Preference Signaling for the Otolaryngology Interview Market

 From the journal The Laryngoscope, a thoughtful description of the growing interest in signaling for medical residency interviewing (which I believe will be implemented for Otolaryngology residency positions in the coming year).

Preference Signaling for the Otolaryngology Interview Market

C.W. David Chang MD  Steven D. Pletcher MD  Marc C. Thorne MD, MPH  Sonya Malekzadeh MD

First published: 06 October 2020 https://doi.org/10.1002/lary.29151

"The impact of the coronavirus disease 2019 pandemic extends beyond patient care and into graduate medical education (GME). The pandemic has created disarray in the residency application process. Visiting rotations and residency interviews—two cornerstones of the application cycle—are gone.

"Just as the pandemic has exposed healthcare disparities in medical care, it also shines a light on inequalities with GME. Even before the pandemic, many residency specialties observed a meteoric rise in the number of applications submitted by each applicant. In 2019, otolaryngology applicants submitted an average of 72 applications, an 80% rise over 15 years.1 This increase drives a cycle of programs receiving more applications and students feeling the need to apply more broadly to maintain competitiveness. Students with monetary resources are better able to mitigate match risk through prolific residency application and by traveling for away rotations to cultivate faculty advocates. Financially disadvantaged applicants may find it more difficult to amass influential social capital.

"With the deluge of applications, applicants are unable to distinguish themselves from the crowd. Such dilution impairs the applicants' abilities to credibly convey interests to programs. Similarly, the program director has a hard time selecting candidates from a pool of excellent applicants for interview.

"The interview is a limited resource. Selection committees often react to this scarcity by declining to interview qualified candidates they think (but do not really know) are unlikely to choose their program and instead interview candidates who they think (but do not really know) are more likely to accept an offer. This approach is inefficient.

"Preference signaling is an intriguing solution. Since 2006, the American Economic Association has operated a signaling service to facilitate job interviews for graduate students. This applicant‐initiated concept aligns goals of interested applicants with programs. Students send signals to up to two employers to indicate their interest in receiving an interview. In reviewing their outcomes, signals were found to increase probability of interview, especially for niche scenarios (nongraduate applicants, applications to liberal arts colleges, and small city locations).2 Signaling has received interest among medical residency specialties as well.3, 4

...

"The Otolaryngology Program Directors Organization (OPDO) Council has worked diligently with stakeholders to incorporate their input throughout the development process. We thank members and leaders of the academic otolaryngology community, including the Association of Academic Departments in Otolaryngology (AADO), the Society of University Otolaryngologists (SUO), and the greater community of program directors for their support. We appreciate the guidance and valuable insight from the Association of American Medical Colleges (AAMC)—specifically the Group on Student Affairs (GSA), the Committee on Student Affairs (COSA), and the Electronic Residency Application Service (ERAS)—along with the National Resident Matching Program (NRMP). We are hopeful that signaling will improve the residency interview selection process by facilitating the successful pairing of applicants with programs."

Ethics of machine learning--an interview with Michael Kearns and Aaron Roth

 Amazon Scholars Michael Kearns and Aaron Roth discuss the ethics of machine learning--Two of the world’s leading experts on algorithmic bias look back at the events of the past year and reflect on what we’ve learned, what we’re still grappling with, and how far we have to go.  By Stephen Zorio

"In November of 2019, University of Pennsylvania computer science professors Michael Kearns and Aaron Roth released The Ethical Algorithm: The Science of Socially Aware Algorithm Design. Kearns is the founding director of the Warren Center for Network and Data Sciences, and the faculty founder and former director of Penn Engineering’s Networked and Social Systems Engineering program. Roth is the co-director of Penn’s program in Networked and Social Systems Engineering and co-authored The Algorithmic Foundations of Differential Privacy with Cynthia Dwork. Kearns and Roth are leading researchers in machine learning, focusing on both the design and real-world application of algorithms.

Their book’s central thesis, which involves “the science of designing algorithms that embed social norms such as fairness and privacy into their code,” was already pertinent when the book was released. Fast forward one year, and the book’s themes have taken on even greater significance.

Amazon Science sat down with Kearns and Roth, both of whom recently became Amazon Scholars, to find out whether the events of the past year have influenced their outlook. We talked about what it means to define and pursue fairness, how differential privacy is being applied in the real world and what it can achieve, the challenges faced by regulators, what advice the two University of Pennsylvania professors would give to students studying artificial intelligence and machine learning, and much more."

