Saturday, October 17, 2020

Broad public support for challenge trials for Covid-19 vaccines

 A broad based survey suggests that challenge trials are not generally regarded as repugnant.

Broad Cross-National Public Support for AcceleratedCOVID-19 Vaccine Trial Designs

by David Broockman, Joshua Kallay, Alexander Guerrero, Mark Budolfson, Nir Eyal, Nicholas P. Jewell , Monica Magalhaes,  Jasjeet S. Sekhony

Abstract: A vaccine for COVID-19 is urgently needed. Several vaccine trial designs may significantly accelerate vaccine testing and approval, but also increase risks to human subjects. Concerns about whether the public would see such designs as ethically acceptable represent an important roadblock to their implementation, and the World Health Organization has called for consulting the public regarding them. Here we present results from a pre-registered cross-national survey (n = 5,920) of individuals in Australia, Canada, Hong Kong, New Zealand, South Africa, Singapore, the United Kingdom, and the United States. The survey asked respondents whether they would prefer scientists to conduct traditional trials or one of two accelerated designs: a challenge trial or a trial integrating a Phase II safety and immunogenicity trial into a larger Phase III efficacy trial. We find broad majorities prefer for scientists to conduct challenge trials (75%, 95% CI: 73-76%) and integrated trials (63%, 95% CI: 61-65%) over standard trials. Even as respondents acknowledged the risks, they perceived both accelerated trials as similarly ethical to standard trial designs, and large majorities characterized them as "probably" or "definitely ethical" (72%, 95% CI: 70-73% for challenge trials; 77%, 95% CI 75-78% for integrated trials). This high support is consistent across every geography and demographic subgroup we examined, including people of diverging political orientations and vulnerable populations such as the elderly, essential workers, and racial and ethnic minorities. These findings bolster the case for these accelerated designs and can help assuage concerns that they would undermine public trust in vaccines.

Friday, October 16, 2020

NRMP conference on Transition into Residency: Oct 16-17


My title will be "The Match as part of the larger system of transition to residency."

One of the topics I expect to discuss is the proliferation of applications and interviews, in the NRMP and also in many of the fellowship matches.

Thursday, October 15, 2020

Frequent flier programs during the pandemic slowdown in air travel

 It turns out that frequent flier programs get a lot of their income from credit cards that reward purchases with miles. So they are one of airlines' big profit centers, that hasn't suffered so much from the slowdown in air travel.

Here's a NY Times story:

Airline Miles Programs Sure Are Profitable. Are You the Loser? United and Delta have been boasting to lenders about fat margins in frequent-flier mile programs. Time for customers to pay a bit more attention.  By Ron Lieber

"Even as the coronavirus pandemic has sapped the ability and desire to travel, miles programs are a winner for the airlines. In the first half of 2020, Delta’s passenger revenue fell 60 percent, but the cash the airline got from American Express’s purchases of miles for its customers fell less than 5 percent. ...

"United puts a different but no less illuminating set of words and numbers to our mile lust. It goes into granular detail in its pitch about its ability to “nimbly” control its mile redemption costs on “peak days.” That explains why it’s so hard to use your miles to get a great deal during school vacations, Mardi Gras or other occasions."


******

Here's Market Watch:

Airlines are using frequent flyer programs to sell debt. Here’s how it works  By Sunny Oh

"In essence, miles are sold to credit card companies who offer them as part of their reward programs to their customers. The revenues earned from selling the miles are much higher than the cost of any flight travel redeemed by passengers,

...

"In a June filing, United Airlines valued their MileagePlus loyalty program at $21.9 billion which is around double the total market capitalization of the company itself."

Wednesday, October 14, 2020

Some links following the Nobel Prize to Milgrom and Wilson

 In my limited experience (but not just limited to my own experience) Nobel prizewinners are often asked about how they were notified of the fact that they won the prize, and by whom. Paul Milgrom and Bob Wilson certainly have one of the best stories to answer that question, and millions of people have already viewed the video from the Milgroms' Nest doorbell camera, as Bob tried to arouse Paul and give him the news.

Here's how USA Today covered that story:

Doorbell camera captures moment Nobel Prize winner is told by fellow recipient he's won

Paul Milgrom discovered via a Nest camera that he'd won the Nobel Prize in Economic Sciences.<>

The Nest doorbell broadcast also to Paul's wife Eva, who was visiting family in Stockholm, and who was alerted at the same time he was. Here's the view from the Swedish press (including a video of the video playing on her laptop...):

Här väcks pristagaren av sin kollega: ”Du har vunnit Nobelpriset” 
(Google translate: Here the laureate is awakened by his colleague: "You have won the Nobel Prize")

That before-dawn encounter was recounted in this early interview:
"AS: We just spoke with Paul Milgrom and he said that he heard the news by you walking across the street and ringing his doorbell.

