississippi does.  There’s been some bickering over whether the stats he used to back him up are valid or not (short version: given the margin of error they could be wrong, but it’s not overly likely), but that’s not what I wanted to talk about.  
What I wanted to talk about was how in the world a state goes about proving they’re not racist in their voting practices.  
This is a tough question.  Voter turnout is a funny thing….it’s typically low enough that the environment in which the vote is taking place can actually make a difference.  Here’s a few things you’d have to consider when assessing how many people in a particular :
  1. Which elections are we counting?  The census data Chief Justice Roberts was citing was from this lower court decision, which clarifies this was from the 2004 election.  I would like to see some more robust data that shows where these numbers go when it’s not a presidential election.
  2. What/who else was on the ballot in the individual states in the year the data was pulled.  Some issues just effect certain groups more.  We should really at least attempt to tease out if there was any significant differences in ballot measures/state level races in 2004 before comparing the numbers.
  3. Does it matter more who votes, or how much it took to get there? Voter turnout’s a funny thing…sometimes the more hurdles in people’s way, the more dedicated they get.  If two states have identical turnout rates, it wouldn’t always mean that it was equally easy for people to get to the polls. At no point in any of these decisions did I see an attempt to assess how easy/difficult people felt it was to vote.
  4. How many laws have they tried to pass but not been able to? When looking at who votes, it’s important to remember that those votes were cast using the setup of laws actually implemented. Sotomayor mentioned the first day that Shelby County has had 240 laws blocked under Section 2, and as I noted above, Massachusetts has tried to pass laws that did not hold up in court.
  5. Can we separate the effect of race from the effect of socioeconomic status? I voted in urban precincts for a number of years.  They can be terrible.  
  6. How are other minorities doing? I mean I get why the focus is where it is, but doesn’t it matter how other races are doing to?
So those are my thoughts on how you’d start to assess racism in elections in a meaningful way.  Other facets the court cited but I didn’t comment on included proportion of black elected officials (which I put less credence in because if the minority population isn’t even distributed throughout the state this skews easily) and the number of observers the federal government has sent to monitor elections (a circular argument the court admits, the federal government sends people where it thinks there’s a problem, you shouldn’t then use that to prove there’s a problem).
To be clear, this is more a thought experiment on how you would assess state by state racism than any commentary on what should happen with the Voting Rights Act.  I’ve also never been to Mississippi, and thus will withhold any judgment on the level of racism there in comparison to my state.  I have enough trouble figuring out where the heck I’m supposed to show up to vote in general (I’ve moved a lot) to have any idea if our voting policies are good, bad, or indifferent.  

Friday Fun Links 3-1-13

/ bs king / 2 Comments

Hey!  Happy Friday! In celebration, I think it’s time you ask the internet “Am I Awesome?”

I mentioned that in Salt Lake City I rekindled my love affair with dinosaurs.  Thus, this Tumblr makes me happy.

This also makes me happy: the most obscenely titled peer reviewed paper you’ll see all day.

Also from io9, the scientists that would make the best superheros.

I know I’m feeling pretty burnt out on politics, but this site is pretty cool….locate your state level representation, and get the bills they sponsor, committees they serve on, and other such fiddle faddle.