What do we know about the effects of payments to participants in challenge trials for vaccines, and other public spirited activities?

There is starting to be an empirical literature associated with payments for socially productive activities, such as participating in challenge trials of vaccines, donating plasma, etc.

Here's a blog post in the Medical Ethics blog of the Journal of Medical Ethics:

Is it acceptable to pay nothing or little to challenge trial participants?  By Sandro Ambuehl, Axel Ockenfels and Alvin E Roth.   October 30, 2020

Here's a paragraph (with some links).:

"we hope that the debates about payments in medical research, and on other transactions subject to restrictions on payments such as blood plasma donations, will converge as empirical results accumulate. To date, there is empirical evidence on the underlying motivations for volunteering, on the impact of high payment on human risk taking, on decision quality and well-being, on the signal value of small payments, on strategies to evade regulation, and on the general public’s assessment of appropriate activities and  payments. Moreover, there are studies that document biases affecting normative judgment in general, and biases affecting paternalistic restrictions and moral intuitions in particular.

***********

This blog post was written in connection with our paper in the JME:

Payment in challenge studies from an economics perspective 

by Sandro Ambuehl, Axel Ockenfels, and Alvin E. Roth

published online early, Oct 28, 2020. http://dx.doi.org/10.1136/medethics-2020-

Why I have signed election day letters

 I am a reluctant letter signer, but this election season I have signed two open letters.  My reluctance stems in part from the fact that, when I am one among many who sign a letter, I'm often prominently mentioned in the resulting news stories, even though my expertise on the subject of the letter is no more than the other signers.

But, we are entering on an important election, and I'm a concerned citizen.  So, I let myself be counted (even if over-counted), and when asked to explain, I sometimes feel moved to respond.

Here's the latest, from Business Insider:

More than 1,000 economists have now signed letter urging voters to reject 'reckless and selfish' Trump on Election Day. Alvin Roth, a Nobel winner, tells us why he's among them.

by Kate Duffy.

"As of Friday, 1,027 prominent economists from major institutions across America, including numerous Nobel winners, had signed the open letter, which is being updated until Election Day.

"The number of signatures has increased by more than 300 since last Friday, when it was first created.

"Alvin Roth, who shared the Nobel Memorial Prize in Economic Sciences in 2012, told Business Insider he signed the letter because he was "concerned that some voters might believe President Trump's essentially false claims that his careless stewardship has been good for the US economy."

"Roth said: "That certainly isn't the view of those who study these things. Letters like this may also help many people know that they are not the only ones to notice that the current president is trying to keep us divided and misinformed." He added that "democracy depends on reliable information, and the letter was meant to provide some of that."

...

"Roth, an economics professor at Stanford University, believes the re-election of Trump could severely damage the US economy. ...economic progress in the US is made through working with trading partners, he said.  

"But "President Trump prefers trade wars, with government subsidies to help staunch the bleeding in those parts of the economy that are harmed," such as the damage to American overseas agricultural markets, Roth added.

"Roth said that if Biden were elected as president, he would most likely appoint advisors who have knowledge in their areas of responsibility, and could therefore "restore America's relations with our allies and trading partners."

"Biden's tax and economic policies will not aim to benefit only the wealthiest Americans and political supporters, according to Roth, who emphasized how divided the country he believes the country is."

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Related posts:

Monday, October 26, 2020

Vote! Here's another open letter, this one from business school professors

 Open letters are in season, and I've signed another one.  You can too, at the link.

It’s Time for America’s Business Leaders to Speak Out Against the Threat Trump Poses to Our Republic

Thursday, October 22, 2020

Open letter by economists opposing re-election of current U.S. president

 Open Letter: 690 Economists Oppose Trump's Re-Election

Don't forget to vote.

Challenge trials for Covid-19 vaccine are being planned (and a recent NBER cost/benefit analysis)

 Here's the NY Times:

To Test Virus Vaccines, U.K. Study Will Intentionally Infect Volunteers--The hotly contested strategy of deliberate exposure, known as a human challenge trial, could speed up the process of identifying effective coronavirus vaccines.  By Benjamin Mueller

"Scientists at Imperial College London plan to deliberately infect volunteers with the coronavirus early next year, launching the world’s first effort to study how vaccinated people respond to being intentionally exposed to the virus and opening up a new, uncertain path to identifying an effective vaccine.