RW: Well that’s right because he had turned his phone off for the … to get a good night’s sleep, and so somebody had to wake him, and he lives across the street so I just walked over and knocked on the door. I roused him.

AS: I think … I think this must be a first in the history of the Nobel Prize.

RW: Yes, how many times does … first to have a knock on the door, which sounds like something from the 19th century, and secondly that in fact the two of us live only, what, 40 m apart."
*****************

It turns out that Bob Wilson went to Lincoln High School in Nebraska (and that you can never escape your high school):

MARGARET REIST, Lincoln Journal Star Oct 13, 2020 
"The Lincoln High School wall of distinguished alumni — the one with photos lining the school's main hallway — will need to make room for another photo.

"Robert Wilson, who graduated from Lincoln High in 1955, left for Harvard on a prestigious scholarship and ultimately landed at Stanford, won the Nobel Prize in economics Monday."
***********


************
The day of the prize, the NY Times story by Jeanna Smialek got this fairly coherent quote from me before dawn:

“They haven’t just profoundly changed the way we understand auctions — they have changed how things are auctioned,” said Alvin E. Roth, a Nobel laureate himself who was one of Mr. Wilson’s doctoral students. 
***********
Joshua Gans, one of Paul's students, republished the remarks he had made on the occasion of Paul's 65th birthday (long ago...)
"There are so many things one could say about Paul but it turned out that I said what I wanted to say back in 2013 at a conference in his honor to celebrate his 65th Birthday."
*************
Bob's longtime colleague (and my one time housemate when we were grad students) David Kreps has a lovely essay, which includes this quote from Hugo Sonnenschein: 
"Great economists write great papers. But the greatest economists are those who found new schools of thought." 
He writes that Bob's 
" impact on the discipline of economics, in my opinion, puts him in the company of giants such as Ken Arrow and Paul Samuelson: Bob is, as much as anyone, the founder of the “School of Economic Theory as Engineering.” Both in his own work, but even more through his influence on his students and colleagues, Bob has brought economic theory to the real world, both as a mechanism for understanding “how things work” and then in the design of better institutions. The Nobel Prize announced today is for his and Paul’s work on the design of complex auctions, such as the spectrum auctions, which is a prime example of economic theory as engineering. But, in addition:
  • Bob himself has taken the theory of nonlinear pricing to practical applications in electricity markets.
  • His student, Nobel Laureate Al Roth, brought matching-markets theory to the design of assignment algorithms, assigning MDs to internships, and to kidney exchange “markets.”
  • His student, Nobel Laureate Bengt Holmstrom, brought incentive theory to practical considerations in the design of pay-for-performance systems (some in collaboration with Milgrom) and, more recently, to issues in financial institutions.
  • His student and co-Nobel Laureate Paul Milgrom, besides his work on auction design, and in collaboration with our colleague John Roberts, brought economic theory to bear on the design and management of complex organizations (which, for my money, is even more important than his pathbreaking work on auctions; Paul could have been given the Nobel for any of several different topics, and his work on “the modern corporation” happens to be my personal favorite).
  • And it continues: A third generation — students of Paul, Bengt, and Al, as well as others who have embraced this style of work and so became “adopted” members of Bob’s tribe — are building an intellectual edifice that mixes superb theory with real-world insight and applicability."
***************
Did you know that Paul has a company?  Here's the tribute on the Auctionomics website: 
***************

And amidst all the toasts, I had occasion to recall that the first footnote of my 2002 paper "The Economist as Engineer..." said 
"This paper is dedicated to Bob Wilson, the Dean of Design."


***********
Earlier post: 

Monday, October 12, 2020


Tuesday, October 13, 2020

Drug delivery: antibiotics and vaccines

 Two recent papers discuss different issues concerning drug delivery to those in need, where the obstacles may be individual reluctance to take the drug (antibiotics) or lack of social support for the drug program (for vaccines):

Predicting and improving patient-level antibiotic adherence

Isabelle Rao, Adir Shaham, Amir Yavneh, Dor Kahana, Itai Ashlagi, Margaret L. Brandeau & Dan Yamin, Health Care Management Science (2020), 05 October 2020

