Friday, March 13, 2009

Costs of unraveling: elementary school basketball players

One of the costs of "unraveling," in which transactions come to be made increasingly early, is that matches are made on the basis of very noisy information. I've posted earlier about the competition by colleges for basketball players (Market for (seventh grade) basketball players ), and a recent story highlights just how noisy those early signals can be: First Impressions Can Create Unrealistic Expectations for Recruits .

"Amid the clamor to find the next basketball wunderkind, the evaluation of sixth graders remains an uncertain pursuit. Francis, who runs the Hoop Scoop recruiting service, said the process involved much guesswork.
The players can stop improving, stop caring or stop growing." (emphasis added: the source of uncertainty is different in different markets:)

"In January, the N.C.A.A.lowered the school year a basketball player was considered a prospect from ninth grade to seventh grade.
Though the change seemed curious, it closed a loophole that had allowed college coaches to gain a recruiting edge by inviting middle school players to private camps. Those middle school prospects are now protected by the N.C.A.A. the same way as high school recruits.
For now, elementary school students are not included in this new rule. An associate commissioner of the Big East, Joseph D’Antonio, the chairman of the N.C.A.A.’s legislative council, hopes there is no need to change that.
“I think the seventh- and eighth-grade endpoint is a place to begin, because that’s where the problem has been identified,” D’Antonio said. “Whether or not we see bylaws in the future that lower the age even further is going to be driven by what the coaching involvement is.”"

HT Muriel Niederle

Thursday, March 12, 2009

The production of news: The NEJM news cycle

My previous post was about the recent kidney exchange innovation by the Alliance for Paired Donation, just reported in today's issue of the New England Journal of Medicine. That NEJM immediately attracted some press, and in this post I consider the role that the NEJM's press embargo policy might play in generating news stories about some of the articles they publish.

The press policy of the NEJM is communicated to authors as follows (emphasis added):
"Your Brief Report will appear in the March 12, 2009 issue of the New England Journal of Medicine (NEJM). This information is confidential. There is a press embargo on the contents of the issue until 5:00 PM ET on Wednesday March 11, 2009. On Friday, March 6, 2009 the content of the March 12, 2009 issue will made available to reporters who have agreed to respect our embargo. "

That is, a week before publication, the NEJM makes the forthcoming issue available to reporters who have agreed not to write about it until a specified time the next week.

To better understand how this kind of policy plays out, I asked a public relations person about the NEJM and their policy, and got the following reply:
"...they have a reputation of being one of the best PR machines there is. Their embargo is one of the toughest on the planet as well; reporters and any others who violate it are dead for the rest of their lives in getting information on future NEJM articles. Anyone in the medical writing community knows and fears this."

At 9 pm on March 11, four hours after the embargo ended, here's what a Google news search for "kidney exchange" looked like (note the link to "all 217" news articles):

Kidney-transplant chain broadens donations
Boston Globe - ‎1 hour ago‎
Dr. Frank Delmonico of Massachusetts General Hospital, one of the architects of the New England Program for Kidney Exchange, disagreed. ...
New Computer Models Successfully Link Donors And Kidney Transplant ... Science Daily (press release)
Living Kidney Donation Chains May Help More Get Transplants U.S. News & World Report
Chain results in 10 kidney swaps among strangers The Associated Press
Pittsburgh Post Gazette
all 217 news articles »

The first of these articles, in the Globe, was written by a reporter who talked to several of the participants, concentrating on those in Boston (which is where the economists on the team all reside, and also where another kidney exchange program, the New England Program for Kidney Exchange was started). The second (in Science Daily) is a press release issued by Boston College (where my economist colleagues Tayfun Sonmez and Utku Unver both teach). Some of the remaining stories have original content, but many are largely if not completely taken from some of the original reporting and press material. (I like the story that ran in the Washington Post, because it has a slideshow that shows off Mike Rees, the innovative--and apparently good looking--surgeon who is the lead author of the NEJM article, and a figure of emerging importance in the national discussion of kidney exchange).

So...I've written a lot of articles that attract little or no press, and certainly not a flood in a few hours. While kidney exchange is undoubtedly a subject with wider popular appeal than, say, the lattice structure of fixed points, I'm guessing that the NEJM's embargo policy plays at least some role (recall the comment that they are one of the best PR machines...). Here are three hypotheses--one psychological and two economic--about why the embargo might matter.