"The hotly contested strategy, known as a human challenge trial, could potentially shave crucial time in the race to winnow a number of vaccine candidates. Rather than conducting the sort of trials now underway around the world, in which scientists wait for vaccinated people to encounter the virus in their homes and communities, researchers would purposely infect them in a hospital isolation unit.

"Scientists have used this method for decades to test vaccines for typhoid, cholera and other diseases, even asking volunteers in the case of malaria to expose their arms to boxes full of mosquitoes to be bitten and infected. But whereas the infected could be cured of those diseases, Covid-19 has few widely used treatments and no known cure, putting the scientists in charge of Britain’s study in largely uncharted ethical territory.

...

"The volunteers in London will be paid roughly Britain’s minimum wage, which is about £9, or $11, per hour, for their time in taking part in the trial and their two to three weeks in mandatory quarantine. The researchers said they were wary of offering additional incentives that could cloud the judgment of volunteers."

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And here's a recent NBER paper on the efficiency of challenge trials:

A Cost/Benefit Analysis of Clinical Trial Designs for COVID-19 Vaccine Candidates

Donald A. Berry, Scott Berry, Peter Hale, Leah Isakov, Andrew W. Lo, Kien Wei Siah & Chi Heem Wong

ID w27882, DOI 10.3386/w27882, October 2020

Abstract: We compare and contrast the expected duration and number of infections and deaths averted among several designs for clinical trials of COVID-19 vaccine candidates, including traditional randomized clinical trials and adaptive and human challenge trials. Using epidemiological models calibrated to the current pandemic, we simulate the time course of each clinical trial design for 504 unique combinations of parameters, allowing us to determine which trial design is most effective for a given scenario. A human challenge trial provides maximal net benefits—averting an additional 1.1M infections and 8,000 deaths in the U.S. compared to the next best clinical trial design—if its set-up time is short or the pandemic spreads slowly. In most of the other cases, an adaptive trial provides greater net benefits.

Paying participants in challenge trials of Covid-19 vaccines, by Ambuehl, Ockenfels, and Roth

 Here's a new short paper in Journal of Medical Ethics: (it's ungated, you can read it all at the link): 

Payment in challenge studies from an economics perspective 

by Sandro Ambuehl, Axel Ockenfels, and Alvin E. Roth

published online early, Oct 28, 2020. http://dx.doi.org/10.1136/medethics-2020-

"Participants in medical studies perform a service. Outside the domain of research participation, there is nearly universal agreement that workers providing a service should be compensated fairly, and that work involving more discomfort and risk should be compensated more generously. Accordingly, labour regulations impose floors (minimum wage laws), not caps on compensation. Caps, even if intended to protect against undue inducement, also raise concerns about illegal price-fixing that disadvantages workers. Such limits on payment for egg donors have successfully been challenged in court.

...

"Payment caps can lead to attempts to circumvent the regulation. For example, many countries that prevent payment for the donation of blood plasma instead import it from the USA where payment is legal—the volume of the US export market for plasma products approaches $20 billion per year.ii Similarly, restrictions on CHIM trial payments may lead to an increase in trials in countries with less stringent regulation.

...

"we note that increasing hourly pay by a risk-compensation percentage as proposed in the target article provides compensation proportional to risk only if the risk increases proportionally with the number of hours worked. (Some risky tasks take little time; imagine challenge trials to test bulletproof vests.) To ensure that equal consequences are compensated with equal amounts across a wide variety of studies, we instead recommend a three-part contract consisting of: (1) salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, (2) insurance against ex post adverse outcomes and (3) ex ante compensation for risks that cannot be compensated ex post (such as death). Such a scheme also increases transparency about what is requested from participants and thus contributes to high-quality participation decisions."

...

"The current discussion about payment in challenge trials is important because the potential benefits of well-designed challenge trials that could accelerate the development of safe and effective vaccines are enormous. Overall, economic research has shown, first, that ethical concerns over high payments may rely on intuitive predictions about behavioural effects that find little or no empirical support, and that the dangers of underpayment are at least as real as those of overpayment. Second, a part of the ethics literature attaches significantly more weight to concerns of undue inducement than the general population. Accordingly, it appears to us that there is sufficient public support for preparing for challenge trials, with paid participants, without a need for excessive ethical concern that payments might inadvertently become too generous to trial participants."