Abstract: Low adherence to prescribed medications causes substantial health and economic burden. We analyzed primary data from electronic medical records of 250,000 random patients from Israel’s Maccabi Healthcare services from 2007 to 2017 to predict whether a patient will purchase a prescribed antibiotic. We developed a decision model to evaluate whether an intervention to improve purchasing adherence is warranted for the patient, considering the cost of the intervention and the cost of non-adherence. The best performing prediction model achieved an average area under the receiver operating characteristic curve (AUC) of 0.684, with 82% accuracy in detecting individuals who had less than 50% chance of purchasing a prescribed drug. Using the decision model, an adherence intervention targeted to patients whose predicted purchasing probability is below a specified threshold can increase the number of prescriptions filled while generating significant savings compared to no intervention – on the order of 6.4% savings and 4.0% more prescriptions filled for our dataset. We conclude that analysis of large-scale patient data from electronic medical records can help predict the probability that a patient will purchase a prescribed antibiotic and can provide real-time predictions to physicians, who can then counsel the patient about medication importance. More broadly, in-depth analysis of patient-level data can help shape the next generation of personalized interventions.

********

Covid-19: how to prioritize worse-off populations in allocating safe and effective vaccines

Harald Schmidt, Parag Pathak, Tayfun Sönmez, and M Utku Ünver, BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3795 (Published 05 October 2020)

"When compared with previous pandemics covid-19 is unique, not only in its substantial economic impact but in exposing the consequences of historical and ongoing structural disadvantages among minority groups,123 particularly in the US. Minorities have experienced far higher rates of unemployment, infections, hospital admissions, and deaths.23456 So, as safe and effective vaccines become likely but in limited supply, should policy makers prioritize worse-off minorities in their allocation of stocks?

"Traditional allocation focuses on maximizing overall benefits, with less regard to how these benefits are distributed among different population groups. Giving more vaccines to disadvantaged groups who are expected to live less long would generally be deemed undesirable. However, the current debate around covid-19 vaccines indicates a profound reorientation in what worse-off population groups are owed."

Monday, October 12, 2020

Finally! Paul Milgrom and Bob Wilson win the 2020 Nobel Prize in Economics

 Could this be the best Nobel pairing ever?  (It's certainly a great one, and one of the best things to come out of 2020 so far...) Here's the announcement:

"The 2020 Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel has been awarded to Paul R. Milgrom and Robert B. Wilson “for improvements to auction theory and inventions of new auction formats" https://www.nobelprize.org/


I've known Paul at least since 1978, when he attended a course I taught while on leave at Stanford, on Axiomatic Models of Bargaining. Bob advised both of our dissertations, although not at the same time.  

Bob is a legendary advisor of grad students.  Paul is now the third of Bob's  students to win a Nobel.  So Bob is well established as the patriarch of a Nobel dynasty.



Bob Wilson's Nobel dynasty (to date): Wilson (with Milgrom) 2020, and Bob's students Roth (with Shapley) 2012, Holmstrom (with Hart) 2016, and Milgrom (with Wilson) 2020

It looks like we should check back in 2024...

Here's another picture, from another celebration:



Bob Wilson being celebrated for the 2017 CME MSRI prize, by his students Al Roth, Paul Milgrom, and Bengt Holmstrom.


I've often blogged about  both Milgrom and Wilson, separately and together.

Here's a paragraph I wrote about Bob's work in our (only) joint paper, in which we interviewed each other:

Alvin E. Roth and Robert B. Wilson
Journal of Economic Perspectives—Volume 33, Number 3—Summer 2019—Pages 118–143

"Wilson (1977) introduced the model of common-value auctions (sometimes called the “mineral rights model”). The model and its equilibrium initiated a large body of theoretical, experimental, and applied work. One important insight from this model is that winning an auction contains “bad” news, since it implies in equilibrium that the winner’s estimate is the highest. In equilibrium, rational bidders fully account for this, but the paper raises the empirical question of the extent to which actual  bidders are able to fully discount for the fact that, if they win the auction, they likely overestimated the value of winning. Thus, Wilson’s work initiated a new research program on the winner’s curse, involving systematic overbidding compared to equilibrium, sometimes involving losses to the winning bidder. The private-value model of Vickrey (1961) and the common-value model of Wilson (1977) together form the basis of much of modern auction theory and practice, since most auctions have elements of both private and common value." 

Right after that, Bob and I talked about important influences on our work. Bob included this:

"I was deeply affected in the early 1990s by working with Paul Milgrom on design of the FCC spectrum auctions. I marveled at his insights and creativity in constructing rules for a “simultaneous ascending auction” that would have good prospects of yielding an approximately efficient outcome in an environment afflicted with strong complementarities, dispersed private information about market fundamentals, and substantial market power."  