Hypothesis 1 (behavioral/psychological): telling reporters they can't publish before 5PM Wednesday makes them want to write about the story more...

Hypothesis 2. (coordination equilibrium): telling reporters that no one can publish before 5PM Wednesday reassures them that the time they put into the story won't be wasted, they won't be scooped by someone else who finishes their story earlier.

Hypothesis 3. (common value/winner's curse): in the absence of an embargo, a reporter tempted to try to write the first story might be worried that the absence of previous stories means that the subject isn't as interesting as it looks, won't be picked by editors, etc. To put it another way, whoever writes the first story might be (like the high bidder in a common value auction) the person who thought it was the most interesting, and the fact that no one else agreed how interesting it was might mean that he has overestimated its value. But, when there is an embargo, this kind of negative selection can't be going on; no one else could have published earlier, so the absence of earlier stories isn't a negative signal.

(Blogs, incidentally, seem to work on a different schedule; here are the March 12 takes by Steve Levitt and by Tim Harford on the original story...)

Update: television works on a different schedule still: Mike Rees was interviewed later that evening (March 12) on the CBS Evening News: A Transplant Surgeon Matches 10 Donors With Recipients In The Longest Chain In History

Wednesday, March 11, 2009

Advances in kidney exchange, in the New England Journal of Medicine

One of the satisfying things about the ongoing collaboration between economists and kidney surgeons is that sometimes the results are very concrete. Today's New England Journal of Medicine reports on such a case in the article: Rees, Michael A., Jonathan E. Kopke, Ronald P. Pelletier, Dorry L. Segev, Matthew E. Rutter, Alfredo J. Fabrega, Jeffrey Rogers, Oleh G. Pankewycz, Janet Hiller, Alvin E. Roth, Tuomas Sandholm, Utku Ünver, and Robert A. Montgomery, “A Non-Simultaneous Extended Altruistic Donor Chain,New England Journal of Medicine, 360;11, March 12, 2009. The paper reports a chain of kidney surgeries that resulted in ten transplants. It began with an altruistic donor, and was able to accomplish so many transplants because they didn't all have to be done simultaneously. There's a simple economic idea at work here. Mostly in kidney exchange, all the surgeries are done simultaneously. The reason is that if two patient-donor pairs are exchanging kidneys, and if one pair were to donate a kidney to the other first, and the other were subsequently unable or unwilling to reciprocate, the pair that donated the kidney would be severely harmed; not only wouldn't they get the kidney they had been counting on, but they would have donated their donor's kidney and thus be unable to participate in a future exchange. But if there is an altruistic donor who doesn't have a specific patient in mind, and if he or she gives to a patient-donor pair, and they can't subsequently continue the chain, that is a loss, but no one is irreparably harmed. So, when chains begin with an undirected donor, they don't have to be simultaneous, since the costs of a breach are less. Mike Rees and the Alliance for Paired Donation are the heroes of this story: here is the APD's press release. Here's a story from the Boston Globe, that emphasizes the Boston/economist connection of Roth, Sonmez and Unver: Kidney-transplant chain broadens donations. Here's an article from the Pittsburgh Post Gazette that takes note of the collaboration with Carnegie Mellon computer scientists, represented in the NEJM paper by Tuomas Sandholm: Altruistic kidney donations.

Market for airline flights

As the pricing, scheduling, and seating options grow more complex, booking an airline ticket is looking more like a combinatorial auction. Some travel sites, like TripAdvisor and Kayak.com aim to help with that by displaying more clearly the available bundles of choices: A Clearing in the Fog of Complicated Booking.

" ' We’re bringing clarity to the marketplace, with disclosure up front,” said Bryan Saltzburg, the TripAdvisor general manager for new initiatives. More clarity and disclosure in the marketplace? Let’s hope it’s a trend."

Tuesday, March 10, 2009

Financial market design: the view from the Fed

Fed chairman Ben Bernanke, in a speech today (March 10) to the Council on Foreign Relations, after speaking of immediate steps to bail out financial institutions, talks about ways in which the financial markets might be redesigned in the longer term.

