Monday, April 23, 2012

Hospital ripoffs

Hospital charges are all over the map: according to the report published Monday in the Archives of Internal Medicine, fees for a routine appendectomy in California can range from $1,500 to — in one extreme case — $182,955. Researchers found wide variations in charges even among appendectomy patients treated at the same hospital.

“We expected to see variations of two or three times the amount, but this is ridiculous,” said Dr. Renee Y. Hsia, the study’s lead author and an assistant professor of emergency medicine at the University of California, San Francisco. “There’s no rhyme or reason for how patients are charged or how hospitals come up with charges.” ....

Hospital charges appear on patients’ bills, but they often bear no relation to the discounted fees that an insurer will end up paying. Still, some patients do get stuck paying the retail price. They include the uninsured, those with bare-bones or high-deductible plans, and even some fully insured people like Mr. Hong. ...

After reviewing all the cases and accounting for individual variations in health, Dr. Hsia said one-third of the variation in charges still could not be explained.

The wide range of hospital prices isn’t limited to appendectomy. In 2007, researchers at the University of Pittsburgh and elsewhere posed as patients trying to get pricing information from hospitals in advance of a procedure, a right under California state law. Hospital hysterectomy charges ranged from $3,500 to $65,300, the researchers found. Gallbladder removal charges ranged from $2,700 to $36,000, and a colonoscopy screening might cost anywhere from $350 to $5,805.

Fewer than one-third of the 353 hospitals that were queried even responded to requests for pricing information. Those that did often did not provide all the information requested or say whether physician fees were included, said Dr. Ateev Mehrotra, an assistant professor of medicine at University of Pittsburgh School of Medicine and a RAND policy analyst who was the senior author of that study.
--Roni Caryn Rabin, NYT, on the nonsense of hospital bills

Sunday, April 22, 2012

University of Florida gives up on the future

Wow, no one saw this coming. The University of Florida announced this past week that it was dropping its computer science department, which will allow it to save about $1.7 million. The school is eliminating all funding for teaching assistants in computer science, cutting the graduate and research programs entirely, and moving the tattered remnants into other departments.

Let’s get this straight: in the midst of a technology revolution, with a shortage of engineers and computer scientists, UF decides to cut computer science completely?
--Steven Salzberg, Forbes, on eating the seeds meant for your future plantings. HT: CF

Irreproducibility in cancer research

Over the past decade, before pursuing a particular line of research, scientists... in the haematology and oncology department at the biotechnology firm Amgen in Thousand Oaks, California, tried to confirm published findings related to that work. Fifty-three papers were deemed 'landmark' studies. It was acknowledged from the outset that some of the data might not hold up, because papers were deliberately selected that described something completely new, such as fresh approaches to targeting cancers or alternative clinical uses for existing therapeutics. Nevertheless, scientific findings were confirmed in only 6 (11%) cases. Even knowing the limitations of preclinical research, this was a shocking result. ...

Unfortunately, Amgen's findings are consistent with those of others in industry. A team at Bayer HealthCare in Germany last year reported that only about 25% of published preclinical studies could be validated to the point at which projects could continue. Notably, published cancer research represented 70% of the studies analysed in that report, some of which might overlap with the 53 papers examined at Amgen. ...

Some non-reproducible preclinical papers had spawned an entire field, with hundreds of secondary publications that expanded on elements of the original observation, but did not actually seek to confirm or falsify its fundamental basis. More troubling, some of the research has triggered a series of clinical studies — suggesting that many patients had subjected themselves to a trial of a regimen or agent that probably wouldn't work.


Table 1: Reproducibility of research findings
Preclinical research generates many secondary publications, even when results cannot be reproduced.
Journal impact factorNumber of articlesMean number of citations of non-reproduced articles*Mean number of citations of reproduced articles
Results from ten-year retrospective analysis of experiments performed prospectively. The term 'non-reproduced' was assigned on the basis of findings not being sufficiently robust to drive a drug-development programme.
*Source of citations: Google Scholar, May 2011.
>2021248 (range 3–800)231 (range 82–519)
5–1932169 (range 6–1,909)13 (range 3–24)

--C. Glenn Begley (former global head of Hematology and Oncology Research at Amgen) and Lee M. Ellis, Nature, on one reason the war on cancer isn't progressing quickly

Psychologists, beware!

