Thursday, December 2, 2021

Supervised drug injection sites open in NYC

 The NY Times has the story:

Nation’s First Supervised Drug-Injection Sites Open in New York. During the first official day in operation at the two Manhattan facilities, trained staff reversed two overdoses, officials said.  By Jeffery C. Mays and Andy Newman

"New York, the country’s most populous city, became the first U.S. city to open officially authorized injection sites — facilities that opponents view as magnets for drug abuse but proponents praise as providing a less punitive and more effective approach to addressing addiction.

"Other cities including Philadelphia, San Francisco, Boston and Seattle have taken steps toward supervised injection but have yet to open sites amid debate over the legal and moral implications of sanctioning illegal drug use.


"Mayor Bill de Blasio began championing safe injection sites in 2018, citing their use and success in European and Canadian cities. The decision to officially allow the sites to open comes during the mayor’s last few weeks in office and as he considers a run for governor. He said in a statement that the decision will show other cities that “after decades of failure, a smarter approach is possible.”

"The mayor also sent a letter to the providers promising “not to take enforcement action” against their operations. Four of the city’s five district attorneys — excluding only the Staten Island district attorney, Michael McMahon — support supervised drug sites."

Wednesday, December 1, 2021

School choice using deferred acceptance algorithms increases competition for selective schools, by Terrier, Pathak and Ren

 Here's a working paper from the LSE which concludes that making it safe for parents to truthfully report their preferences increases the competition for selective schools (called grammar schools, which prioritize students based on admission tests), with the unintended consequence of disadvantaging poorer families in England. The paper contains a good description of past and present school assignment regimes in England.

From immediate acceptance to deferred acceptance: effects on school admissions and achievement in England by Camille Terrier Parag A. Pathak and Kevin Ren,  Centre for Economic Performance Discussion Paper No.1815, November 2021

"Abstract: Countries and cities around the world increasingly rely on centralized systems to assign students to schools. Two algorithms, deferred acceptance (DA) and immediate acceptance (IA), are widespread. The latter is often criticized for harming disadvantaged families who fail to get access to popular schools. This paper investigates the effect of the national ban of the IA mechanism in England in 2008. Before the ban, 49 English local authorities used DA and 16 used IA. All IA local authorities switched to DA afterwards, giving rise to a cross-market difference-in-differences research design. Our results show that the elimination of IA reduces measures of school quality for low-SES students more than high-SES students. After the ban, low-SES students attend schools with lower value-added and more disadvantaged and low-achieving peers. This effect is primarily driven by a decrease in low-SES admissions at selective schools. Our findings point to an unintended consequence of the IA to DA transition: by encouraging high-SES parents to report their preferences truthfully, DA increases competition for top schools, which crowds out low-SES students."

And here are the paper's concluding sentences:

" In England, selective schools pick students based on test scores, which favors high-SES parents. After the transition to DA, high-SES parents enroll at these schools at higher rates. Selective admissions are widespread throughout education, so our results provide an important caution to equity rationales for DA over IA in settings where selective schools have large market share."

Tuesday, November 30, 2021

Interview with Ido Erev

 Here's a short interview with Ido Erev, the great behavioral scientist at the Technion, from whom I learned a lot about learning:

Interview with Ido Erev

Here is his closing comment:

"When I started  studying the effect of experience, in the 90s, I asked several famous  researchers why they have stopped studying this effect. Here are some of  the answers that affected me the most (as I remember them): Duncan Luce: Now that I am old, I am more interested in my own mistakes.  In particular, I try to understand why I exhibit the Allais paradox.  Herb Simon: I got more reinforcements from studying bounded rationality.  Amos Tversky: It is clear that if you hit subjects with a 5Kg “feedback hammer” they will learn to be rational. I  want to study what people learn before they arrive at the lab. Alvin E.  Roth: There is no good answer, let's study it."