To which I replied:
" I was also much influenced by Paul when we developed and co-taught what may have been the first courses in market design, in 2000 and again in 2001 when he was on leave at Harvard and MIT." 


*********
Here's an old snapshot:
Bob Wilson and Paul Milgrom in 2006

There's a rabbinical literature about the relationships between students and teachers. It often comes to mind when I think about how lucky I have been to have the students I've had. But today I'm reminded of my luck in having Bob Wilson as my teacher and friend, and Paul as my friend and colleague.

"Joshua ben Perahiah used to say: provide yourself a teacher and acquire yourself a friend. Judge everyone favorably." (Pirkei Avot, chapt 1 verse 6)


Here's how I recalled Bob as a teacher, in an autobiographical essay of a kind that they will each now be asked to write:

"Bob Wilson agreed to be my advisor and rescued me from having what looked to be a very short academic career after I failed one of my Ph.D. qualifying exams. He was on sabbatical that year, but met with me regularly once a week for an hour. In memory, our meetings followed a kind of script: I would spend a while explaining to him why I hadn’t made progress that week, and then he would spend a while telling me not to be discouraged. Then I would describe some roadblock to further progress, and he would, as we finished our meeting, recommend a paper for me to read. Because his recommendations had always been very much on target, I would go straight from his office to the library and start to read the paper. As I did, I would think, this time Bob made a mistake, this paper has nothing to do with my problem. But then, somewhere in the middle of the paper would be a lemma or remark that helped me get around that roadblock …"
*************
And here's a final picture from Stockholm in 2012, of me and Emilie and Paul and Eva, with Parag Pathak (one of Bob's academic grandchildren) in the  background.
**************************************************

Read the press release

"The Royal Swedish Academy of Sciences has decided to award the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2020 to

Paul R. Milgrom
Stanford University, USA

Robert B. Wilson
Stanford University, USA

“for improvements to auction theory and inventions of new auction formats”

...

“This year’s Laureates in Economic Sciences started out with fundamental theory and later used their results in practical applications, which have spread globally. Their discoveries are of great benefit to society,” says Peter Fredriksson, chair of the Prize Committee."
Learn more in the popular information

"Every day, auctions distribute astronomical values between buyers and sellers. This year’s Laureates, Paul Milgrom and Robert Wilson, have improved auction theory and invented new auction formats, benefitting sellers, buyers and taxpayers around the world."
Read the scientific background


Sunday, October 11, 2020

5000 Market Design blog posts and counting

 Peter Coles and I started this blog in September 2008, to help alert students in our market design class at Harvard that market design was everywhere.  Sometime recently I passed the 5000 posts mark.  It turns out I like to blog about market design, broadly construed. And I'm still teaching market design.

The modal tag on my posts turns out to be repugnance, as I've been fascinated by trying to understand which kinds of transactions and markets get social support and which don't. Various design efforts that I've been involved in also have been the subject of multiple posts, with tags like residents and fellowsschool choice, and kidney exchange

Some of my favorite posts (from an incomplete series, whenever I manage to get a picture) commemorate dissertation defences. And under a variety of tags (such as market designers) I like to mark when students and colleagues are celebrated or win a prize. (I look forward to writing more of those.)

Less fun is the growing number of posts tagged  RIP, in which I note the passing of people with whom I've intersected, mostly but not always in a market design connection.

In the first years of the blog I allowed comments, but after I got involved in kidney exchange, I had to regularly erase comments--typically sprinkled each night among old posts--that offered to buy kidneys, at unrealistically high prices, phishing for fools. So at some point I shut down comments, noted in this post: August 25, 2018  No comment(s)

Here are ten posts from the last five years that caught my eye as I scrolled through them before giving up on the clunky scrolling device:

September 30, 2020 A modest proposal for the design of presidential debates

March 2, 2018 The Economist discusses repugnant transactions

Saturday, October 10, 2020

De-adopting zombie medical procedures

What happens to medical procedures that are found to be no more effective than placebos?  Some live on for quite a while. One thing that works is to stop paying for them.