"At the same time that we are addressing such immediate challenges, it is not too soon for policymakers to begin thinking about the reforms to the financial architecture, broadly conceived, that could help prevent a similar crisis from developing in the future. We must have a strategy that regulates the financial system as a whole, in a holistic way, not just its individual components. In particular, strong and effective regulation and supervision of banking institutions, although necessary for reducing systemic risk, are not sufficient by themselves to achieve this aim.
Today, I would like to talk about four key elements of such a strategy. First, we must address the problem of financial institutions that are deemed too big--or perhaps too interconnected--to fail. Second, we must strengthen what I will call the financial infrastructure--the systems, rules, and conventions that govern trading, payment, clearing, and settlement in financial markets--to ensure that it will perform well under stress. Third, we should review regulatory policies and accounting rules to ensure that they do not induce excessive procyclicality--that is, do not overly magnify the ups and downs in the financial system and the economy. Finally, we should consider whether the creation of an authority specifically charged with monitoring and addressing systemic risks would help protect the system from financial crises like the one we are currently experiencing."

Regarding the financial infrastructure, he mentions among other things that
"To help alleviate counterparty credit concerns, regulators are also encouraging the development of well-regulated and prudently managed central clearing counterparties for OTC trades. Just last week, we approved the application for membership in the Federal Reserve System of ICE Trust, a trust company that proposes to operate as a central counterparty and clearinghouse for CDS transactions. "

On the subject of clearinghouses, he goes on to say
"The Federal Reserve and other authorities also are focusing on enhancing the resilience of the triparty repurchase agreement (repo) market, in which the primary dealers and other major banks and broker-dealers obtain very large amounts of secured financing from money market mutual funds and other short-term, risk-averse sources of funding.
...
it may be worthwhile considering the costs and benefits of a central clearing system for this market, given the magnitude of exposures generated and the vital importance of the market to both dealers and investors. "

His comments on "procyclicality" e.g. on making sure that regulation of capital reserves don't cause banks to cut back lending just when credit needs to be loosened, are also worth reading. His concluding paragraph is a sober look at market design contemplated (as it often must be) in advance of reliable scientific knowledge, but in light of recent experience:

"Financial crises will continue to occur, as they have around the world for literally hundreds of years. Even with the sorts of actions I have outlined here today, it is unrealistic to hope that financial crises can be entirely eliminated, especially while maintaining a dynamic and innovative financial system. Nonetheless, these steps should help make crises less frequent and less virulent, and so contribute to a better functioning national and global economy."

Job fairs and flower shows

Job fairs, which are intended to reduce search costs and make it easier for recruiters and recruits to find each other, seem to persist both in good times, when it may be hard for firms to fill their openings, and in hard times, when it may be hard for job seekers to find firms with openings:
At Career Fairs, Anxiety and Hope for Job-Seekers.

Flower shows, which are similarly intended to make it easier for big nurseries and their potential customers to find each other, only recover their costs when there are lots of potential customers: Economic Crisis Takes a Toll on Flower Shows. So the recession is causing many traditionally annual shows to be cancelled.

Monday, March 9, 2009

Prediction markets: why aren't they used more?

While prediction markets have a distinguished history, and are currently used in some interesting applications, the Economist magazine writes: Prediction markets: An uncertain future, A novel way of generating forecasts has yet to take off.

"NOT SO long ago, prediction markets were being tipped as a fantastic new way to forecast everything from the completion date of a vital project to a firm’s annual sales. But although they have spread beyond early-adopting companies in the technology industry, they have still not become mainstream management tools. Even fervent advocates admit much remains to be done to convince sceptical managers of their value. “It’s still a pretty evangelical business,” says Leslie Fine of CrowdCast, one of the firms that provide trading platforms for companies keen to pool the collective wisdom of their employees."

The Economist has some hypotheses about the difficulties so far:
"A big hurdle facing managers using prediction markets is getting enough people to keep trading after the novelty has worn off. "...
"Another reason prediction markets flop is that employees cannot see how the results are used, so they lose interest. "...
"Bosses may also be wary of relying on the judgments of non-experts."

At Crowdcast (formerly Xpree) they have a market design hypothesis. They blog in response to the Economist article:
"we believe prediction markets are not yet mainstream because the current solutions rely on mechanisms designed for the stock market, not for the enterprise."