Monday, November 29, 2021

An experimental study whose participants are compensated donors in the legal Iranian market for kidneys, by Kelishomi and Sgroi

 A recent working paper from Warwick reports an experiment and survey study whose participants are compensated kidney donors (and prospective donors) in the legal Iranian monetary market for kidneys.

Kelishomi, Ali Moghaddasi, and Daniel Sgroi. A Field Study of Donor Behavior in the Iranian Kidney Market. No. 1381. University of Warwick, Department of Economics, October 2021.

Abstract: Iran has the world’s only government-regulated kidney market, in which around 1000 individuals go through live kidney-removal surgery annually.  We report the results of the first field study of donor behavior in this unique and controversial market. Those who enter the market have low income, typically entering to raise funds.  They have lower risk tolerance and higher patience levels than the Iranian average.  There is no difference in rationality from population averages.  There is evidence of altruism among participants.  This might shed light on the sort of people likely to participate if other nations were to operate suchmarkets.

From the introduction:

"There is no doubt that the notion of paying for a kidney raises ethical concerns and some see this form of market transaction as incompatible with the “sacred value” of human life (Elias et al., 2015). However, given the apparent success of the Iranian kidney market and the existence  of long waiting lists, patient suffering and significant loss of life elsewhere, there has also been something of a re-evaluation of the potential for regulated organ markets in the developed world


"Given the nature of the debate it seems important to consider the characteristics of those likely to  come  forward  as  donors  if  a  market  is  established  and  to  ask  what  special  features  they may possess.  Since there is only one existent regulated market, this must involve a controlled examination of participants in the Iranian kidney market.  Our paper reports the outcome of an unprecedented first study of patient behavior in the Iranian kidney market in which we obtained direct access to donors before and after surgery. We provided full incentives where appropriate during our experimental treatments, providing incentive payments of around $50 (in terms of purchasing power parity) on top of a show-up fee of roughly $15.2 We also collected data that is similar to existing generic data on the Iranian population. This allows us to not only provide comparisons within our sample but also between our sample and Iranian averages where data is available.


" The study started in August 2017 (shortly after the end of sanctions between the UK and Iran) and live sessions continued until May 2019,with further telephone interviews and follow-up sessions continuing until February 2021.  78 subjects were first interviewed post-donation while the remaining 137 were interviewed pre-donation.  Of the pre-donation group 91 were contacted a second time to confirm their final status in February 2021.  35 had donated by this point with the remaining 56 dropping out of the market (30 for medical reasons and 26 through choice).  Following this process we were able to measure behavioral variables such as risk aversion, time preference (patience), altruism, rationality (consistency with GARP, the generalized axiom of revealed preference), and a wide variety of demographic and socioeconomic data.  Where feasible we incentivized answers and used the most prominent measures available.  We also examined why these patients enter the market and what alternatives might have been available to them.  We are able to compare our patient data with available data for typical Iranians to provide a benchmark (Falk et al., 2018)


"While the typical donor is in considerable financial difficulty, they are significantly more patient and exhibit lower tolerance for risk than an average Iranian (though conditional on entering the market those with lower patience are more likely to have donated during our study).   Those who go through with the process exhibit higher levels of altruism than those who drop out.   We find no difference in rationality between participants in the market and the subjects in a leading study of rationality from which we take our core measure  (Choi  et  al.,  2014).   We  would  argue  that  alternative  options  for  those  in  financial difficulty such as approaching a loan shark might be more appealing to the risk-loving (and perhaps more impatient) since this offers an immediate solution but replaces it with a serious and risky long-term liability, while the organ market is a difficult short-term prospect but does not result in higher levels of debt in the long run. Our findings on altruism are consistent with the idea that, while donors are being paid, they are nevertheless taking part in a difficult process that has the potential of saving a life, and this may also be important when considering alternatives."

Sunday, November 28, 2021

The Elements of Choice (Architecture) by Eric Johnson

Eric Johnson's new book is about choice architecture, and how when choices are presented in a confusing way, we may make bad decisions.


