Reforming kidney care, by Drs. Ben Hippen and Thao Pascual.

 Ben Hippen is a transplant nephrologist who I encountered not too long after I started to think about kidney transplants. I've always found it enlightening to listen to him. And he's changed where he sits, most recently by taking a position with Fresenius, the big dialysis provider.

Here's a snippet of his professional history from his cv:

Current positions:

•Senior Vice President, Global Head of Transplant Medicine, Fresenius Medical Care. Sept 2021

•Clinical Professor of Internal Medicine, University of North Carolina, Chapel Hill School of Medicine. (Non-tenure track appointment) April 2015-present.

Past Positions:

•General and Transplant Nephrologist, Metrolina Nephrology Associates, P.A, Charlotte, North Carolina. 2005-2021

•Attending General and Transplant Nephrologist, Transplant Center, Carolinas Medical Center, Charlotte, North Carolina. 2005 - 2021

•Medical Director, FKC Baxter Street Hemodialysis Unit (in-center and home therapies).2009-2021.

Here are some of his current thoughts, with his colleague Dr. Pascual, in Medpage Today on how to advance kidney care and transplantation.

The Kidney Transplant Ecosystem Is Ripe for Reform— Here are the policies and payment systems that need to change  by Benjamin Hippen, MD, and Thao Pascual, MD

"A centralized data repository of patients' clinical evaluations, laboratory, and radiologic testing accessible by multiple transplant centers could reduce the time, expense, and waste of redundant or obsolete testing.

...

"Quality outcomes for transplant programs should be pegged to the patient outcome that really matters: Receiving a successful kidney transplant in the shortest period of time. A recent survey of patients with kidney disease regarding tradeoffs between being transplanted earlier and waiting for a "better organ" confirms that a wide majority of patients prioritize being transplanted sooner. "Transplant soon and well" should be the mantra for regulators and policy makers when considering nephrologist and dialysis provider-facing metrics to achieve the right outcomes for patients. 

...

"several reforms can be made to the transplant ecosystem to make it easier for transplant centers to be more aggressive in their organ acceptance behaviors. Changing the organ offer system to use the approach of "simultaneously expiring offers" can streamline organ placement timelines, placing higher-risk organs with more risk-tolerant centers more quickly and efficiently. Aligned with the goal of getting patients to transplant faster, regulators and payors (public and private) should prioritize shortening time to transplant over sky-high 1-year patient and graft survival thresholds. The lowest performing third of transplant centers are conferring longer and better survival rates to patients compared to any maintenance dialysis therapy. We should seek to remove regulatory and financial barriers to transplant centers seeking to safely make use of every gift of life. If we expect transplant centers to transplant higher-risk organs, we should recognize that it may cost more to perform those transplants successfully. The payment system for transplants should account for these higher costs so that transplant centers are not faced with losing money when transplanting higher-risk organs.

"A key component of the kidney transplant ecosystem is the generosity of living donors, and we should do more to support their decision to give the gift of life. This means protecting living donors from insurer efforts to exclude them from life or disability insurance coverage because of their donation. In addition, enhancing education efforts to increase living donor kidney transplants can help bridge the gap between organ need and supply. One pending solution to these challenges is the passage of the Living Donor Protection Act (H.R.1255/S.377). The bill would prohibit discrimination by insurers based on an individual's status as a living organ donor. Employers can also do their part through adjusting their paid leave policies for employees who become living donors, by joining the AST Living Donor Circle of Excellence."

"Benjamin Hippen, MD, is senior vice president and head of transplant medicine and emerging capabilities at Fresenius Medical Care. Thao Pascual, MD, is associate chief medical officer at U.S. Renal Care. They are both members of Kidney Care Partners."

********

As a long time, thoughtful  observer of kidney care and transplantation, Dr Hippen's point of view has shifted over time. Below are some (much) earlier blog posts featuring some of his earlier thoughts.

Wednesday, March 16, 2011

How not to assign kidneys

Saturday, April 9, 2011

Should there be a donor kidney market? Latest version of a familiar debate

Sunday, July 26, 2015

Ben Hippen on the economics of transplantation and dialysis

Privacy and data gathered by home devices

 Does your robot vacuum cleaner make a map of your house as it moves around, and store it on the web?  Could the fact that your kitchen chairs haven't moved all week allow someone to know that no one is home?  These are the kinds of things that people worry about when thinking of all the data collected by smart devices.

The Washington Post has this story:

Tour Amazon’s dream home, where every appliance is also a spy. Here’s everything Amazon learns about your family, your home and you.  by Geoffrey A. Fowler

"Echo speaker

"Echos respond to the wake word “Alexa” to summon the voice assistant to play music, answer questions, shop and control other devices.

"What it knows: Collects audio recordings through an always-on microphone; keeps voice IDs to differentiate users; detects coughs, barks, snores and other sounds; logs music and news consumption; logs smart-home device activity and temperature; detects presence of people though ultrasound.

"Ring doorbell

"What it knows: Live and recorded video, audio and photos of the outside of your house; when people come and go and you receive packages; status of linked devices like lights.

...

"Kindle or Fire Tablet

"What it knows: What and when you read and watch entertainment and news; when you open, close and how long you use third-party apps; your location.

"Why that matters: Amazon knows exactly how fast you read and how far you actually got through your last novel. Kindles and Fire Tablets are another way Amazon gets to know your tastes, which helps it sell you things.

...

"Roomba vacuum cleaner

"A vacuum cleaner that automatically roams around your house to clean, which Amazon is acquiring in a still-pending deal for $1.7 billion.

"What it knows: Camera identifies obstacles and layout of rooms and furniture; when, how often and where you clean.

"Why that matters: When the deal was announced, some Roomba owners balked at the idea that Amazon might gain access to maps of their home, created by the robots to help them clean. "

The past and future of the transition from medical school to residency, in the Journal of Graduate Medical Education, by Williamson, Soane, and Carmody

 The October issue of the Journal of Graduate Medical Education considers the past and future of the transition to residency.