(N.B. A blog that follows prediction markets is Midas Oracle .ORG )

Sunday, March 8, 2009

College admissions decisions: signaling and waiting

Right now, American high school seniors who have applied to colleges are mostly waiting to hear where they will be admitted. (The major exceptions are seniors who applied and were admitted to a college through a single-application, binding early admissions program, in which they agreed in advance to attend if accepted.) Once the colleges make their acceptance decisions, it will be their turn to wait, to see which students will accept their offers. Because of the recession, there is more uncertainty than usual: In a Shifting Era of Admissions, Colleges Are Sweating.

So colleges are trying to determine which students are likely to come if admitted, and the signals that students send (and have sent) in this regard may turn out to be important in admissions decisions.


"Typically, they rely on statistical models to predict which students will take them up on their offers to attend. But this year, with the economy turning parents and students into bargain hunters, demographics changing and unexpected jolts in the price of gas and the number of applications, they have little faith on those models.
...
"In response, colleges are trying new methods to gauge which applicants are serious about attending: Wake Forest, in North Carolina, is using Webcam interviews, while other colleges say they are scrutinizing essays more closely."
...
"Colleges consider an amalgam of factors, comparing them to past trends, to predict whether a student will attend, including, for example, what high school he went to; the strength of his grades, scores and recommendations; how much financial aid he has been offered; and whether he plays the cello or wants to study ethnobotany or economics. (If he is a she, the equation looks different still.)
They consider how many phone calls, Web hits, campus visits and applications they have received. "


Hat tip to Neil Dorosin of the Institute for Innovation in Public School Choice (IIPSC).

Saturday, March 7, 2009

Microstructure of Macro Behavior

In connection with the launch of the paperback version of his book The Logic of Life, Tim Harford has a nice video illustrating one of Tom Schelling's demonstrations of how market outcomes may not reflect the preferences of any individual market participant: The Logic of Life: Racial Segregation and Thomas Schelling.

Schelling's demo had to do with a residential real estate market in which everyone preferred to live in a racially integrated neighborhood in which people of their own race were in a slight majority, and how the resulting dynamics could lead to segregation that nobody wanted. Harford's video dramatizes this with brown and white eggs.

(The title of this blog post comes from Micromotives and Macrobehavior, Schelling's wonderful book on the subject, originally published in 1978.)

School choice in Europe

I've frequently blogged about the design of school choice systems, and that is in part because the problems of school choice are so widespread, and difficult.

In Flanders, where there is a first-come-first-served allocation system, parents have been camped out for a week in winter weather to secure places for their children (here is a story, in Flemish, with a picture).

In England, where lotteries decide many school allocations, the costs of randomness are being felt: Identical twins go to schools 18 miles apart.

We now do better than that in NYC and Boston.

Friday, March 6, 2009

Another contested auction, and some precautions

In an earlier post, Auction disruption by fake bids, I followed an auction of Chinese artifacts that was opposed by the Chinese government, and was ultimately disrupted when the high bidder indicated that his bid was fraudulent. Today's news is of an auction in Manhattan of Gandhi memorabilia (a watch and some other personal property) opposed by the Indian government (which had offered a pre-emptive bid of $20,000 for the items in an attempt to halt the sale, and had obtained an injunction in an Indian court when this was refused): Gandhi Items Sold for $1.8 Million.

The high bidder was an Indian national who may or may not be planning to donate the items to the Indian government. The auction house took some steps intended to protect themselves against the kind of disruption by false bid that occurred in the auction of Chinese artifacts.

"For the first time, Antiquorum Auctioneers, which focuses on watches, is requiring banking references, said Mr. Maron, the chairman.
Recently, Cai Mingchao, a collector and auctioneer, raised an uproar after he submitted two winning bids for bronze sculptures from China’s Qing Dynasty at a Christie’s auction in Paris. Mr. Cai later refused to pay for the items, saying he had deliberately sabotaged the auction because the sculptures had been illegally looted in the 19th century from an imperial palace outside Beijing.
“We are concerned about what happened at Christie’s,” Mr. Maron said in a phone interview. "

Thursday, March 5, 2009

Trust and trustworthiness: promoting and maintaining it

Trust is essential for all sorts of transactions, and how to set up institutions to promote trust and trustworthiness in the marketplace is a big concern of market design.

