Lunch at the Labs

Various web links I found to be of interest recently:

• Oliver Sacks: Sabbath

  One of the most interesting people I've run across, contemplates his life and dying.

  And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual, but on what is meant by living a good and worthwhile life -- achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one's life as well, when one can feel that one's work is done, and one may, in good conscience, rest.

  He died August 30 2015. One eulogy,

• The Costs of Accountability

  The ballooning demand for misplaced and misunderstood metrics, benchmarks, and performance indicators is costing us big.

  The attractions of accountability metrics are apparent. Yet like every culture, the culture of accountability has carved out its own unquestioned sacred space and, as with all arguments from presumed authority, possesses its characteristic blind spots. In this case, the virtues of accountability metrics have been oversold and their costs are underappreciated. It is high time to call accountability and metrics to account.
  ...
  Clearly, the attempt to measure performance, however difficult it can be, is intrinsically desirable if what is actually measured is a reasonable proxy for what is intended to be measured. But that is not always the case, and between the two is where the blind spots form.
  ...
  Gaming the metrics also takes the form of diverting resources from their best long-term uses to achieve measured short-term goals.

• This is how science can finally start to fix itself

  Reproducibility Problems

  The amount of funding available to scientific research hasn't kept up with the growing number of scientists in training. To get a bite of the funding pie, many scientists have been led astray. How many? Witness the ten-fold rise in the number of retractions issues in scientific literature, nearly half of which may be the result of fraud.
  ...
  Scientists need to balance their work on research that pushes the boundaries of science with less eye-catching studies that simply strengthen convictions on what we already know.

• The Case for Teaching Ignorance

  Presenting ignorance as less extensive than it is, knowledge as more solid and more stable, and discovery as neater also leads students to misunderstand the interplay between answers and questions.
  
  People tend to think of not knowing as something to be wiped out or overcome, as if ignorance were simply the absence of knowledge. But answers don't merely resolve questions; they provoke new ones.

• Tech's Enduring Great-Man Myth

  The idea that particular individuals drive history has long been discredited. Yet it persists in the tech industry, obscuring some of the fundamental factors in innovation.

  Musk's success would not have been possible without, among other things, government funding for basic research and subsidies for electric cars and solar panels. Above all, he has benefited from a long series of innovations in batteries, solar cells, and space travel. He no more produced the technological landscape in which he operates than the Russians created the harsh winter that allowed them to vanquish Napoleon. Yet in the press and among venture capitalists, the great-man model of Musk persists, with headlines citing, for instance, "His Plan to Change the Way the World Uses Energy" and his own claim of "changing history."
  ...
  Hero myths like the ones surrounding Musk and Jobs are damaging in other ways, too. If tech leaders are seen primarily as singular, lone achievers, it is easier for them to extract disproportionate wealth. It is also harder to get their companies to accept that they should return some of their profits to agencies like NASA and the National Science Foundation through higher taxes or simply less tax dodging.

• Climate Etc.

  Hosted by Judith Curry Professor and former Chair of the School of Earth and Atmospheric Sciences at the Georgia Institute of Technology and President (co-owner) of Climate Forecast Applications Network (CFAN)

  A forum for climate researchers, academics and technical experts from other fields, citizen scientists, and the interested public to engage in a discussion on topics related to climate science and the science-policy interface.

  A balanced discussion in my opinion.
• Don't Hate the Phone Call, Hate the Phone

  Our telephone habits have changed, but so have the infrastructure and design of the handset.

  When asked, people with a distaste for phone calls argue that they are presumptuous and intrusive, especially given alternative methods of contact that don't make unbidden demands for someone's undivided attention.
  ...
  But when it comes to taking phone calls and not making them, nobody seems to have admitted that using the telephone today is a different material experience than it was 20 or 30 (or 50) years ago, not just a different social experience. That's not just because our phones have also become fancy two-way pagers with keyboards, but also because they've become much crappier phones. It's no wonder that a bad version of telephony would be far less desirable than a good one. And the telephone used to be truly great, partly because of the situation of its use, and partly because of the nature of the apparatus we used to refer to as the "telephone"--especially the handset.