One of the points the book makes is that having too many choices may impede the quality of your decision: you might do better if the choice architect had narrowed or better organized your choice set to make it easier for you to fluently understand the choices presented, which would enable you to make a more accurate decision.

Here is a picture of the first search result that appeared when I searched for the book, which I surmise is an ad composed by the publisher:

I read with interest his discussion of school choice, in which he argues that much of the potential welfare improvement produced by market design could potentially be undone by confused decision making by participants, and that welfare could be improved if market designers did a better job of actively curating and organizing the choices offered.

He writes "Increasing the number of options increases the probability that families will be presented with the best school for them, but it does not mean they will see it."

Some of his recommendations suggest that market designers should get involved at all level of detail: e.g. easier to read fonts may increase fluency and allow more choices to be presented effectively.

Others of his recommendations seem to me to be further removed from the actual practice of school choice: e.g. "If we can remove any terrible schools from the set, choosers, even if they were picking randomly, would on average get better outcomes." Closing underperforming schools (e.g. by not admitting new students) is much more complicated than that.

I haven't finished reading the book yet (Eric pointed me first to the section on school choice), and I'm looking forward to it.  Choice architecture is certainly an important part of market design.

Saturday, November 27, 2021

Deceased donor sperm recovery and conception

I guess it's a case of deceased donor transplantation of sorts. Above the Law has the story:

Posthumous Conception: It Happens More Often Than You Think by Ellen Trachman

 "In the latest high-profile controversy over posthumous conception, last month, we learned of the birth of a baby girl to an Australian woman named Ellidy Pullin, the widow of Olympic snowboarder Alex “Chumpy” Pullin. The Olympian died tragically in a diving accident in 2020.

"Ellidy Pullin turned to their fertility doctor, Andrew Davidson, and asked that her spouse’s sperm be harvested from his body after his death. Davidson described how he entered fertility medicine never expecting to do posthumous sperm retrievals, but now, those requests are becoming more common. The doctor noted that he has done two other posthumous sperm retrievals since the Olympian’s death.

"The process was successful for Pullin — as Davidson notes, it usually is, so long as the sperm is successfully retrieved within 48 hours of death.


"In the United States, the hospital itself is the most frequent obstacle that prevents a surviving loved one from having a chance to conceive with the DNA of their deceased spouse or partner. Many hospitals are unwilling to permit the retrieval of reproductive material without specific written consent. And by specific consent, that frequently means not just that the deceased wanted to have children with the survivor. The bar is often set higher. The consent must be that the deceased specifically agreed for their sperm or eggs to be harvested and used for reproductive purposes after their death."

Friday, November 26, 2021

NRMP Statement On Interviewing

 The National Resident Matching Program (NRMP) has a statement on interviewing, which precedes the NRMP match for new American doctors, and that reflects concerns that the interviewing process has become congested.

NRMP Statement On Interviewing

"The National Resident Matching Program® (NRMP®) has heard the concerns of learners and programs in the medical education community about the interview process and wants to encourage equitable practices among applicants and programs. As such we have developed the following recommendations. Although especially true during the enduring times of the pandemic, the recommendations align with the NRMP’s long-standing commitment to maintaining a fair, efficient, reliable, and transparent process for all. Recommendations also foster well-being among all parties.

"NRMP Recommendations for Programs:

1. Programs should conduct all interviews virtually for the 2021-2022 cycle.

2. Programs should extend interview offers that equal, not exceed, the total number of available interview slots.

3. Applicants should be given a minimum of 48 hours to respond to an interview offer.

"NRMP Recommendations for Applicants:

1. Applicants should make timely decisions about interview offers and promptly notify programs in which they are no longer interested, freeing up interview slots.

2. Applicants should give ample, adequate (e.g., one week) notice to programs in the event they change their minds and decline accepted interviews."