It is even a big concern of armies trying to win the hearts and minds of a population in the face of a guerrilla insurgency. There's a very interesting essay in the Washington Post about earning, maintaining and restoring trust, by Admiral Mike Mullen, the Chairman of the Joint Chiefs of Staff: Building Our Best Weapon.

On a more technical note, I'm reading Community Structure and Market Outcomes: Towards a Theory of Repeated Games in Networks by Itay Fainmesser (who you can try to hire next year). He is interested how patterns of connections between buyers and sellers can promote trustworthy behavior through repeated play, and how the effort to achieve trust in the marketplace by engaging in long term relationships may exclude some parties from the market. In this connection he writes "...repeated interactions cannot perfectly substitute for institutions..."

The kinds of institutions he is thinking of are both legal (if you can sue me for non-performance, this makes it easier to trust me), and reputational (if you can give me a credible negative review that will impede my ability to transact in the future, this also makes it easier to trust me).

As it happens, I've also been reading about the recent redesign of eBay's reputational system: "ENGINEERING TRUST - RECIPROCITY IN THE PRODUCTION OF REPUTATION INFORMATION," - by Gary Bolton, Ben Greiner, and Axel Ockenfels. It is a very nice market design paper.

They describe some of the design concerns behind eBay's 2007 rollout of its new, more detailed feedback system, in which buyers are able to give some feedback on sellers anonymously. In particular, they describe how they and eBay became concerned that the old reputation system became less informative than it might have been, because the pattern of reciprocally positive feedback concealed underlying dissatisfactions. They describe how (both prospectively and retrospectively) they compared the relevant field data, and how laboratory experiments helped verify the intuitions gained in that way, and allowed them to see the efficiency effects of an improved reputation system.

Wednesday, March 4, 2009

Student loans

"If Congress approves the plan, there will be no need to set subsidies because there will be no banks to subsidize. "

No no, not the current bank bailout (although it's easy to see how that sentence could be misinterpreted). In this case it refers to an auction the federal government is planning to hold to determine which lenders will be authorized to issue federally subsidized student loans: Education Dept. Forges Ahead With Student-Loan Auction. The idea is that banks would submit bids indicating how much federal subsidy they would require to issue student loans on agreed terms, and the lowest subsidies would win.

But "...by the time the auction process is complete, it could be moot. President Obama has called for abolishing the guaranteed-loan program altogether. If Congress approves the plan, there will be no need to set subsidies because there will be no banks to subsidize. "

Tuesday, March 3, 2009

Markets for studying

The NY Times reports on incentive programs designed to motivate students to study, and on some apparent controversy between economists and psychologists interested in the subject: Rewards for Students Under a Microscope.

My colleague Roland Fryer is organizing several of these incentive programs, in collaboration with schools in NYC, Washington DC, and Chicago, through Ed Labs at Harvard.

The Times story reports that some psychologists are skeptical, because of concerns that incentives may damage intrinsic motivation:
"Still, many psychologists warn that early data can be deceiving. Research suggests that rewards may work in the short term but have damaging effects in the long term.
...
"This kind of psychological research was popularized by the writer Alfie Kohn, whose 1993 book “Punished by Rewards: The Trouble With Gold Stars, Incentive Plans, A’s, Praise and Other Bribes” is still often cited by educators and parents. Mr. Kohn says he sees “social amnesia” in the renewed interest in incentive programs.
“If we’re using gimmicks like rewards to try to improve achievement without regard to how they affect kids’ desire to learn,” he said, “we kill the goose that laid the golden egg.” "

But the story gives Roland the last word:
"Meanwhile, Dr. Fryer of Ed Labs urges patience in awaiting the economists’ take on reward systems. He wants to look at what happens over many years by tracking subjects after incentives end and trying to discern whether the incentives have an impact on high school graduation rates.
With the money being used to pay for the incentive programs and research, “every dollar has value,” he said. “We either get social science or social change, and we need both.”"