The US Residency Match at 70: What Was, What Is, and What Could Be  by Edwin Williamson, MD; Caroline Soane, BA; J. Bryan Carmody, MD, MPH, J Grad Med Educ (2022) 14 (5): 519–521., https://doi.org/10.4300/JGME-D-22-00248.1

"But while early offers are long gone, the residency selection process now faces a new set of challenges related to the increasing number of applications submitted by contemporary applicants. In 2020 the average US medical school graduate submitted 70 residency applications.9  The average for some specialties is even higher. For instance, in 2022, the average osteopathic medical school applicant in obstetrics and gynecology submitted 85 applications, while US MD applicants in orthopedic surgery submitted 96 applications, and international medical graduates submitted 100 applications each to internal medicine programs.10  This overapplication increases costs for applicants and programs, leads to reliance on convenient screening metrics in applicant evaluation, and does not ultimately improve Match rates.9 "

School choice consulting in New York City

 It is a truth universally acknowledged that any stressful process in which affluent people participate must be in need of a consulting industry.

New York City's school choice processes are no exception:

The School-Admissions Whisperer Joyce Szuflita can assuage Brooklyn’s most anxious parents.  By Caitlin Moscatello

"For the better part of two decades, Szuflita has demystified the process of public-school admissions for some of Brooklyn’s most overwhelmed, optimization-prone parents. ... Prekindergarten and elementary admission are largely based on where you live. But the game gets significantly more byzantine come middle school and more complex yet for high school, with its tier of “screened” institutions that have traditionally required students to test in, audition, or undergo other high-stress assessments. The process of getting into certain schools — and don’t kid yourself, everybody wants in — has long been a brutal one. Until it got slightly easier. And then brutal again. Or maybe some middle level of brutal? This is why parents need Szuflita.

...

"On September 29, schools chancellor David C. Banks abruptly announced that some of the city’s most prestigious middle and high schools would move away from an open lottery system and increase their use of merit-based admissions. The approach prioritizes students with an A average — children Banks calls “hardworking,” a loaded description in a city with one of the greatest wealth disparities in the country — and reverses the previous mayor’s strategy, which aimed to usher more lower-income students into New York’s top schools.

...

“The pendulum is swinging back a little bit,” Szuflita says of the Banks announcement, insisting that the changes are not as sweeping as they might seem. “The algorithm is still exactly the same.” Contrary to how some have read the news, the old lottery is still partially in use. The random number (a hexadecimal, actually) that each student is assigned works as a tiebreaker to get into screened high schools and can sometimes be a major factor when families submit their ranked choices of preferred schools.

"Clients often panic about their lottery numbers and want to change the ranking of their list, which Szuflita doesn’t recommend for anyone except those with exceptionally high or low numbers. Trying to outsmart the process, she says, is pure “magical thinking.” She’s constantly telling parents to trust the fairness of the city’s sorting algorithm, whose authors literally won the Nobel Prize, and rank in true preference order. (Or, as she tends to put it in emails: “RANK IN TRUE PREFERENCE ORDER!!!!!!!”) Despite this, clients sometimes persist, asking, How do we work the algorithm to our advantage? How do we strategize ranking our list? “That’s when I yell at people in the nicest way,” she says, because they don’t know what they’re talking about and they’re cutting into her time. “Like, ‘No, shut up. Shut up and listen to me. You’re not going to get everything you need to know.’” But most of her consults take two hours, she says, and don’t involve a lot of back-and-forth. “They tell me about their children and then what follows is usually a rapid-fire, two-hour information dump from me. There is not a lot of airing of concerns, because I already anticipate their concerns.” The download is intensely specific, tailored to each family and covering individual schools, principals, teachers, and facility upgrades few people are aware of. She verifies rumors (or sets the record straight) and knows things you can’t find on the internet."

**********

Related recent post:

Sunday, October 2, 2022

Return to previous school assignment policies (in some respects) under New York City's new mayor

Market Design Job Market Candidate Profiles 2023, from ACM SIGecom Exchanges,

 Market designers come in multiple flavors: economics and computer science are prominently represented.

Market Design Job Market Candidate Profiles 2023

ACM SIGecom Exchanges, Vol. 20, No. 2, October 2022

Inspired by the SIGecom Exchanges’ annual survey of job market candidates,1 this is the third annual collection of profiles of the junior faculty job market candidates of the market design community. The eleven candidates are listed alphabetically. Along with information regarding the candidate’s bio, job market paper, other representative papers, and short research summary, each profile also contains links to the candidate’s homepage and CV.

–Yannai A. Gonczarowski, Assaf Romm, and Ran Shorrer

Contents (page number)

Altmann, Sam 2

Chan, Alex 2

Feng, Di 3

Ferdowsian, Andrew 3

Ferreira, Matheus V. X. 3

Kang, Zi Yang 4

Lee, Kwok-Hao 4

Pernoud, Agathe 5

Rudov, Kirill 5

Sandomirskiy, Fedor 6

Thomas, Clayton 6

My Morse Lecture at INFORMS 2022, tomorrow

 Tomorrow, Wednesday October19, from 8-9am Eastern time, I'll be giving the Morse Lecture at the INFORMS 2022 annual meeting in Indianapolis

Market Design: The Dialog Between Simple Abstract Models and Practical Implementation

I’ll review some of the elegantly simple models that underlie the initial designs for matching processes like the medical residency Match, school choice and kidney exchange, and the modifications, complications and  computations that were needed to get new designs adopted, implemented and maintained over the years.

You can read about the occasion of this lecture, my Philip McCord Morse Lectureship Award here.

Jacques Drèze (1929-2022)

Jacques Drèze, the eminent Belgian economist who was the founding director of the Center for Operations Research and Econometrics (CORE) at UCLouvain has died.

Aside from his considerable professional contributions as a researcher, he was an institution builder.  CORE was a center of game theory when game theory was young, and played an important role in its development.

Here is the memorial page at CORE.

Here is the Econometric Society memorium: IN MEMORIAM: Jacques Drèze

"CORE and its prestigious visitors’ program, thanks initially to the support from the Ford foundation, was his initiative as well as the European Doctoral Program in Quantitative Economics(EDP)."

 

Eliciting beliefs is a difficult task: Danz, Vesterlund and Wilson in the AER

 Experimental economists have long been faced with the difficulty of eliciting coherent beliefs from participants in experiments, even when they seem to act in a way consistent with having coherent beliefs.  This is consistent with the psychological view that beliefs in the full Bayesian sense may not closely correspond to people's internal psychological representation of the world. So techniques for belief elicitation that would work well for idealized utility maximizers may not be ideal for human subjects.

Here's a thoughtful effort to come to grips with that.