• As You Sow Files Notice Of Legal Action Against Soylent Super Food

  High Levels of Lead and Cadmium Found by As You Sow in Two Samples of the Trendy Meal Replacement Powering Silicon Valley Coders

• The Top Ten Things You Should Know About Alternative Medicine

  Harriet Hall, M.D. The SkepDoc

  I'm an equal opportunity skeptic. I'm skeptical about alternative medicine, pseudoscience, and quackery; but I apply the same standards of skepticism to conventional medicine. I don't write about conventional medicine so much, because I don't need to. Science itself is inherently skeptical and scientific medicine is self-criticizing and self-correcting. When better evidence comes along medical practices change

  1. Alternative v. Conventional Medicine
  2. Swine Flu Vaccine Fear Mongering
  3. Chiropractic: A Little Physical Therapy, A lot of Nonsense
  4. Vaccines and Autism: A Deadly Manufactroversy
  5. The Placebo Effect
  6. What to Eat: Food Not Too Much. Mostly Plants
  7. Homeopathy: Still Crazy After All These Years
  8. Acupuncture
  9. But It's Natural, and Natural is Good!
  10. Detoxify This!

• No Evidence for an Early Dementia Epidemic

  Another interpretation is that people are just getting older. From 1990 to 2010, life expectancy increased and there are more old people now. Everyone knows that dementia is more common in old people. So an ageing population will, all else being equal, inevitably suffer more dementia.
  ...
  As 'control conditions', they consider deaths from cancer and heart disease in the 75+ group. These deaths have not increased from 1990 to 2010 -- in fact they have fallen. The authors argue that since cancer and heart disease are diseases of old age too, the "people are just older" argument would equally well apply to those diseases, yet neurological diseases have increased more, so there must be more than just an age effect.

  The problem is that this is comparing apples to oranges. For one thing, cancer and heart disease are often treatable, and we're getting better at treating them. There have been lots of new drugs, treatments and screening programs for cancer and heart disease since 1990, so it's no surprise that death rates fell. Dementia, on the other hand, is not treatable, nor are many other neurological disorders.

• How to get the most out of your rechargeable batteries

  Every battery has a finite lifespan, and this is given as the "recharge cycle" or "battery cycle." Put simply, this is the number of charge/discharge cycles that a battery is expected to endure before it is no longer fit for service.
  ...
  If you only let your battery discharge by 25 percent, then doing this four times counts as a single cycle.

• Acupuncture and Quack Medicine at Georgetown University

  I was surprised when I saw this news item from Georgetown,

  Acupuncture Impacts Same Biologic Pathways in Rats that Pain Drugs Target

  and the coverage of it at The Guardian,

  Rats help scientists closer to solving the mystery of acupuncture.

  But thanks to Science Based Medicine it became clear:

  Basically, quackademic medicine is a phenomenon that has taken hold over the last two decades in medical academia in which once ostensibly science-based medical schools and academic medical centers embrace quackery. This embrace was once called "complementary and alternative medicine" (CAM) but among quackademics the preferred term is now "integrative medicine." Of course, when looked at objectively, integrative medicine is far more a brand than a specialty. Specifically, it's a combination of rebranding some science-based modalities, such as nutrition and exercise, as somehow being "alternative" or "integrative" with the integration of outright quackery, such as reiki and "energy healing," acupuncture, and naturopathy, into conventional medicine.
  ...
  Having received a ($1.7 million) grant from the then-National Center for Complementary and Alternative Medicine (NCCAM), renamed in December the National Center for Complementary and Integrative Health (NCCIH), to integrate CAM into its core curriculum, Georgetown proceeded to do just that.

  And as for the study in question:

  The kindest description of the conclusions of this study is that it shows that running electrical current through the leg, as opposed to running current through the skin of the back, might decrease stress by decreasing the effect of stress hormones. It does not show that acupuncture works. A more realistic description of these results is that they don't show much of anything that is scientifically interesting. One even wonders if, for instance, there is a simpler explanation, namely that having a needle stuck in the leg and having current run through it hurts less than having a needle stuck in the back and having current run through it. There's no way of knowing because we can't ask the rat. Alternatively, I also note that St36 is rather close to the sciatic nerve, whereas the acupuncture point on the flank used for the sham-EA control is nowhere near a major nerve.