***********

Our article is an invited commentary on

• Payment in challenge studies: ethics, attitudes and a new payment for risk model

  Olivia Grimwade Julian Savulescu Alberto Giubilini Justin Oakley Joshua Osowicki Andrew J Pollard Anne-Marie Nussberger  J Med Ethics, 2020

Related comments appear in

1. Compensating for research risk: permissible but not obligatory
   Holly Fernandez Lynch et al., J Med Ethics
2. Payment of COVID-19 challenge trials: underpayment is a bigger worry than overpayment
   Jennifer Blumenthal-Barby et al., J Med Ethics, 2020
3. How much money would it take for you to be infected with COVID-19 for research?
   
   By Olivia Grimwade and Julian Savulescu., JME blog, 2020

Citizenship for sale

 The Financial Times has the latest:

Cyprus scandal exposes EU ‘golden passport’ problem by Michael Peel

"No sooner had Cyprus moved this week to suspend its scandal-ridden programme that offered EU “golden passports” to rich investors than others began jostling to fill the gap.

“Choose Montenegro citizenship instead of Cyprus!” trumpeted the website of Discus Holdings, an official agent of the Montenegrin scheme, pointing to the visa-free access available to Europe’s 26-country common Schengen travel zone.

...

"Attention has focused on the three EU members — Cyprus, Malta and Bulgaria — that offer full citizenship in exchange for investment. But many other European countries, including France, the UK and Austria, offer “golden visas” granting a right of abode to the wealthy — and a potential path to nationality after a qualifying period of residence."

Auction of art from Jerusalem museum postponed at the last moment

The Guardian has the latest:

Auction for Jerusalem museum’s treasures postponed at last minute--Sotheby’s in London had been due to sell more than 200 items from cash-strapped museum  by Oliver Holmes 

The plan was that Sotheby's would sell a set of artifacts today from the Mayer Museum for Islamic Art in Jerusalem.

Select Works from the L.A. Mayer Museum for Islamic Art | Jerusalem--Live Auction: 27 October 2020 • 10:30 AM GMT • London (now postponed)

Unsurprisingly, this sale drew some opposition.

Here's the story from Haaretz:

Now on Display at the Jerusalem Museum for Islamic Art: Selloff--Financially strained, the L.A. Mayer Museum is auctioning off dozens of rare items, despite harsh criticism: 'They’re going for the easy way out'    by Naama Riba

Vote! Here's another open letter, this one from business school professors

 Open letters are in season, and I've signed another one.  You can too, at the link.

It’s Time for America’s Business Leaders to Speak Out Against the Threat Trump Poses to Our Republic

An Open Letter & Call for Action - Signed by Business School Professors from Across America
Click here to add your name.

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

Related recent post

Thursday, October 22, 2020

Open letter by economists opposing re-election of current U.S. president

 Open Letter: 690 Economists Oppose Trump's Re-Election (850 last time I checked)

The Economist reflects on market designers as economic engineers, in celebration of the Milgrom-Wilson Nobel

 Here is The Economist on Milgrom and Wilson:

The Nobel prize in economics rewards advances in auction theory--For the third time since 2007, it goes to designers of market mechanisms

HT: Mary Wilson

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

Related recent posts:

Monday, October 12, 2020

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

Wednesday, October 14, 2020

Some links following the Nobel Prize to Milgrom and Wilson

Medically assisted dying and the U.S. Supreme Court

 The Washington Post has the story:

Judge Amy Coney Barrett and the future of physician-assisted suicide  by 

Charles Lane

"Barrett co-wrote a 1998 law review article in which she distinguished the dilemmas Catholic judges might face in following church teachings against capital punishment, as well as what she called a more “absolute” doctrine banning abortion and euthanasia, which “take away innocent life.” (updated link: http://pragerfan.com/articles/Catholic_Judges_Capital_Cases.pdf )

...

"Eight of the 50 states and D.C. have permitted physician-assisted suicide, by statute or referendum. (In one, Montana, the state Supreme Court decreed it as a matter of state law, and legislators have tried, unsuccessfully so far, to overturn that ruling.)