Belief Elicitation and Behavioral Incentive Compatibility  by David Danz, Lise Vesterlund, Alistair J. Wilson AMERICAN ECONOMIC REVIEW  VOL. 112, NO. 9, SEPTEMBER 2022  (pp. 2851-83)

Abstract: "Subjective beliefs are crucial for economic inference, yet behavior can challenge the elicitation. We propose that belief elicitation should be incentive compatible not only theoretically but also in a de facto behavioral sense. To demonstrate, we show that the binarized scoring rule, a state-of-the-art elicitation, violates two weak conditions for behavioral incentive compatibility: (i) within the elicitation, information on the incentives increases deviations from truthful reporting; and (ii) in a pure choice over the set of incentives, most deviate from the theorized maximizer. Moreover, we document that deviations are systematic and center-biased, and that the elicited beliefs substantially distort inference."

"We argue that to secure truthful revelation, elicitation mechanisms need to not only be incentive compatible in a purely theoretical sense, but also in a behavioral one. We propose for assessment two weak conditions for behavioral incentive compatibility, that information on deployed incentives increases truthful revelation; and that most participants, when given a choice over the pure incentives, select the outcome thought to be uniquely maximizing under the mechanism (i.e., a requirement of behavioral incentive compatibility for a representative agent).

"To demonstrate we explore a state-of-the-art belief elicitation, the binarized scoring rule (BSR) (Hossain and Okui 2013). The BSR is seen as a particularly promising alternative to elicitations requiring risk neutrality because its incentive compatibility expands to arbitrary EU preferences—in fact, to any decision-maker who maximizes the overall chance of winning a prize. Building on the insights of Roth and Malouf (1979), this is achieved by linking reported beliefs to a pair of state-contingent lotteries, where for each distinct belief, the mechanism provides a lottery pair with a stochastically dominant reduction. That is, decision-makers who maximize their chance of winning are given strict incentivizes under the BSR to reveal their true belief.

"In addition to being incentive compatible for a wider set of preferences, initial empirical evidence shows that the BSR outperforms its narrower forerunner, the quadratic scoring rule (Hossain and Okui 2013; Harrison and Phillips 2014). Weakened theoretical assumptions and evidence for superior relative performance has quickly rendered the BSR the preferred elicitation.3  However, limited evidence exists on whether subjects behave in a truth-telling manner, and the conservative reporting patterns that identified failures in quadratic-scoring elicitations have also been detected in BSR elicitations. For example, in Babcock et al. (2017), despite the qualitative comparative statics for beliefs mirroring behavior, the elicited reports appeared overly conservative."

...[and from the conclusion]

"In pursuing improved elicitations, we need to be cognizant that we are designing mechanisms for behavioral agents. In this respect, our findings and proposed tests for behavioral incentive compatibility relate to Li’s (2017) concepts of obvious dominance and obvious strategy proofness. Both our work and Li (2017) stress the importance of considering cognitive limitations (in addition to a broader set of preferences) when designing incentive compatible mechanisms. However, while Li (2017) provides a theoretical criterion of a mechanism’s incentive compatibility for a class of cognitively limited agents, our work stresses the importance of, and provides means to, testing whether a theoretically incentive compatible mechanism is behaviorally incentive compatible in an empirical sense. As in the BSR, relatively weak-seeming theoretical assumptions permit the design of fully separating mechanisms, to measure beliefs at arbitrary precision. But such precision may well be costly—where we need to empirically test that the assumptions put in place hold, and that behavioral agents actually perceive truthful revelation as beneficial.

"Our study has proposed weak conditions for behaviorally incentive compatible elicitations and provided diagnostic tools for checking them. The hope is that new elicitations will be assessed against and succeed in passing these standards. Given the challenges associated with this task though, we caution that it may be time to question whether it is reasonable to assume that participants in our studies hold exact probabilistic beliefs, let alone our ability to use monetary incentives to elicit such beliefs at arbitrary precision. Instead of taking our results as a call for the development of mechanisms that are incentive compatible for an ever-more-general class of decision-maker, we might instead ask whether the necessary economic inferences could be drawn with less-precise measurements, where the incentives for truthful reporting can be simpler and starker.63 For example, in discrete settings it may be sufficient to elicit the event the participants deem most likely and incentivize the elicitation by offering compensation only in the event that the report is correct.64 In continuous settings, the same can be achieved by paying participants if the true population outcome falls within some bounds around their guess.65 Alternatively, it may be sufficient to determine whether a belief lies within a certain fixed interval. This allows for deviations between the potential intervals to come at a higher perceived cost and may still provide the information necessary for inference.66 For example, suppose that in understanding individual behavior we wish to elicit the belief that an opponent will select action A or B, and that the individual’s predicted behavior theoretically depends on the belief on A exceeding a 30 percent cutoff. Rather than eliciting the precise belief that action A is chosen, it may secure more reliable and truthful reporting to instead focus the elicitation on whether or not the belief on A exceeds the theoretical cutoff. If elicited beliefs are collected primarily as controls or for auxiliary tests of a behavioral mechanic, inference may be improved with starker incentives over coarser elicitations.

"While there are many paths to improve belief elicitation, we propose two simple assessments: that information on the incentives increases truthful reporting, andt hat most participants when given a choice over the pure set of incentives select the theorized maximizer. In demonstrating the very substantial inferential consequences from using biased elicitations, our results serve as a call for elicitations to be incentive compatible both theoretically and behaviorally, but also as a strong caution against elicitations that rely on incentives that decrease truthful reporting."

**********

One quick thought I have is that when binary lottery games were introduced in Roth, A. E., & Malouf, M. W. (1979), it was to allow the predictions of utility maximizing theories to be precisely specified, rather than to control the behavior of the experimental subjects.

*********

Not so long ago I posted about another paper in the AER that deals with simple and robust ways of eliciting beliefs about others' behavior.

Tuesday, March 1, 2022

Targeting High Ability Entrepreneurs Using Community Information: Mechanism Design in the Field By Reshmaan Hussam, Natalia Rigol, and Benjamin N. Roth

"Mechanisms designed to elicit truthful reporting in the laboratory sometimes are cumbersome to administer and difficult to explain.  Here's a paper that finds that simple attempts to incentivize truthful reporting (including allowing other participants to hear each report, as well as small payments for reports that conform to community consensus) can help eliminate incentives to boost family and friends, when reports concern who could make most effective use of a cash grant."

Kidney exchange in The Times of India

 The Times of India covers my talk at the Indian Society of Transplantation meeting:

Alvin Roth for legal boost to kidney exchange pool in India by Chaitanya Deshpande, Oct 15, 2022c

 The site makes it hard to extract text, but here's a photo of some comments, which make me hope that some action may be taken:

Update: 

Scientific honors and gender gaps

 Changing from an old equilibrium to a new one can involve some actions that may not persist once a new equilibrium is reached.  Here's a paper on the awarding of scientific honors.