Auction disruption by fake bids

In an earlier post, Markets and Fraud, I discussed the case of an environmental activist who disrupted an auction for oil and gas drilling rights by submitting the winning bids on several tracts. Now comes a report of an auction by Christies of some Chinese bronzes that the Chinese government claims as national cultural artifacts: Chinese Man Bids but Won’t Pay for Looted Bronzes , and Chinese Bidder Says He Won’t Pay for Looted Bronzes

"A man claiming to be the mysterious bidder who bought two Qing dynasty bronzes at an auction in Paris surfaced Monday, saying it was his patriotic duty to refuse to pay the $40 million winning bid.
A Chinese collector and auctioneer, Cai Mingchao, said at a news conference in Beijing he had made the anonymous winning bids for the 18th-century bronze heads of a rat and a rabbit. He described himself as a consultant with the Lost Cultural Relics Recovery Program, a nongovernmental group that seeks to bring looted artifacts back to China.
...
"On moral grounds, and as a way to protest the auction, Mr. Cai added, “I want to emphasize that the money won’t be paid.”"


"The Chinese government had attempted to halt the sale of the relics, saying they should be returned, not sold.
However, the government denied having anything to do with the fake bid."
...
"In a statement, Christie's said: ''We are aware of today's news reports. As a matter of policy, we do not comment on the identity of our consignors or buyers, nor do we comment or speculate on the next steps that we might take in this instance.''"

One aspect of auction design that may need greater attention if these kinds of disruptions become commonplace is how to qualify and verify bidders and winners, and notify other bidders in the event that winners default, so that auctions can be made more resistant to attack by fake bidders.

Monday, March 2, 2009

Design of electricity markets (and salute to Bob Wilson)

For roughly the retail price of 1200 kilowatt hours of electricity, you can buy the Elsevier book Competitive Electricity Markets: Design, Implementation, Performance . (It seems to have been out for almost a year, but I've just noticed it now...)

I haven't read it yet, but the first chapter looks worthwhile: it is by Hung-Po Chao, Shmuel Oren, and Robert Wilson, and is called "Reevaluation of Vertical Integration and Unbundling in Restructured Electricity Markets."

Bob Wilson is of course the dean of design, one of the pioneers not only of the design of electricity markets, but of auction design generally. Here are some of his papers. (And for those of you who come only recently to the economics biz, and don't know what a role model looks like, here is his cv.) Chao and Oren and Wilson seem to have published their first joint paper on electricity in 1986.

While I'm remembering, I'm reminded that Bob's students produced an online Festschrift in his honor in 2002, called Game Theory in the Tradition of Bob Wilson. Here are the first paragraphs of the introduction, which was written by Bengt Holmstrom, Paul Milgrom, and myself.

"One of the nicer events in academic life is when we pause to recognize a scholar whose work is unusually important and influential, whose work marks the start of a new tradition.

"When that scholar is also a great teacher and advisor, his students have the added pleasure of recalling his influence on them, and how it is reflected both in their own scholarship, and in how they teach and advise their own students. Students are the generations through which traditions are transmitted. This volume of selected published papers by Bob’s students, accompanied by new introductory essays, is a celebration of Bob’s tradition, by those of us who had the exceptional good fortune to receive it at first hand.

"And what is this tradition? Scholarship as varied and wide ranging as Bob’s defies easy characterization. He was among the first to recognize that it was going to be of the utmost importance for game theorists to understand how information is distributed and manipulated, concealed, and revealed. He was among the first to emphasize the importance in strategic calculations of players’ beliefs about what other players would do, even in situations that were not anticipated to arise. But what especially marks him as a leader among the great economists of his generation is his view of the role of theory. In his understated way, he wrote in the preface to his book Nonlinear Pricing: “The value of theory is its usefulness in addressing practical problems. . . ” And he went on to reflect on the role of practical problems in his own scholarly development: “. . . for the theorist, the problems encountered by practitioners provide a wealth of topics.”

"So, game theory in the tradition of Bob Wilson is game theory in the service of economics as a confident, practical, useful discipline. And research in the style of Bob Wilson is work that takes its inspiration not only from a wide reading and deep understanding of the work of other academics, but also from the ordinary stuff of economic life. In this spirit, Bob’s work has produced not only acute conceptual insights of great generality, but also advice about and solutions to knotty problems of strategy and design."

Sunday, March 1, 2009

Medical data as an underprovided public good

Evidence based medicine requires data that are often difficult to assemble. Since drugs and medical devices are regulated, regulators have the option of requiring data to be collected. But data collection costs money (particularly in light of stringent laws that require the privacy of individual patients to be protected), and so it is often difficult to study the effect of medical interventions by following up on the health of patients.