If you’re a psychologist, the news has to make you a little nervous—particularly if you’re a psychologist who published an article in 2008 in any of these three journals: Psychological Science, the Journal of Personality and Social Psychology, or the Journal of Experimental Psychology: Learning, Memory, and Cognition.

Because, if you did, someone is going to check your work. A group of researchers have already begun what they’ve dubbed the Reproducibility Project, which aims to replicate every study from those three journals for that one year. The project is part of Open Science Framework, a group interested in scientific values, and its stated mission is to “estimate the reproducibility of a sample of studies from the scientific literature.” This is a more polite way of saying “We want to see how much of what gets published turns out to be bunk.” ...

The researchers point out, fairly, that it’s not just social psychology that has to deal with this issue. Recently, a scientist named C. Glenn Begley attempted to replicate 53 cancer studies he deemed landmark publications. He could only replicate six. Six! Last December I interviewed Christopher Chabris about his paper titled “Most Reported Genetic Associations with General Intelligence Are Probably False Positives.” Most!
--Tom Bartlett, Chronicle of Higher Education, on the replication police arriving. HT: Marginal Revolution

Why the Boston sushi scene is mediocre

But just because sushi is everywhere in Boston doesn’t mean it’s good.

“ ‘Where should I go for the best sushi?’ I’m asked this question a lot,” says Merry White, a professor of anthropology at Boston University who specializes in food and Japan. “I have a snarky answer. Go to Logan and get on a plane. But that’s not helpful.” ...

“We have the fish, we have a population that’s pretty well-educated and sophisticated, and we have people from all over the world,” White says. “But we don’t have a significant Japanese business population, especially since the 1991 economic downturn. The first wave of sushi [in the US] went to places where there were high-flying businessmen. We got the second wave, which is cheerful and cheap sushi.”
--Devra First, Boston Globe, on the surprising dearth of good sushi in Boston

Wednesday, April 18, 2012

Employment prospects for humanities majors

[Yale] Professors interviewed said they think students are misguided in their fears that humanities courses will not lead them to a job after graduation.
--Antonia Woodford, Yale Daily News, on the view from the ivory tower



Unemployment rates by college major (from the Washington Post):

Food deserts are not the problem

It has become an article of faith among some policy makers and advocates, including Michelle Obama, that poor urban neighborhoods are food deserts, bereft of fresh fruits and vegetables.

But two new studies have found something unexpected. Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents.

Within a couple of miles of almost any urban neighborhood, “you can get basically any type of food,” said Roland Sturm of the RAND Corporation, lead author of one of the studies. “Maybe we should call it a food swamp rather than a desert,” he said.

Some experts say these new findings raise questions about the effectiveness of efforts to combat the obesity epidemic simply by improving access to healthy foods.

Monday, April 16, 2012

How Tupac was resurrected at Coachella

The biggest buzz at Sunday's Coachella music festival in California wasn't for a hot new DJ or indie-rock band. It was for Tupac Shakur, the rapper who died more than 15 years ago and "performed" Sunday night alongside Snoop Dogg and producer Dr. Dre.

Internet video of the Sunday evening show became an instant sensation on Monday morning. That response is helping push the possibility of a virtual Tupac tour in coming months.

The rapper's ghostly image was created by Digital Domain Media Group Inc., the visual-effects house responsible for making the virtual versions of Brad Pitt that populated 2008's "The Curious Case of Benjamin Button." The movie won the Oscar for visual effects.

[Digital Domain's chief creative officer Ed Ulbrich] said that the performances of the rapper's hits "Hail Mary" and "2 of Amerikaz Most Wanted" weren't simply old ones captured on film and repurposed: "This is not found footage. This is not archival footage. This is an illusion." ...

First, the image was created on a computer, using physical characteristics and movements captured from recorded performances.

Advances in computer graphics and video projection allowed Sunday night's illusion to be far more lifelike than other recent efforts.