Gender Gaps at the Academies by David Card, Stefano DellaVigna, Patricia Funk & Nagore Iriberri

NBER WORKING PAPER 30510  DOI 10.3386/w30510  September 2022

"Historically, a large majority of the newly elected members of the National Academy of Science (NAS) and the American Academy of Arts and Science (AAAS) were men. Within the past two decades, however, that situation has changed, and in the last 3 years women made up about 40 percent of the new members in both academies. We build lists of active scholars from publications in the top journals in three fields – Psychology, Mathematics and Economics – and develop a series of models to compare changes in the probability of selection of women as members of the NAS and AAAS from the 1960s to today, controlling for publications and citations. In the early years of our sample, women were less likely to be selected as members than men with similar records. By the 1990s, the selection process at both academies was approximately gender-neutral, conditional on publications and citations. In the past 20 years, however, a positive preference for female members has emerged and strengthened in all three fields. Currently, women are 3-15 times more likely to be selected as members of the AAAS and NAS than men with similar publication and citation records."

************

That paper is a followup to their previous paper on Econometric Society Fellows, which has just come out in the current issue of Econometrica:

ECONOMETRICA: SEP 2022, VOLUME 90, ISSUE 5

Gender Differences in Peer Recognition by Economists

https://doi.org/10.3982/ECTA18027
p. 1937-1971

David Card, Stefano DellaVigna, Patricia Funk, Nagore Iriberri

We study the selection of Fellows of the Econometric Society, using a new data set of publications and citations for over 40,000 actively publishing economists since the early 1900s. Conditional on achievement, we document a large negative gap in the probability that women were selected as Fellows in the 1933–1979 period. This gap became positive (though not statistically significant) from 1980 to 2010, and in the past decade has become large and highly significant, with over a 100% increase in the probability of selection for female authors relative to males with similar publications and citations. The positive boost affects highly qualified female candidates (in the top 10% of authors) with no effect for the bottom 90%. Using nomination data for the past 30 years, we find a key proximate role for the Society's Nominating Committee in this shift. Since 2012, the Committee has had an explicit mandate to nominate highly qualified women, and its nominees enjoy above‐average election success (controlling for achievement). Looking beyond gender, we document similar shifts in the premium for geographic diversity: in the mid‐2000s, both the Fellows and the Nominating Committee became significantly more likely to nominate and elect candidates from outside the United States. Finally, we examine gender gaps in several other major awards for U.S. economists. We show that the gaps in the probability of selection of new fellows of the American Academy of Arts and Sciences and the National Academy of Sciences closely parallel those of the Econometric Society, with historically negative penalties for women turning to positive premiums in recent years.

**********

Update: here's the published version of the NBER paper, in PNAS, JANUARY 24, 2023, VOL. 120, NO. 4:

Gender gaps at the academies

David Card https://orcid.org/0000-0001-6914-6698 card@econ.berkeley.edu, Stefano DellaVigna, Patricia Funk, and Nagore Iriberri

This contribution is part of the special series of Inaugural Articles by members of the National Academy of Sciences elected in 2021. January 19, 2023 120 (4) e2212421120

https://doi.org/10.1073/pnas.2212421120

The Dr H.L. Trivedi Oration at the Indian Society of Transplantation (ISOT) Meeting 2022

Here's the meeting announcement:

ISOT 2022 NAGPUR

32^nd Annual Conference of The Indian Society of Organ Transplantation
2^nd Mid-term Meeting of Liver Transplantation Society of India
15^th Annual International Conference of NATCO
Dates : 12^th - 16^th October 2022 | Venue : Hotel Le Meridien, Nagpur

My talk, the Dr H.L. Trivedi Oration   is scheduled for 11:00am on Friday the 14th in Nagpur, which means I'll be giving it by zoom tonight, Thursday evening at 10:30 pm Pacific Time.

The presentation, which  will be about "Increasing the availability of transplants in India" is in honor of the late Dr. Hargovind Laxmishanker "H. L." Trivedi (August 1932 – October 2019), who I had the privilege of meeting,

Here's his obituary : 

Kute, Vivek, Himanshu Patel, Pankaj Shah, Pranjal Modi, and Vineet Mishra. "Professor Dr. HL Trivedi pioneering nephrologist and patriot who cared for his country (31-08-1932 TO 2-10-2019)." Indian Journal of Nephrology 29, no. 6 (2019): 379.

*********

Here's my concluding slide:

• India has enormous talent and accomplishment in living-donor transplantation
• To more nearly reach it’s potential, India needs to invest in recovering deceased donor organs.
• In the near term, it can build on it’s accomplishments in kidney transplantation, by 
• establishing national (not just regional) kidney exchange
• Continuing to explore international exchange for the hardest to match pairs
• Reducing restrictions on who can be an exchange donor
• Allowing non-directed donors and chains
• Allowing some chains to begin with a deceased-donor kidney
• Reducing financial barriers by increased investment in public hospitals and government health insurance, for organ donors as well as recipients

***********

Update: 

Attack on Sharif University in Iran: an open letter

 I'm among the signers of yet another open letter protesting events in Iran, this one against violent attacks on peaceful protesters in Iranian universities, related in turn to official violence against women. (click to see all the signers...):

Statement in Condemnation of the Attacks on University Students in Iran

"The recent events surrounding the death of Mahsa Amini in police custody on September 16, 2022, have pained and astounded many Iranians within Iran and abroad, including many students and academics [1]. Mahsa’s death engendered a visceral reaction across Iran. Iranians have raised their voices in protest to demand justice, freedom, and equality for women and beyond [2,3].

"On the evening of October 2, 2022, in brutal response to a protest staged by students at the Sharif University of Technology, one of Iran’s leading universities, various anti-riot forces violently stormed the university campus and surrounding areas. They laid siege to the university’s campus, brutally attacking and arresting students and faculty en masse [4,5]. This attack is followed by attacks on other universities that are continuing as we write this letter, including an attack on Tabriz University.   