Here's an article in JAMA:

De-adopting Low-Value Care--Evidence, Eminence, and Economics

Brian W. Powers, MD, MBA1; Sachin H. Jain, MD, MBA2,3; William H. Shrank, MD, MHSA1   JAMA. Published online October 2, 2020. doi:10.1001/jama.2020.17534 

"An often cited shortcoming of the US health care system is the slow pace with which new innovations are adopted into routine clinical practice.1 A parallel problem receives comparably less attention: the US and other countries are slow to abandon practices that provide little or no benefit to patients. Despite robust research cataloguing common practices that confer little or no value,2,3 these practices remain widespread, accounting for an estimated $67 billion in spending annually.4 For example, estimates suggest that the Centers for Medicare & Medicaid Services (CMS) spends more than $274 million annually on carotid artery disease screening for asymptomatic patients and more than $111 million annually on cervical cancer screening for women older than 65 years.2 The concept of de-adopting these and other low-value services is embedded in the Less Is More series in JAMA Internal Medicine5 and in the Choosing Wisely campaign from the American Board of Internal Medicine.6"

Friday, October 9, 2020

Jobs for market designers in Washington D.C. and at Facebook

 I still get a small thrill when I see jobs for market designers appear, appropriately, in places that not so very long ago hadn't heard of market design.. Here's an ad from the Congressional Budget Office.

Climate and Energy Economist, Congressional Budget Office – Washington DCPublished October 2, 2020  

"The Energy, Environment, and Infrastructure Unit conducts research and analysis on certain topics of interest to the Congress, including climate change, energy and related environmental issues, transportation and infrastructure, and federal policy toward research and development. In the coming years, the unit expects to expand its capacity to model the effects of climate change and climate change policy on the budget and the economy.

...

"Qualifications: Applicants must have either a Ph.D. in economics or a related discipline or a master’s degree with five years of experience in one of those fields. They should also have strong quantitative and modeling skills; preference will be given to candidates with experience modeling energy markets or systems. A background in industrial organization or market design, public finance, or a related microeconomic field is desirable"

********

And here's an ad for a crypto-economist at Facebook:

Novi Economics/Blockchain at Facebook

"Description: Novi is a Facebook subsidiary whose goal is to provide financial services for Libra, a new global currency powered by blockchain technology. The first product Novi will introduce is a digital wallet, which will be available in Messenger, WhatsApp and as a standalone app. The first version of Novi will support peer-to-peer payments and a few other ways to pay such as QR codes which small merchants can use to accept payments in Libra. Over time there will be many other use-cases for Novi including in-store payments, integrations into Point-of-Sale systems, and more. When launched, Novi will have strong fraud and privacy protections. The Novi digital wallet is expected to launch in 2020.

"The Novi economics team is seeking exceptional candidates from all fields, with a special focus on applied microeconomics, development, macroeconomics, finance, and market design, to join our team. Individuals in this role are expected to have deep expertise and the ability to leverage economic theory into real-world, practical solutions for blockchain based problems."

Thursday, October 8, 2020

PNAS celebrates Janet Currie

 The National Academy of Sciences celebrates Janet Currie in the current issue of PNAS, with an interview and an inaugural article.

QnAs with Janet Currie, by Tinsley H. Davis, PNAS September 29, 2020 117 (39) 24008-24009; https://doi.org/10.1073/pnas.2017808117

"Many mental illnesses arise in adolescence, and a study of national insurance claims in the United States finds a large variance in how adolescent patients are treated even within the same zip code. The findings, reported in Janet Currie’s Inaugural Article (IA) (1), reveal that 45% of adolescents receive first-line treatments that are not approved by the US Food and Drug Administration (FDA) (1). Currie, elected to the National Academy of Sciences in 2019, has studied children’s health for three decades. A professor of economics and public affairs at Princeton University, Currie has undertaken pioneering economic analysis of child development, including analysis of the effects of the Head Start program on children (23) and the effects of expansions of the Medicaid program for pregnant women and children (45). In her IA (1), Currie analyzes a large national dataset to reveal disparities in treatment that cannot be attributed to supply-side factors, such as limited availability of treatment providers."

Here's the first question and answer:

"PNAS:What is the link between health and economics?

"Currie: Health can have an impact on how much human capital, like education, people are able to acquire. Moreover, healthcare is a business, and it accounts for almost 20% of US GDP [gross domestic product]. So there are two strands: One is thinking about health as a business, and another is thinking about health as a form of wealth. My work generally focuses more on that second aspect of health as a form of human capital. The Inaugural Article (1) brings those two strands together to a certain extent because mental health problems in children are one of the things that causes them to have less human capital than they might otherwise, and I’m looking at how those children with mental health problems end up getting treated by the healthcare system."