For the projection aspect, a San Diego company called AV Concepts used a variation of a visual effect that was discovered in the 19th century, known as Pepper's Ghost.
Though the projected image has been widely described as a "hologram," it is a 2-D image and not a hologram, which is 3-D. ...

The effect relies on an angled piece of glass in which a "ghostly" image is reflected.

Sunday, April 15, 2012

The low financial returns to cybercrime

Popular accounts suggest that cybercrime is large, rapidly growing, profitable and highly evolved; annual loss estimates range from billions to nearly $1 trillion. ...

We have examined cybercrime from an economics standpoint and found a story at odds with the conventional wisdom. A few criminals do well, but cybercrime is a relentless, low-profit struggle for the majority. ...

Structurally, the economics of cybercrimes like spam and password-stealing are the same as those of fishing. Economics long ago established that common-access resources make for bad business opportunities. No matter how large the original opportunity, new entrants continue to arrive, driving the average return ever downward. Just as unregulated fish stocks are driven to exhaustion, there is never enough “easy money” to go around. ...

How do we reconcile this view with stories that cybercrime rivals the global drug trade in size? One recent estimate placed annual direct consumer losses at $114 billion worldwide. It turns out, however, that such widely circulated cybercrime estimates are generated using absurdly bad statistical methods, making them wholly unreliable. ...

A cybercrime where profits are slim and competition is ruthless also offers simple explanations of facts that are otherwise puzzling. Credentials and stolen credit-card numbers are offered for sale at pennies on the dollar for the simple reason that they are hard to monetize. Cybercrime billionaires are hard to locate because there aren’t any. Few people know anyone who has lost substantial money because victims are far rarer than the exaggerated estimates would imply.
--Dinei Florêncio and and Cormac Herley, Microsoft Research, on cybercrime not paying

Saturday, April 14, 2012

The Harvard Red Book

The first thing you need to know about the Red Book is that when Harvard graduates talk about it (which they do a lot), they’re not talking about Mao Zedong’s pamphlet of axioms. That is, they’re not talking about “The Little Red Book” but about The Big One, the one that lands at five-year intervals with the thud of a Manhattan phone directory on the doorstep of everyone who has ever graduated from the college, and keeps on arriving for as long as they live, whether they want it or not, a gift from the tireless alumni association.

This trance-inducing volume, a facebook that came before Facebook, consists of dispatches from graduates who have chosen to file and have evaded the terse message “last known address,” “address unknown” or (it doesn’t get terser) “died.”

The information includes the biographical basics — address, e-mail, occupation, spouse, children — and an account of their lives, often true, over the last half-decade. The tagline for Deborah Copaken Kogan’s new novel, “The Red Book,” sums it up: “There’s the story we tell the world, and then there’s the real story.” ...

A sometimes ghastly mix of covert self-congratulation, awkward confession and wry philosophizing undercut by heavy-handed irony, Red Book prose can be an exercise in confessional self-concealment. What often emerges, after several throat-clearing paragraphs, is that life has not invariably been so good, whether the author knows it or not; and it’s that feature — the truth inadvertently revealed — that makes these thick volumes so horribly fascinating.

Tuesday, April 10, 2012

Bad-ass CV entry of the month

STATA COMMAND 

“CQIV” with Victor Chernozhukov, Ivan Fernandez-Val, and Sukjin Han.
--Tucked within Yale assistant economics professor Amanda Kowalski's curriculum vitae

Saturday, April 7, 2012

Who should architecture serve?

As Modernist buildings reach middle age, many of the stark structures that once represented the architectural vanguard are showing signs of wear, setting off debates around the country between preservationists, who see them as historic landmarks, and the many people who just see them as eyesores. ...

Completed in 1967, the [Goshen, NY county government center, designed by the celebrated Modernist architect Paul Rudolph,] has long been plagued by a leaky roof and faulty ventilation system and, more recently, by mold; it was closed last year after it was damaged by storms, including Tropical Storm Irene.

Edward A. Diana, the Orange County executive, wants to demolish it, an idea that has delighted many residents but alarmed preservationists, local and national, who say the building should be saved. ...