Medically assisted dying, at any age, in the Netherlands

 The NY Times has the story:

Netherlands to Allow Doctors to Help End Lives of Terminally Ill Children--Hugo de Jonge, the Dutch health minister, said that “incurably ill” children ages 1 to 12 should be able to die with the help of a doctor.  By Maria Cramer and Claire Moses

"The Dutch government announced plans this week to allow doctors to end the lives of terminally ill children who are under 13 years old, a decision that is bound to inflame the debate over physician-assisted death.

"The Netherlands already allows doctors to facilitate the deaths of people who are over 12 or less than a year old as long as parents have given their consent.

"In a letter to parliament on Tuesday, the Dutch health minister, Hugo de Jonge, proposed expanding the law to include children between the ages of 1 and 12 who are dying and suffering.

“In a small number of cases, palliative care isn’t sufficient,” Mr. de Jonge wrote. “Because of that, some children suffer unnecessarily without any hope of improvement.”

...

"Three other European countries — Luxembourg, Belgium and Switzerland — allow physician-assisted death, though the laws differ in each country. Belgium allows children to die with the help of a doctor, but in Luxembourg, the law is restricted to adults with an incurable medical condition.

"Canada, parts of Australia and Colombia have also legalized physician-assisted death for adults in certain cases.

...

"Eight states and Washington, D.C., have laws that allow mentally competent adults with a terminal illness and six months or less to live to obtain prescription medication that will hasten their deaths, according to Death With Dignity, an Oregon-based nonprofit that supports such laws."

********

The first link above is to this Gallup Poll report:

MAY 31, 2018,  Americans' Strong Support for Euthanasia Persists  BY MEGAN BRENAN

"72% say doctors should be able to help terminally ill patients die

"Fewer, 65%, express support when the question includes "commit suicide"

"54% think doctor-assisted suicide is morally acceptable"

Information for those in need of a kidney donor, from Harvey Mysel, founder of the Living Kidney Donors Network

Here's an announcement from Harvey Mysel, the founder of the Living Kidney Donors Network, about information available for people in need of a kidney transplant.

 Living Kidney Donors Network has released its new FREE online program Having Your Donor Find YOU! for those who need or will need a kidney transplant. www.havingyourdonorfindyou.org That may seem like an unusual title, but that’s what really happens. You get the word out and someone will be motivated to help you…your donor finds you. 

The program’s 3 goals are to:

1. Motivate someone in need to pursue a living donor
2. Overcome the myth that you need to ASK someone to donate
3. Explain that it’s all about sharing YOUR STORY and the importance of having advocates share it too.

 Having Your Donor Find YOU! consists of 9 videos, each under 3 minutes with Supporting Resources that helps you develop the campaign that’s outlined in the videos. The program will soon be available in Spanish. 

 Should you be involved with an organization that would like to offer the program to your patients or followers, you can have your own URL: www.your_name.havingyourdonorfindyou.org Here’s an example: www.nekf.havingyourdonorfindyou.org 

Open letter by economists opposing re-election of current U.S. president

 Open Letter: 690 Economists Oppose Trump's Re-Election

Don't forget to vote.

********

update: 932 economists the last time I checked.

NBER market design meeting today through Saturday on Zoom

The NBER market design conference is on Zoom this year, today through Saturday, starting each day at noon Eastern time (9am Pacific time).  I'll be speaking today at 2:45 EST (11:45 PST), about a new proposal for global kidney exchange using chains that begin overseas and end in the U.S., and about the background and history to this proposal, which initially met with considerable opposition.

2:45 pm	Mohammad Akbarpour, Stanford University Afshin Nikzad, University of Southern California Michael A. Rees, University of Toledo Medical Center Alvin E. Roth, Stanford University and NBER Global Kidney Chains

The full schedule, with links to papers, is here:

Market Design Working Group Meeting

Michael Ostrovsky and Parag A. Pathak, Organizers

October 22-24, 2020, on Zoom.us

 

Ned Brooks interviews me at the National Kidney Donor Organization virtual conference (video)

 For easy access, here's the video of my talk at the National Kidney Donor Organization virtual conference, about which I blogged this morning.  We talked about kidney exchange, global kidney exchange, and repugnant transactions...

National Kidney Donor Advocate Conference, on YouTube

 Here's an announcement I received from Ned Brooks, the founder of  NKDO, National Kidney Donation Organization (formerly Donor to Donor).  If I understand correctly, the different talks and interviews will be available at the link after first streaming in conference style, starting at 9am Pacific time. It includes a video of Ned interviewing me.

I'll update this post as necessary. 