"This unspeakable violence against students is an assault on the sanctity of education, academe, and fundamental human rights. We, the undersigned members of the global community of academics, condemn this attack and severe acts of aggression against universities and students in Iran and demand the immediate release of all arrested students and faculty and their protection against further attacks and arrests. "

"To sign this petition, please fill out this google form:

https://forms.gle/8i2bQrTrTKU45jZD9 

For information, please reach out to: academics-supporting-iranian-students@googlegroups.com 

[1]https://www.theguardian.com/world/2022/oct/01/women-life-liberty-iranian-civil-rights-protests-spread-worldwide

[2]https://www.theguardian.com/world/2022/sep/30/iranian-protesters-are-part-of-a-worldwide-fight-for-womens-rights

[3]https://www.reuters.com/world/middle-east/iran-lawmakers-chant-thank-you-police-amid-growing-public-fury-over-womans-death-2022-10-02/ 

[4]https://www.bbc.com/news/world-middle-east-63111767

[5] https://www.bbc.com/persian/world-63113519

************

Here's a story about the attack on Sharif University, in the NY Times

‘Geniuses’ Versus the Guns: A Campus Crackdown Shocks Iran. Universities across Iran have erupted in protests after more than decade of being politically dormant, with students joining the unrest that has convulsed the country for the past three weeks.  By Farnaz Fassihi

"The scenes that unfolded at Sharif University on Sunday afternoon were some of the most shocking in the three weeks of protests led by women calling for an end to the Islamic Republic’s rule that have convulsed Iran since a 22-year-old woman, Mahsa Amini, died in the custody of the morality police. Security forces have cracked down violently on the protests but they continue."

Sorority rush: the paper and the podcast

 Years ago, my late student Sue Mongell and I wrote a paper about sorority rush:

Mongell, Susan, and Alvin E. Roth. "Sorority rush as a two-sided matching mechanism." The American Economic Review (1991): 441-464.
 

Just over 20 years later, you can listen to a short NPR broadcast about it on Planet Money (which leaves out a few of the details;-)

THE INDICATOR FROM PLANET MONEY

The economics behind sorority rush

October 5, 2022 by WAILIN WONG and ADRIAN MA

8-Minute Listen

"how do new recruits land at their sorority houses?

"The answer lies in a classic economic concept used in contexts ranging from organ donation to New York public high schools. Today, we're exploring matching markets"

Ambivalence on recreational cannabis in Amsterdam

 The Guardian has the story:

Amsterdam considers banning ‘cannabis tourists’ from its coffee shops. Fed up with stoned visitors and worried by hard-drug criminality, the mayor wants to clean up the city. But will it work? by Senay Boztas

Here's one bit that suggests that ambivalence is widespread, and baked into current regulations.

"In April, in a 13-page policy proposal, the mayor asked for the council’s support to temporarily enforce the residents-only law, largely because of concerns about the “criminal back door” of the coffee shops. Smoking and possessing weed for personal consumption are “tolerated”, but commercial growing is not – so coffee shops must buy from criminals. An influential 2019 report on the capital’s “dark side” suggested revisiting the residents-only rule to help tackle this “urban jungle”.

Public Lecture at Iowa State (video): "Who Gets What and Why? Economists as Engineers."

 Iowa State University in Ames Iowa has made available a video of a public lecture I gave there on September 22, called "Who Gets What and Why?  Economists as Engineers."

Black markets in abortion pills

 Americans differ in their opinions about whether American women have a right to end a pregnancy, or whether state legislators have the right to decide the issue for residents of their state.  Six American Supreme Court justices hold the latter opinion, and so overturned the constitutional right defined 50 years ago by the same court in Roe v. Wade.

This means that different states are going to have different laws about abortion. But medical technology is such that abortion pills exist, and can arrive in the mail. So even State laws criminalizing that may not stop it, when abortion and abortion pills remain legal in other states. That is, we're about to see a situation ripe for black markets. We may also see a legal conflict among the states.

The NY Times has a story on that:

Risking Everything to Offer Abortions Across State Lines. Doctors and midwives in blue states are working to get abortion pills into red states — setting the stage for a historic legal clash.  By Emily Bazelon

"When the landscape settles, abortion is likely to be illegal or severely restricted in at least 20 states — where just two years ago, in 2020, about 250,000 people had abortions. It is clear that clinicians in those states will face imminent prosecution if they continue to provide abortions. What is much less clear is what happens if providers in blue states offer telemedicine abortions to women in states where that’s against the law. These clinicians, too, could be arrested or sued or lose their medical licenses. To protect themselves, they may have to give up traveling to certain parts of the country — and it’s still no guarantee.

"In the face of so much uncertainty and an invigorated anti-abortion movement, large organizations and most clinicians are loath to gamble. But Aid Access providers think that the end of Roe calls for doctors to take bold action. Their answer is to mail many more pills to women who otherwise may be forced to carry pregnancies they don’t want.

"The court’s decision overturning Roe last June, Dobbs v. Jackson Women’s Health Organization, polarized the public while opening the door to a new threat — a direct clash among the states over abortion law. In jettisoning the single national standard Roe established, the court invited states to pass or enforce their own laws, which could be diametrically opposed to those of neighboring states."

"Sitting in her office in New York, hundreds of miles from states that could go after her, Prine, at 71, was close to retirement and willing to take chances. “I don’t want younger physicians to be embroiled in lawsuits or criminally charged,” she said. “I’m the one that should happen to. Doctors like me who are at the end of our careers, we should be the ones to step up.”

"Article IV of the Constitution, which addresses the relationships among states, says that if a person charged with a crime in one state flees to another, she must be “delivered up,” or extradited, to the first state. If a doctor from Connecticut, for example, went to Texas, performed an illegal abortion there and then went home, Connecticut would have to send that doctor to Texas for prosecution. But courts have held in the past that if the person never set foot in the state that is prosecuting her, then she didn’t flee, and her state of residence has no constitutional obligation to extradite her. 

...

"But there’s a catch. If a provider travels outside her home state while Texas has a warrant for her arrest, another state without a shield law could follow the customary practice of interstate cooperation — and extradite her to Texas. In addition, if an abortion provider in a pro-access state like Connecticut is sued in Texas rather than prosecuted, Article IV requires the states to help enforce a civil judgment. Connecticut would probably be obligated to comply in collecting damages, for example, if a family member of a woman who had an abortion won a lawsuit for the wrongful death of a fetus. To deter these sorts of suits, Cohen, Donley and Rebouché suggest that states that want to shield their abortion providers could authorize them to countersue for interfering with legally protected health care. “If you’re hoping for a $1 million judgment in Alabama, but you know New York will let someone try to get it back from you, maybe you don’t sue in the first place,” Cohen says.