Those who want to save it call it a prime example of an architectural style called Brutalism that rejected efforts to prettify buildings in favor of displaying the raw power of simple forms and undisguised building materials, like the center’s textured facade.

“Preservation is not simply about saving the most beautiful things,” said Mark Wigley, the dean of Columbia’s Graduate School of Architecture, Planning and Preservation. “It’s about saving those objects that are an important part of our history and whose value is always going to be a subject of debate.” ...

In an interview Theodore Dalrymple, a fellow at the Manhattan Institute who has written about the architecture of Le Corbusier, described Brutalist buildings as “absolutely hideous, like scouring pads on the retina.”

“One of those buildings can destroy an entire cityscape that has been built up over hundreds of years,” he said.
--Robin Pogrebin, NYT, on buildings only an architect could love

How to make the best sushi in the world

At 85, [Jiro] Ono is the acknowledged master of his art. Michelin gave Sukiyabashi Jiro a rare three-star rating, meaning that it’s “worth traveling to the country just to eat there.” Superstar chef Anthony Bourdain has bowed down and declared his unworthiness, and the Japanese government has named Jiro a living national treasure. In person, he’s smiling but ascetic, a lean, weathered artisan whose devotion to his craft is complete. Gelb’s camera follows him to the Tsukiji fish market, where we get a hint of what makes Ono’s sushi stand out from the pack (he has special arrangements with vendors whose standards are as exacting as his). Would you be willing to massage an octopus for 45 minutes, until its flesh possesses just the right amount of chewability? Jiro is. “It always has to taste better than last time,” he says.

Friday, April 6, 2012

Bringing Moneyball to boxing

"Hit and don't get hit," goes the old adage in boxing. And from a statistical perspective, at least, it seems no one is better at living up to that credo than Floyd Mayweather Jr.

According to Bob Canobbio, owner and founder of CompuBox -- a computerized scoring system that counts every punch a boxer throws and lands -- Mayweather's average connect rate of 46 percent, compiled during his past nine fights (a "prime" designated by CompuBox), ranks as the best among current active fighters. ...

More impressive than Mayweather's own connect percentage is that of Floyd's opponents against him. They land a mere 16 percent of punches thrown, the lowest collective figure recorded in CompuBox's 4,000-fight database. ...

Subtract the average connect percentage of Mayweather's opponents from Mayweather's own hit rate during that designated prime, and the numbers reveal an enormous chasm between Floyd and today's other top fighters.

With a plus/minus connect percentage rating of plus-30 percent, Mayweather is at least twice as effective in the hit-and-don't-get-hit game as any of his contemporaries.

So how does Pacquiao compare? The numbers are undeniably impressive. His 21.8 punches connected per round is greater than Mayweather's. But with Pacquiao, the numbers also illuminate his most glaring weakness, one he shares with countless other warriors of the ring: He gets hit a lot.

Measured against Mayweather's plus-30 rating at 147 pounds, Pacquiao's plus/minus is puny (plus-4.7). Manny throws his jab twice as often as Mayweather, but he connects with that punch only 12.3 percent of the time, compared with Mayweather's 41.6 percent jab connect rate.

More telling is the comparison of power punching. Pacquiao's connect rate on power punches is an astronomical 45.3 percent, only slightly below that of Mayweather, who lands at 47.8 percent. But opponents land 33.6 percent of their punches on PacMan. Pretty Boy's foes? They touch him up at roughly half that rate (18.6 percent). ...

Statistically speaking, Mayweather clearly reigns supreme over his contemporaries. But he also stacks up very well against history's pugilistic pantheon. ...

In a plus/minus comparison, greats such as Marvin Hagler (plus-17 percent) and Sugar Ray Leonard (plus-13 percent) don't come close. Roberto Duran (plus-8 percent), Thomas Hearns (plus-6 percent) and Muhammad Ali (plus-4 percent) fall short, too. ...

Only heavyweight great Joe Louis, at plus-26 percent, approached Mayweather's peak.
--Igor Guryashkin, ESPN.com, on the greatest plus-minus of all time