"This Wednesday, October 21^st, NKDO, National Kidney Donation Organization (formerly Donor to Donor) will release the virtual National Kidney Donor Advocate Conference. This event is designed to give volunteer living donor advocates the information they need to be more effective advocates for living donation. Transplant industry experts across the country will be presenting to you and delivering invaluable advice about their area of expertise.

The conference will stream on our YouTube channel beginning at 12:00 noon Eastern this Wednesday. The conference will be in segments and accessed through the “playlist”, either streaming as one event or accessed at different points in the conference. The link is  https://www.youtube.com/channel/UCsoS-yavRQCVl7bwcjT2iCA , which will go live at noon Eastern on Wednesday.

- Have you ever wondered about the transplant surgeons who do the surgery? What they are thinking and what they would like you to know? Dr. Joshua Mezrich, transplant surgeon at UWMadison and author of “When Death Becomes Life: Notes from a Transplant Surgeon” talks about his experience with organ donors and recipients.

- Are you a living donor or a transplant recipient, or expecting to be one? Do you remember the experience of being evaluated at the transplant center and listening to all the information, and maybe feeling a little overwhelmed? Living Donor Coordinator Marian Charlton and Patient Coordinator Janet Hiller are two of the most respected voices in transplant, and they will tell you what they want you to know to better understand the process. Anyone who goes through this experience or has a loved one in transplant will want to see these segments.

- Living kidney donors deserve all protections available, from reimbursement for out-of-pocket costs and lost wages to medical coverage for medical issues that may arise months or years after donation. Garet Hil, founder and CEO of the National Kidney Registry, talks about the suite of protections available to living donors through Donor Shield.

-  Are you a kidney patient in need of a donor? Harvey Mysel, a two-time kidney recipient and founder and CEO of the Living Kidney Donor Network, talks about how to have your kidney donor find you.

- Professor Alvin Roth won the Nobel Prize in Economics for his work creating the algorithms that contributed to the creation of the “kidney chain”, a development that transformed kidney transplant procedures. Prof. Roth discusseshis work and the business known by the intriguing moniker of “repugnanttransactions.”

- All kidney patients will benefit by watching nephrologist Dr. David Serur talk about kidney disease and what every kidney patient and advocate needs to know to be properly informed about how to deal with renal disease. 

- Non-directed, or altruistic, donors are a rare breed, though we are trying to change that. No one knows the brain of the non-directed donor better than Professor Abigail Marsh, who has been studying non-directed donors for years. If you want to better understand why someone will happily donate a kidney to a stranger, this presentation will help answer that question.  Prof. Marsh is the author of “The Fear Factor: How One Emotion Connects Altruists, Psychopaths, and Everyone In-Between.”

- If you listen to podcasts, you are probably familiar with “Freakonomics” and its creator, Stephen Dubner. It was the Freakonomics interview with Prof. Roth that set Donor to Donor and NKDO into motion, and our interview with Mr. Dubner will interest anyone who understands “the power of the pod”.

- Jim Gleason is a heart transplant recipient and the president of TRIO, Transplant Recipients International Organization. Mr. Gleason is a motivational speaker who asks the question, “Are you a cookie monster?”

Here's the video of my video

Surgery Grand Rounds at UCSF. "Kidneys and Controversies: Kidney Exchange Within and Across Borders" Oct 21 (7am PST)

 Tomorrow at dawn I'll give a seminar to the surgeons at UCSF, about kidney exchange, and the controversies it has overcome, and is overcoming.

Surgery Grand Rounds | Kidneys and Controversies: Kidney Exchange Within and Across Borders

Date: October 21, 2020 Time: 7:00am-8:00am Place: Webinar

Rishwain Visiting Speaker: Alvin E. Roth, PhD

Al Roth is the Craig and Susan McCaw Professor of Economics at Stanford University and the George Gund Professor Emeritus of Economics and Business Administration at Harvard University. He shared the 2012 Nobel memorial prize in Economics. His research interests are in game theory, experimental economics, and market design. In the 1990’s he directed the redesign of the National Resident Matching Program (NRMP) and currently is a member of the Board of Directors. He has been involved in the design and organization of kidney exchange, which helps incompatible patient-donor pairs find life-saving compatible kidneys for transplantation. He is on the Advisory Board of the National Living Donor Assistance Center (NLDAC). His work on kidney transplantation led him to become interested in repugnant transactions, and more generally how markets, and bans on markets, gain or fail to gain social support.