A recent story summarized the issue succinctly: Heart Device Dispute Renews Push for User Registry

"Conflicting data this week about the failure rate of a critical and widely used Medtronic heart device has set off a debate among researchers who want to understand the discrepancies and the implications for patient care.
But some experts say that debate would not be occurring if federal officials, medical device makers and more doctors had thrown their weight more fully behind efforts to develop a national database of patients who get heart devices.
The Obama administration has announced plans to pour hundreds of millions of dollars into studies to compare the effectiveness of competing medical treatments and devices. Monitoring patients’ outcomes through registries could be part of that process.
But setting up such registries in this country has proved difficult so far. "

It seems that Medicare mandated the establishment of such a registry for defibrillators, but didn't fund it.

"And while defibrillator makers did help support the $3 million annual cost of operating the registry in its first year, they have since cut back that financing... Dr. Alan Kadish ... said he did not think that manufacturers believed that they would “be fulfilling their fiduciary obligations to shareholders by funding” studies that compare the effectiveness of their devices to those of competitors. " "

HT Scott Kominers

Saturday, February 28, 2009

Real estate auctions for price discovery

Sales by auction are coming to the new condo market in New York City: And Do I Hear $2 Million? No? $1 Million? Sold!

"Real estate auctions, rarely used in New York, have the potential to both move property and indicate to reluctant buyers what the true market prices are. Given the current sales drought, even a handful of auctions could reset prices for new condominiums citywide, said Jonathan J. Miller, the president of Miller Samuel, a Manhattan research and appraisal company. He said he expects the auctioned properties to sell for 40 to 45 percent below the asking prices of the first quarter of 2008, when the market peaked"
...
"In the auctions run by Accelerated, only a portion of a building’s unsold units are sold in one swoop, to avoid depressing values more than necessary. The remainder are marketed the traditional way, at the new, lower auction prices. "
...
"Auctions have succeeded in loosening other battered markets, like South Florida. In two held there last fall by Accelerated, 30 to 40 units in partly sold developments went for about half their peak prices. The developers say sales have picked up since then, at prices slightly below those received at auction. "

The real estate auction firm mentioned in the article is Accelerated Marketing Partners, of Boston.

Friday, February 27, 2009

Kidney Exchange in Australia

Western Australia has a new Kidney Exchange Program directed by Professor Paolo Ferrari of the University of Western Australia. Like kidney exchange programs in the U.S. they are finding the benefits of organizing exchanges as chains: Domino donations reduce kidney transplant wait .

"Prof Ferrari said he expected a national paired kidney exchange program to be established in 2009."

It looks like his confidence is well founded, since when the Prime Minister of Australia gave a speech on organ donation (Rudd opens Organ Donor Awareness Week), he included the following: "The [Australian Organ and Tissue Donation and Transplantation] Authority is also working to implement the new National Paired Kidney Exchange Program"

Thursday, February 26, 2009

Market for hand crafted food

Like the town that was too small to support one lawyer, and so had to have two, Brooklyn is becoming a center of artisan-produced fine food: Brooklyn’s New Culinary Movement. Not only does a cluster of local food producers help build demand, they also support each other in production:

"To design a boning knife, Mr. Bukiewicz has been sitting in on Mr. Mylan’s butchering classes and taking note of how his hands move.
That sort of collaboration is common.
Two weeks ago Sixpoint Craft Ales, in Red Hook, introduced Dubbel Trubbel, an ale made with cacao nibs from Mast Brothers Chocolate. Sixpoint Craft Ales already brews Gorilla Warfare, an American porter made with Ethiopian Yirgacheffe from Gorilla Coffee, the Park Slope cafe and roaster. At Wheelhouse Pickles, based in Park Slope, Jon Orren uses wort, a byproduct of brewing from Sixpoint Craft Ales, to flavor his Ploughman’s pickle, a mild, earthy relish made with Greenmarket root vegetables.
And McClure’s Pickles, of Williamsburg, is making a strong, grainy mustard with Brooklyn Brewery’s Brown Ale. (Mr. McClure, by the way, sometimes pays his picklers in pickles.)
Local store owners play an important role, more collaborators than simply merchants. Urban Rustic, Spuyten Duyvil Grocery, Blue Apron Foods, Bedford Cheese Shop and Marlow & Daughters all make a point of carrying Brooklyn-made foods."