"The closest historical analogy, however imperfect, for the coming clash may be the conflict between Southern and Northern states over fugitive slave laws in the 19th century. “There are genuinely significant differences between slavery and abortion, morally and legally,” says Jamal Greene, a law professor at Columbia University. “But it’s a reasonable starting point for understanding why it’s a problem, in a nation that wants to hold itself together, when individual states are allowed to make policy about basic rights that people feel extremely strongly about, on both sides.”

"Tensions among the states can become corrosive. The framers of the Constitution gave enslavers the power to recapture enslaved people who escaped to free states. As the cause of abolition gained support, some free states passed personal liberty laws that protected Black people from kidnapping. In 1842, in Prigg v. Pennsylvania, the Supreme Court weighed in on the side of the South, striking down the conviction in Pennsylvania of a slave catcher for kidnapping a mother and her children."

This Supreme Court term has many cases on repugnant transactions and controversial markets

 The newly conservative-dominated Supreme Court is ready for its second term, and has a docket full of what readers of this blog know I think of as controversial markets and repugnant transactions.  While previous court decisions have expanded individual rights on these subjects, such as abortion, the present court seems to view them not as individual rights but as States' rights.  But that may be too simple a characterization of this brand of conservative jurisprudence. We're going to learn more about that as the term plays out. (I'm personally most worried about what decisions will be made about election law, because of the effect those decisions may have on future decisions.)

Here's the NYT on the coming caseload:

As New Term Starts, Supreme Court Is Poised to Resume Rightward Push. The justices return to the bench on Monday to start a term that will include major cases on affirmative action, voting and discrimination against gay couples. Several will take on questions about race.  By Adam Liptak

"The last Supreme Court term ended with a series of judicial bombshells in June that eliminated the right to abortion, established a right to carry guns outside the home and limited efforts to address climate change. As the justices return to the bench on Monday, there are few signs that the court’s race to the right is slowing.

"The new term will feature major disputes on affirmative action, voting, religion, free speech and gay rights. And the court’s six-justice conservative supermajority seems poised to dominate the new term as it did the earlier one.

...

"Several of the biggest cases concern race, in settings as varied as education, voting and adoptions.

"They include challenges to the race-conscious admissions programs at Harvard and the University of North Carolina. As in last term’s abortion case, Dobbs v. Jackson Women’s Health Organization, longstanding precedents are at risk.

"The court has repeatedly upheld affirmative-action programs meant to ensure educational diversity at colleges and universities, most recently in 2016. In an interview that year, Justice Ruth Bader Ginsburg said the issue had been permanently settled.

...

"Mr. Trump went on to name three members of the Supreme Court, including Justice Amy Coney Barrett, who succeeded Justice Ginsburg after her death in 2020.

"Those changes put more than 40 years of affirmative action precedents at risk, including Grutter v. Bollinger, a 2003 decision in which the Supreme Court endorsed holistic admissions programs, saying it was permissible to consider race as one factor among many to achieve educational diversity. Writing for the majority in that case, Justice Sandra Day O’Connor said she expected that “25 years from now,” the “use of racial preferences will no longer be necessary.”

"The court seems poised to say that the time for change has arrived several years early in the two new cases, Students for Fair Admissions v. Harvard, No. 20-1199, and Students for Fair Admissions v. University of North Carolina, No. 21-707. They are set to be argued on Oct. 31.

...

"A challenge to the constitutionality of the Indian Child Welfare Act of 1978, which makes it hard for non-Native Americans to adopt Native children, may also turn on whether the court views those safeguards as based on race, making them vulnerable to constitutional review. The law at issue in the case, Haaland v. Brackeen, No. 21-376, was a response to a history of children being removed from their tribes and heritage; arguments will be heard on Nov. 9.

*******

I think the two university affirmative action cases are no longer as closely linked as they were before the appointment by President Biden of Justice Ketanji Brown Jackson, who has two degrees from Harvard, and may have to recuse herself. See this cryptic note from the Supreme Court's website: 20-1199 STUDENTS FOR FAIR ADMISSIONS V. PRESIDENT AND FELLOWS OF HARVARD COLLEGE

*********

Earlier:

Wednesday, June 8, 2022

What might the assisted reproduction gray market look like, post Roe?

Tuesday, June 11, 2019

Adoption is complex even when it doesn't include State and Tribal rights...

Gay couples, surrogacy, IVF and health insurance

 The Guardian has a story about the obstacles consulting a married gay couple in New York. They have an ongoing lawsuit regarding discrimination in health insurance for IVF. (Much of the article is also about the debate over whether surrogacy is ethical or exploitative):

‘We are expected to be OK with not having children’: how gay parenthood through surrogacy became a battleground  by Jenny Kleeman

"That’s when they first became aware of the eye-watering cost of biological parenthood for gay men. Maggipinto reels off the price list in a way that only someone who has pored over every item could. There’s compensation for the egg donor: no less than $8,000 (£6,600). The egg-donor agency fee: $8,000-10,000. The fertility clinic’s bill (including genetic testing, blood tests, STD screening and a psychiatric evaluation for all parties, sperm testing, egg extraction, insemination, the growing, selecting, freezing and implantation of the resulting embryos): up to $70,000. And that’s if it all goes well: if no embryos are created during a cycle, or if the embryos that are don’t lead to a successful pregnancy, they would have to start again.

"Then there’s the cost of a surrogate (called a “gestational carrier” when they carry embryos created from another woman’s eggs). Maggipinto and Briskin were told agency fees alone could stretch to $25,000, and the surrogates themselves should be paid a minimum of $60,000 (it is illegal for surrogates to be paid in the UK, but their expenses are covered by the intended parents). “That payment doesn’t include reimbursement for things like maternity clothing; lost wages if she misses work for doctors’ appointments or is put on bed rest; transportation; childcare for her own children; [or] lodging.” It takes 15 minutes for Maggipinto to run me through all the expenses they could incur if they tried to have a child genetically related to one of them. The bottom line? “Two hundred thousand dollars, minimum,” he says.

...

"Briskin used to work for the City of New York as an assistant district attorney, earning about $60,000 a year. His employment benefits had included generous health insurance. But when they read the policy, they discovered they were the only class of people to be excluded from IVF coverage. Infertility was defined as an inability to have a child through heterosexual sex or intrauterine insemination. That meant straight people and lesbians working for the City of New York would have the costs of IVF covered, but gay male couples could never be eligible.

...