And here is her INAUGURAL ARTICLE

Treatment of mental illness in American adolescents varies widely within and across areas

Emily Cuddy and  Janet CurriePNAS September 29, 2020 117 (39) 24039-24046; https://doi.org/10.1073/pnas.2007484117

"Abstract: Many mental health disorders first manifest in adolescence, and early treatment may affect the course of the disease. Using a large national database of insurance claims, this study focuses on variations in the type of care that adolescent patients receive when they are treated for an initial episode of mental illness. We found large variations in the probability that children receive follow-up care and in the type of follow-up care received across zip codes. We also found large variations in the probability that children receive drug treatments that raise a red flag when viewed through the lens of treatment guidelines: Overall, in the first 3 mo after their initial claim for mental illness, 44.85% of children who receive drug treatment receive benzodiazepines, tricyclic antidepressants, or a drug that is not Food and Drug Administration-approved for their age. On average, these children are 12 y old. While the supply of mental health professionals impacts treatment choices, little of the overall variation is explained by supply-side variables, and at least half of the variation in treatment outcomes occurs within zip codes. These results suggest that other factors, such as physician practice style, may play an important role in the types of treatment that children receive."

Wednesday, October 7, 2020

Informs Auctions and Market Design (AMD) Online Seminar Series

I recently gave a talk on kidney exchange, to help launch the Informs Auctions and Market Design (AMD) Online Seminar Series.  If I've done it right, the video below should begin at minute 6, skipping the first 6 minutes of silence when Zoom was started but the talk had not.


 

Tuesday, October 6, 2020

An open letter to Canadian health authorities on laws against compensating Canadian plasma donors

 The letter is available on a website called Donation Ethics: Ethicists and Economists for Ethical Donation-Compensation Practices  organized by Peter M. Jaworski and  David Faraci. (I am among the signers.)

"Ethicists and Economists express concerns about banning compensation for plasma donors with regards to ensuring the security of a safe Immune Globulin Product Supply.

"Submission to the Expert Panel on Immune Globulin Product Supply and Related Impacts in Canada

"INTRODUCTION

We are professional ethicists in the fields of medical ethics, business ethics, and/or normative ethics, and academic economists who study how incentives and other mechanisms affect individual behaviour. We all share the goal of improving social welfare.

"The Provinces of Québec (1994),1 Ontario (2014),2 and Alberta (2017)3 have passed Voluntary Blood Donation Acts or their equivalents that prohibit, amongst other things, compensation for plasma donations for purposes of further processing into plasma-derived medicinal products (hereafter: “PDMPs”), like Immune Globulin (hereafter: “Ig”). Currently, the Nova Scotia legislature is debating a Voluntary Blood Donations Act,4 and the British Columbia government has suggested that it is interested in pursuing similar legislation.5

...

"CONCLUSION

"In our view, none of the moral objections to the compensatory model are persuasive. Furthermore, there is a strong moral presumption against standing in the way of a model that is the most likely to promote security not only of Canada’s supply of PDMPs, including Ig, but also of the global supply. We urge Québec, Ontario, and Alberta to reconsider the Acts currently prohibiting compensation in their provinces.

"Finally, we note that well-informed opponents of the compensatory model should not suggest that PDMPs, including Ig, made with compensated donors are riskier or less safe than PDMPs, including Ig, made with uncompensated donors. This presumption may be harmful to patients."


Monday, October 5, 2020

How King Uzziah became corrupt and was stricken with Covid and quarantined (II Chronicles 26)

Chronicles II chapter 26 describes how King Uzziah became corrupt and power hungry, so that the Lord infected him with the untranslatable disease that the Chronicler called "zaraath," which required him to be quarantined for the rest of his life.

Here it is, starting from verse 16.
 