The University of California, San Francisco School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  CME Course MGR21045

UCSF designates this live activity for a maximum of 43 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

*The above credit is inclusive of credit for all Fiscal Year 2020-2021 Department of Surgery Grand Rounds.

Disclosure declaration – No one in a position to control the content of this activity has a relationship with an ACCME-defined commercial interest. Planners  Wen Shen, MD, Julie Ann Sosa, MD, MA, Lygia Stewart, MD, and Ryutaro Hirose, MD, have stated that they have no relationships to disclose. Speaker Roth has stated that he has no relevant relationships to disclose.

This activity is supported by the Department of Surgery’s Howard Naffziger Endowment Fund.

Join Webinar: https://ucsf.zoom.us/j/252447171?pwd=MWt0bG9vTjBSZEo1UnpidXRVWWU2UT09 

Censoring repugnant words by algorithm

 Some people like to say things that other people think they shouldn't say.  In the age of the internet, politeness can be (somewhat) automated, by banning certain words.  But of course, words have contexts. Here's a funny story from the Guardian:

Overzealous profanity filter bans paleontologists from talking about bones--A virtual conference was thrown into confusion when the platform hosting the event came with a pre-packaged ‘naughty word’ censor by Poppy Noor.

"Participants in a virtual paleontology session found themselves caught between a rock and a hard place last week, when a profanity filter prevented them from using certain words – such as bone, pubic, stream and, er, beaver – during an online conference.

"The US-based Society of Vertebrate Paleontology (SVP) held its annual meeting virtually this year due to the pandemic, but soon found its audience stifled when they tried to use particular words.

"Convey Services, which was was handling the conference, used a “naughty-word filter,” for the conference, outlawing a pre-selected list of words.

"“Words like ‘bone’, ‘pubic’, and ‘stream’ are frankly ridiculous to ban in a field where we regularly find pubic bones in streams,” said Brigid Christison, a master’s student in biology attending the event

...

"Some discovered bias in the algorithm, too. Jack Tseng, a vertebrate paleontologist from the University of Berkley pointed out that the filter had banned the common surname Wang but not Johnson – even though both are frequently used as slang words to describe a man’s genitals."

********

Here's Dr. Tseng's tweet:

Z. Jack Tseng, @Tseng_ZJ

"Wang" is banned but not "Johnson" (both used as slangs). This western-centric filter erasing the surname of 90+ million Chinese but not <2 million people of European descent is unexpectedly on brand for 2020,  ! My PhD advisor is X. **** by the way. "

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Previous related posts:

Monday, September 12, 2016 Repugnant language: some reflections on profanity

 

Friday, August 7, 2015 You can't say that! Repugnant words

HT: Muriel Niederle

Breast milk and the marketing of breast milk substitutes during the pandemic

 

Here's an article in the Lancet:

Marketing of breastmilk substitutes during the COVID-19 pandemic by Christoffer van Tulleken, Charlotte Wright, Amy Brown, David McCoy, and Anthony Costello, October 08, 2020DOI:https://doi.org/10.1016/S0140-6736(20)32119-X

"It is of concern that the US$70 billion infant formula industry has been actively exploiting concerns about COVID-19 to increase sales, in violation of the WHO International Code of Marketing of Breast-milk Substitutes (the Code)1 and national law in many countries.

"Globally, infants who are not exclusively breastfed are 14 times more likely to die than infants who are exclusively breastfed.2 Lockdown measures have diminished household income, and the UN World Food Programme estimates that by the end of 2020, 265 million people may be facing food insecurity,3,  4 making breastfeeding even more important. Public bodies that are independent of industry influence, including WHO5,  6 and the Royal College of Paediatrics and Child Health,7 have unanimously asserted that no evidence exists to suggest breastfeeding increases the risk of infants contracting COVID-19, and that skin-to-skin contact remains essential for newborn health and maternal health.

"By contrast, large manufacturers of breastmilk substitutes have inappropriately positioned themselves as sources of public health expertise, and suggested various unnecessary hygiene measures, the use of expressed breastmilk, and the separation of mothers from their babies. Such recommendations undermine breastfeeding and thus increase the risk of infant death. Baby Milk Action and the International Baby Food Action Network8 have documented numerous infringements of both the Code and laws associated with COVID-19."