"There’s a stark contrast between American and Ukrainian surrogates, Maggipinto says. “Here you have to be a woman who has already had children, who is over a certain age, who can prove that she is independently financially capable of sustaining herself without her surrogate compensation. You effectively cannot be a poor surrogate.” He is referring to the American Society for Reproductive Medicine’s guidelines, but with no official regulation in the US, there’s no compulsion for anyone to follow them.

...

"The EEOC will rule on whether the terms of Briskin’s health insurance were discriminatory within a few weeks. The City of New York has so far defended its policy. The couple’s attorney, Peter Romer-Friedman, tells me: “They say their healthcare plan doesn’t provide surrogacy for anyone, so it’s not discrimination to deny it to Corey and Nicholas.” Just like everyone else, the city’s first response was to assume this was all about access to surrogacy."

Open letters--democracy and academic freedom, in Iran and Turkey

 Around this time of year I think of the various open letters I sign, from among many that I'm invited to sign.  (I try to avoid signing letters in which it might appear that I'm offering expertise where in fact I don't have any--e.g. letters that make macroeconomic predictions or prescriptions.)  But some of the letters I end up signing protest injustices of various sorts, and seem to require only the kind of expertise that comes with being a citizen in a democracy or a professor at a university.

Here are two that I've recently signed.

The first concerns widely reported events in Iran.

AN OPEN LETTER TO THE PEOPLE OF IRAN. Over 120 Nobel Laureates from around the world stand in solidarity with the calls for justice and freedom in the wake of the death of 22 year-old Mahsa Amini.

Here's the beginning:

"Nobel Laureates from around the world stand in solidarity with the courageous actions of the people of Iran and join them in their calls for justice and freedom, and for the protection of human rights for all citizens of the country.

"Nobel laureates condemn the Iranian authorities’ violence against women and protestors.

“We condemn these barbaric actions toward women and protesters in Iran,” said laureate Dr. Shirin Ebadi, Nobel Peace Prize Laureate 2003. “Women should be free and there must be removal of all legal discriminations against women.”

***********

The second concerns a colleague at a Turkish university:

Prof. Dr. Ünal Zenginobuz’un ve Boğaziçi Üniversitesi’nin yanındayız.  We stand by Prof. Ünal Zenginobuz and Boğaziçi University.

The International Academics’ Statement:

"We are outraged by the suspension of Prof. Ünal Zenginobuz from teaching at Boğaziçi University for a period of three months, thereby preventing his academic and educational activities, on grounds of an investigation into actions conducted while he held the position of Department Head.

...

"Cutting Prof. Zenginobuz off from the academic world will harm his students, his university, his country, and the international academic community. This is simply unacceptable. What makes this unjust decision even more grave is that this is a continuation of developments at Boğaziçi University since January 2021 that have been in violation of academic autonomy and merit. Boğaziçi University enjoys success and worldwide renown thanks to values including academic merit, democratic governance, and dedication to public service, which Prof. Zenginobuz represents at its best.

"We stand by Prof. Zenginobuz and Boğaziçi University."

Machine learning plays the ultimatum game via sentence completion by Large Language Models

 One currently growing class of artificial intelligence, machine learning models are Large Language Models, which are trained on potentially all the text on the internet to do sentence completion, i.e. to pick the next words in a sentence. In this way they can generate texts that may be hard to distinguish from human texts, and engage in conversations that may be hard to distinguish from human conversations.

Here's a paper that uses LLM's to (among other things) play the responder in ultimatum games, by varying offers made by a proposer, and information about the proposer and responder, and then having it complete the sentence "[the responder] decides to ___", where valid completions begin with "accept" or "reject".

Using Large Language Models to Simulate Multiple Humans by Gati Aher, Rosa I. Arriaga, Adam Tauman Kalai

Abstract: "We propose a method for using a large language model, such as GPT-3, to simulate responses of different humans in a given context. We test our method by attempting to reproduce well-established economic, psycholinguistic, and social experiments. The method requires prompt templates for each experiment. Simulations are run by varying the (hypothetical) subject details, such as name, and analyzing the text generated by the language model. To validate our methodology, we use GPT-3 to simulate the Ultimatum Game, garden path sentences, risk aversion, and the Milgram Shock experiments. In order to address concerns of exposure to these studies in training data, we also evaluate simulations on novel variants of these studies. We show that it is possible to simulate responses of different people and that their responses are largely consistent with prior human studies from the literature. Using large language models as simulators offers advantages but also poses risks. Our use of a language model for simulation is contrasted with anthropomorphic views of a language model as having its own behavior."

***********

Here's a sample prompt for the ultimatum game:

Here is a graph of the results: a simple language model (LM-1) predicts flat acceptance or rejection regardless of offers, but the larger model LM-5 predicts that the probability of acceptance grows with the offer, in a way comparable to some human data. (The learning models LM-1 to LM-5 are increasingly large versions of GPT-3.)

I guess we'll have to add participation in experiments to the job categories threatened with takeover by AI's...

Choosing (as if) from a menu (by Gonczarowski, Heffetz and Thomas; and by Bó, and Hakimov)

What makes serial dictatorship so obviously strategy proof is that it gives each participant the opportunity to choose from a menu, and get what he/she picks.  So the dominant strategy is to pick what you want (and if you have to delegate the decision by submitting a list of preferences, it is a dominant strategy to state your true preferences.

Here are two papers differently inspired by that thought, which seek to reformulate matching mechanisms so that they look to each player like choice from a menu.

Strategyproofness-Exposing Mechanism Descriptions by Yannai A. Gonczarowski, Ori Heffetz, Clayton Thomas

Abstract: "A menu description defines a mechanism to player i in two steps. Step (1) uses the reports of other players to describe i's menu: the set of i's potential outcomes. Step (2) uses i's report to select i's favorite outcome from her menu. Can menu descriptions better expose strategyproofness, without sacrificing simplicity? We propose a new, simple menu description of Deferred Acceptance. We prove that -- in contrast with other common matching mechanisms -- this menu description must differ substantially from the corresponding traditional description. We demonstrate, with a lab experiment on two simple mechanisms, the promise and challenges of menu descriptions."