And when he became strong, his heart became haughty until he became corrupt, and he trespassed against the Lord his God, and he came into the Temple of the Lord to burn incense on the altar of incense. טזוּכְחֶזְקָת֗וֹ גָּבַ֚הּ לִבּוֹ֙ עַד־לְהַשְׁחִ֔ית וַיִּמְעַ֖ל בַּֽיהֹוָ֣ה אֱלֹהָ֑יו וַיָּבֹא֙ אֶל־הֵיכַ֣ל יְהֹוָ֔ה לְהַקְטִ֖יר עַל־מִזְבַּ֥ח הַקְּטֹֽרֶת:
17And Azariah the priest came after him, and ,with him were priests of the Lord, eighty mighty men. יזוַיָּבֹ֥א אַֽחֲרָ֖יו עֲזַרְיָ֣הוּ הַכֹּהֵ֑ן וְעִמּ֞וֹ כֹּֽהֲנִ֧ים| לַֽיהֹוָ֛ה שְׁמוֹנִ֖ים בְּנֵי־חָֽיִל:
18And they stood beside Uzziah the king and said to him, "It is not for you, Uzziah, to burn incense to the Lord, but for the priests, sons of Aaron, who are consecrated to burn [incense]. Leave the Sanctuary, for you have trespassed, and it will not be glory for you from the Lord God." יחוַיַּֽעַמְד֞וּ עַל־עֻזִּיָּ֣הוּ הַמֶּ֗לֶךְ וַיֹּ֚אמְרוּ לוֹ֙ לֹֽא־לְךָ֣ עֻזִּיָּ֗הוּ לְהַקְטִיר֙ לַֽיהֹוָ֔ה כִּ֣י לַכֹּֽהֲנִ֧ים בְּנֵי־אַֽהֲרֹ֛ן הַֽמְקֻדָּשִׁ֖ים לְהַקְטִ֑יר צֵ֚א מִן־הַמִּקְדָּשׁ֙ כִּ֣י מָעַ֔לְתָּ וְלֹֽא־לְךָ֥ לְכָב֖וֹד מֵֽיְהֹוָ֥ה אֱלֹהִֽים:
19And Uzziah became furious, and in his hand was a censer to burn, and in his fury with the priests, the zaraath shone upon his forehead before the priests in the House of the Lord, over the altar of incense. יטוַיִּזְעַף֙ עֻזִּיָּ֔הוּ וּבְיָד֥וֹ מִקְטֶ֖רֶת לְהַקְטִ֑יר וּבְזַעְפּ֣וֹ עִם־הַכֹּֽהֲנִ֗ים וְ֠הַצָּרַעַת זָֽרְחָ֨ה בְמִצְח֜וֹ לִפְנֵ֚י הַכֹּֽהֲנִים֙ בְּבֵ֣ית יְהֹוָ֔ה מֵעַ֖ל לְמִזְבַּ֥ח הַקְּטֹֽרֶת:
20And Azariah, the chief priest, and all the priests, turned to him, and behold he was stricken with zaraath on his forehead; so they rushed him out of there, and he too hastened to leave, for the Lord had smitten him. כוַיִּ֣פֶן אֵלָ֡יו עֲזַרְיָהוּ֩ כֹהֵ֨ן הָרֹ֜אשׁ וְכָל־הַכֹּֽהֲנִ֗ים וְהִנֵּה־ה֚וּא מְצֹרָע֙ בְּמִצְח֔וֹ וַיַּבְהִל֖וּהוּ מִשָּׁ֑ם וְגַם־הוּא֙ נִדְחַ֣ף לָצֵ֔את כִּ֥י נִגְּע֖וֹ יְהֹוָֽה:
21And King Uzziah was stricken with zaraath until the day of his death, and he lived in a house of retirement, for it had been decreed from the House of the Lord,


HT: Aviya Kushner in the Forward

Sunday, October 4, 2020

Grocery supply chains: TNR reviews "The Secret Life of Groceries"

 The New Republic reviews The Secret Life of Groceries: The Dark Miracle of the American Supermarket, by Benjamin Lorr,  (It tells you more than you want to know about supply chains, from farmed shrimp in Thailand to American long haul trucking...)

There’s No Such Thing as Ethical Grocery Shopping--“The Secret Life of Groceries” exposes the dark secrets of America’s food supply. by Josephine Livingstone

Having read the review but not the book, it sounds like a broad based followup on this 2015 story from the Guardian:

Shrimp sold by global supermarkets is peeled by slave labourers in Thailand

by Associated Press: Margie Mason, Robin McDowell and Esther Htusan in Samut Sakhon and Martha Mendoza in Washington Mon 14 Dec 2015

Saturday, October 3, 2020

Convalescent plasma continues to be used for treatment of covid-19, but demand is flat

 The WSJ has the story:

Wanted in Covid-19 Fight: ‘Superdonors’ of Convalescent Plasma--Blood banks and researchers are mobilizing to find recovered Covid-19 patients who have high levels of antibodies and are willing to donate regularly   By Amy Dockser Marcus


"Blood banks and researchers are mobilizing to find recovered Covid-19 patients who could be blood plasma “superdonors,” people who have high levels of antibodies against the disease and are willing to donate regularly.

"The hunt has intensified in the past month, after the Food and Drug Administration authorized the use of convalescent plasma, derived from patients who have survived the virus, as a potential therapy for hospitalized patients.

...

"Right now, demand for plasma overall is flat, said Dr. Claudia Cohn, chief medical officer for AABB, a group representing the transfusion medicine and cellular therapy community. She said it could reflect reservations about the strength of existing data, the waning of the pandemic in certain areas of the country, or concerns that the authorization was issued under political pressure from the White House—a suggestion the FDA has pushed back on but that continues to generate debate.