  Basically, this is a poorly done study with small numbers that doesn't even test acupuncture but electricity. If this is the "evidence" for acupuncture that Georgetown touts, it's thin gruel indeed. Yet it was published in a respectable journal, Endocrinology. Clearly, Endocrinology needs a better class of peer reviewers, as peer review utterly failed in this case.

  Do read the entire SMB post Bastions of quackademic medicine: Georgetown University as it contains many more details and is entertainingly written.

• The Cure Culture

  There is no cure for cystic fibrosis. There is no cure for cancer. There is no cure for diabetes. There is no cure for HIV. There is no cure for Tay-sachs or Huntington's disease or ALS.

  And yet, scientists, the media, and the foundations that fund research consistently promise patients and their families that cures for very serious, lifelong diseases are imminent, or at least "around the corner." For cystic fibrosis, that cure has been pitched as being gene therapy, in which a faulty gene is replaced with a functioning one.

• An Epidemic of False Claims

  Competition and conflicts of interest distort too many medical findings -- John P. A. Ioannidis | May 17, 2011

  False positives and exaggerated results in peer-reviewed scientific studies have reached epidemic proportions in recent years. The problem is rampant in economics, the social sciences and even the natural sciences, but it is particularly egregious in biomedicine.

• What is medicine's 5 sigma?

  "A lot of what is published is incorrect."

  The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

  Can bad scientific practices be fixed? Part of the problem is that no-one is incentivised to be right. Instead, scientists are incentivised to be productive and innovative.

• Atul Gawande: Overkill

  An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

  The researchers called it "low-value care." But, really, it was no-value care. They studied how often people received one of twenty-six tests or treatments that scientific and professional organizations have consistently determined to have no benefit or to be outright harmful. Their list included doing an EEG for an uncomplicated headache (EEGs are for diagnosing seizure disorders, not headaches), or doing a CT or MRI scan for low-back pain in patients without any signs of a neurological problem (studies consistently show that scanning such patients adds nothing except cost), or putting a coronary-artery stent in patients with stable cardiac disease (the likelihood of a heart attack or death after five years is unaffected by the stent). In just a single year, the researchers reported, twenty-five to forty-two per cent of Medicare patients received at least one of the twenty-six useless tests and treatments.

  Doctors generally know more about the value of a given medical treatment than patients, who have little ability to determine the quality of the advice they are getting. Doctors, therefore, are in a powerful position. We can recommend care of little or no value because it enhances our incomes, because it's our habit, or because we genuinely but incorrectly believe in it, and patients will tend to follow our recommendations.

  The United States is a country of three hundred million people who annually undergo around fifteen million nuclear medicine scans, a hundred million CT and MRI scans, and almost ten billion laboratory tests. Often, these are fishing expeditions, and since no one is perfectly normal you tend to find a lot of fish. If you look closely and often enough, almost everyone will have a little nodule that can't be completely explained, a lab result that is a bit off, a heart tracing that doesn't look quite right.

  Excessive testing is a problem for a number of reasons. For one thing, some diagnostic studies are harmful in themselves--we're doing so many CT scans and other forms of imaging that rely on radiation that they are believed to be increasing the population's cancer rates. These direct risks are often greater than we account for.

  Overtesting has also created a new, unanticipated problem: overdiagnosis.
  ...
  For instance, cancer screening with mammography, ultrasound, and blood testing has dramatically increased the detection of breast, thyroid, and prostate cancer during the past quarter century. We're treating hundreds of thousands more people each year for these diseases than we ever have. Yet only a tiny reduction in death, if any, has resulted.

• Doctor group seeks to clear confusion in cancer screening

  Cancer screening is a balance to ensure the people who will benefit most get checked while not over-testing. After all, there are potential harms including false alarms that spark unneeded extra testing, and sometimes detection of tumors too small and slow-growing to be life-threatening.

  Colonoscopies, which allow doctors to see precancerous growths in the colon, get the most attention. But the ACP advised people ages 50 to 74 to choose from equally good screening choices: a stool test every year; a colonoscopy every 10 years; a sigmoidoscopy, which views the lower colon, every five years; or a combination of a stool test every three years and a sigmoidoscopy every five years.