***************

Pick-an-object Mechanisms by Inácio Bó, Rustamdjan Hakimov

Abstract: "We introduce a new family of mechanisms for one-sided matching markets, denoted pick-an-object (PAO) mechanisms. When implementing an allocation rule via PAO, agents are asked to pick an object from individualized menus. These choices may be rejected later on, and these agents are presented with new menus. When the procedure ends, agents are assigned the last object they picked. We characterize the allocation rules that can be sequentialized by PAO mechanisms, as well as the ones that can be implemented in a robust truthful equilibrium. We justify the use of PAO as opposed to direct mechanisms by showing that its equilibrium behavior is closely related to the one in obviously strategy-proof (OSP) mechanisms, but implements commonly used rules, such as Gale-Shapley DA and top trading cycles, which are not OSP-implementable. We run laboratory experiments comparing truthful behavior when using PAO, OSP, and direct mechanisms to implement different rules. These indicate that agents are more likely to behave in line with the theoretical prediction under PAO and OSP implementations than their direct counterparts."

Return to previous school assignment policies (in some respects) under New York City's new mayor

 In NYC, the pendulum is still swinging between inclusive admissions as measured by demographics and determined by lottery, and meritocratic admissions as measured by tests and grades.

The NYT has the story:

In a Reversal, New York City Tightens Admissions to Some Top Schools. The city loosened selection criteria during the pandemic, policies some parents protested as unfair and others hoped would reduce racial disparities. By Troy Closson

"New York City’s selective middle schools can once again use grades to choose which students to admit, the school chancellor, David C. Banks, announced on Thursday, rolling back a pandemic-era moratorium that had opened the doors of some of the city’s most elite schools to more low-income students.

...

"New York City has used selective admissions for public schools more than any school district in the country. About a third of the city’s 900 or so middle and high schools had some kind of admissions requirement before the pandemic disrupted many measures to sort students by academic performance.

...

"Selective high schools will also be able to prioritize top-performing students.

"The sweeping move will end the random lottery for middle schools, a major shift after the previous administration ended the use of grades and test scores two years ago. At the city’s competitive high schools, where changes widened the pool of eligible applicants, priority for seats will be limited to top students whose grades are an A average.

...

"The announcement came as New York City’s education officials are confronting multiple crises in the wake of the pandemic, complicating a dilemma that has bedeviled previous administrations: how to create more equitable schools, while trying to prevent middle-class families from abandoning the system.

"State standardized test scores released Wednesday showed that many students fell behind, particularly in math, and that many Hispanic, Black and low-income students continue to lag far behind their white, Asian and higher-income peers. At the same time, the district is bleeding students: Roughly 120,000 families have left traditional public schools over the past five years. Some have left the system, and others have gone to charter schools."

*****

And here's the Washington Post:

New York City, embracing merit, rolls back diversity plan for schools By Laura Meckler

"New York City schools announced Thursday they would allow middle schools to consider academics in admitting students to some of the city’s most sought-after programs, unraveling pandemic-era rules aimed at injecting racial and economic diversity into a segregated system.

"High schools would also rely more heavily on merit and less on the luck of a lottery under the new plan, reversing the previous administration’s direction as a new mayor takes command of the nation’s largest school system.

...

"In San Francisco, admissions into the elite Lowell High School were converted from merit-based into a lottery system. As in New York, though, the change was reversed — in this case, after several school board members were recalled, in part over this issue.

"In Northern Virginia, Thomas Jefferson High School for Science and Technology also shifted from an admissions test to a “holistic review” that considers several factors, a move that is being challenged in court and has faced resistance from the Republican governor and his administration.

...

"In New York, the debate is particularly fiery because students are required to apply to middle and high school, and before the pandemic, about a third of the city’s 900 middle and high schools included requirements for admission — such as grades, test scores, attendance and behavior records. 

...

"That system was largely converted into a lottery under Mayor Bill de Blasio.

"For high school, applicants were put into tiers based on their grades. But the top tier included about 60 percent of all students, who had the first crack at the top schools. Competitive schools drew acceptances randomly from this group.

...

"Now, under the new system announced Thursday, it will be harder to get into the top tier, though once in that group, it will still be a lottery. To get into the top tier, students must be in the top 15 percent of their school or of the city overall, and they must have at least a 90 percent on grades.

"Test scores, which had been used for years but also criticized as biased, will not be considered. Banks said exam scores are a flawed measure but grades are “still a very solid indicator of how you are showing up as a student,” even for students who face hardships at home."

Your digital trail, in cyberspace and in public spaces

 Here are two recent privacy-related stories about how the digital trails we leave can be combined in surprising ways.

From the NYT a story about an artist who became a digital sleuth, to capture people working hard to take casual-seeming Instagram photos of themselves in famous locations.

This Surveillance Artist Knows How You Got That Perfect Instagram Photo. A tech-savvy artist unearthed video footage of people working hard to capture the perfect shot for Instagram. It is a lesson in the artifice of social media and the ubiquity of surveillance.  By Kashmir Hill

"The 24/7 broadcast that Mr. Depoorter watched — titled “Live From NYC’s Times Square!” — was provided by EarthCam, a New Jersey company that specializes in real-time camera feeds. EarthCam built its network of livestreaming webcams “to transport people to interesting and unique locations around the world that may be difficult or impossible to experience in person,” according to its website. Founded in 1996, EarthCam monetizes the cameras through advertising and licensing of the footage.

"Mr. Depoorter realized that he could come up with an automated way to combine these publicly available cameras with the photos that people had posted on Instagram. So, over a two-week period, he collected EarthCam footage broadcast online from Times Square in New York, Wrigley Field in Chicago and the Temple Bar in Dublin.

"Rand Hammoud, a campaigner against surveillance at the global human rights organization Access Now, said the project illustrated how often people are unknowingly being filmed by surveillance cameras, and how easy it has become to stitch those movements together using automated biometric-scanning technologies."

******

From the Washington Post, a story about how data from health apps makes its way to advertisers and others, with device identifiers (e.g. with the identity of your phone...):

Health apps share your concerns with advertisers. HIPAA can’t stop it. From ‘depression’ to ‘HIV,’ we found popular health apps sharing potential health concerns and user identifiers with dozens of ad companies  By Tatum Hunter and Jeremy B. Merrill 

"several popular Android health apps including Drugs.com Medication Guide, WebMD: Symptom Checker and Period Calendar Period Tracker gave advertisers the information they’d need to market to people or groups of consumers based on their health concerns.

"The Drugs.com Android app, for example, sent data to more than 100 outside entities including advertising companies, DuckDuckGo said. Terms inside those data transfers included “herpes,” “HIV,” “adderall” (a drug to treat attention-deficit/hyperactivity disorder), “diabetes” and “pregnancy.” These keywords came alongside device identifiers, which raise questions about privacy and targeting."