"Doctors said an expected upturn in demand for convalescent plasma didn’t materialize after the authorization, although they are prepared for one should infections surge later this year."

Friday, October 2, 2020

Trading truthfulness for efficiency in the Israeli medical internship market, by Ariel Rosenfeld and Avinatan Hassidim


Too smart for their own good: Trading truthfulness for efficiency in the Israeli medical internship market, by Ariel Rosenfeld and Avinatan Hassidim, Judgment and Decision Making, Vol. 15, No. 5, September 2020

Abstract: The two most fundamental notions in mechanism design are truthfulness and efficiency. In many market settings, such as the classic one-sided matching/assignment setting, these two properties partially conflict, creating a trade-off which is rarely examined in the real-world. In this article, we investigate this trade-off through the high-stakes Israeli medical internship market. This market used to employ a standard truthful yet sub-optimal mechanism and it has recently transitioned to an “almost” truthful, more efficient mechanism. Through this in-the-field study, spanning over two years, we study the interns’ behavior using both official data and targeted surveys. We first identify that substantial strategic behaviors are exercised by the participants, virtually eliminating any efficiency gains from the transition. In order to mitigate the above, we performed an intervention in which conclusive evidence was provided showing that, for most of the interns, reporting truthfully was much better than what they actually did. Unfortunately, a re-examination of the market reveals that our intervention had only minor effects. These results combine to question the practical benefits of “almost” truthfulness in real-world market settings and shed new light on the typical truthfulness-efficiency trade-off."


Here's their description of the prior, inefficient random serial dictatorship rule:

"For about two and a half decades, until 2014, each intern was asked to submit her ranking of the hospitals relevant for her graduation class, and the assignment itself was decided by the RSD mechanism (with a few minor house rules aimed at providing special treatment for special intern groups such as PhD students and parents of young children), which has come to be known as the Internship Lottery. Up until a few years ago when the system was finally computerized, interns physically gathered in a large auditorium and ID numbers were drawn out of a hat. The RSDT mechanism has been deployed since 2014 in an attempt to increase efficiency (Bronfman et al., 2015) (see (Roth & Shorrer, 2015) for a review and discussion on the transition choice)."

And here (out of the sequence in the paper) is a quick description of the new, efficient mechanism.

"To mitigate the fact that the probability vectors induced by the RSD mechanism may be far from optimal, the RSDT mechanism was proposed: First, after each intern submits a ranked list of hospitals, a large number of RSD simulations is performed to approximate the true probability vector for each intern. Then, using a fitted utility function over probability vectors (learned through structured surveys), probabilities are automatically traded between the interns though a Linear Program (LP) which optimizes social welfare. The LP guarantees that each intern’s expected utility (given the utility function) is no-worse than what she had before the trade."

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Related post:

Thursday, March 26, 2015

Thursday, October 1, 2020

Becky Morton, RIP

 Becky Morton has passed away after a short illness. She was a pioneer in bringing experimental methods to political science, as an individual investigator, an editor and journal founder, textbook writer, and as an institution builder, who made NYU Abu Dhabi a center of experimental work.

Here's the announcement from NYU:

Mourning the Passing of Rebecca Morton September 27, 2020

"She was an extraordinary academic leader for the development of research and teaching in the social sciences at NYUAD, serving as Associate Dean of Faculty Affairs and Development, Program Head of Political Science, and Global Network Professor of Politics and Economics. Becky was the founding Director of the Social Science Experimental Laboratory at NYUAD, one of her proudest creations. Her unfailing commitment to nurturing early career scholars was epitomized in the postdoctoral program in the social science division, which she led as director until the beginning of fall. Becky’s intellectual engagement with colleagues, students, and our postdoctoral fellows helped forge a lively and successful research community in social science.

"Becky Morton was an outstanding scholar whose work ranged across economics and political science. Committed to interdisciplinary inquiry, she was the author and co-author of four books and numerous articles in prominent economics and political science journals, such as the American Economic Review, American Journal of Political Science, American Political Science Review, Journal of Law and Economics, Journal of Politics, and Review of Economic Studies."

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Here's one of her books:

Experimental Political Science and the Study of Causality: From Nature to the Lab"         By Rebecca B. Morton, Kenneth C. Williams


Here's her editor's introduction to the first issue of the Journal of Experimental Political Science, in 

Welcome to JEPS!,  Journal of Experimental Political Science,Volume 1, Issue 1, Spring 2014 , pp. 1-5, by Rebecca B. Morton  Joshua A. Tucker

In short, she was a force for experiments in political science, despite having a Ph.D. in Economics (and, as I recall, drinking Coke for breakfast).