25 August 2016

Social determinants of health, nonfinancial performance metrics, and satisficers.

Dear reader: Insights Weekly is starting a new chapter. Our spotlight topics are now accompanied by a 'newsletter' version of a PepperSlice, the capsule form of evidence-based analysis we've created at PepperSlice.com. Let me know what you think, and thanks for your continued readership. - Tracy Altman, Ugly Research

1. Is social services spending associated with better health outcomes? Yes.
Socialhealth-pepperslice-thumbnail Evidence has revealed a significant association between healthcare outcomes and the ratio of social service to healthcare spending in various OECD countries. Now a new study, published in Health Affairs, finds this same pattern within the US. The health differences were substantial. For instance, a 20% change in the median social-to-health spending ratio was associated with 85,000 fewer adults with obesity and more than 950,000 adults with mental illness. Elizabeth Bradley and Lauren Taylor explain on the RWJF Culture of Health blog.

This is great, but we wonder: Where/what is the cause-effect relationship?

The Evidence. Peer-reviewed: Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000-09.

Data: Collected using longitudinal state-level spending data and analyzed with repeated measures multivariable modeling, retrospective.

Relationship: Social : medical spending → associated → better health outcomes

From the authors: "Reorienting attention and resources from the health care sector to upstream social factors is critical, but it’s also an uphill battle. More research is needed to characterize how the health effects of social determinants like education and poverty act over longer time horizons. Stakeholders need to use information about data on health—not just health care—to make resource allocation decisions."

#: statistical_modeling social_determinants population_health social_services health_policy

2. Are nonfinancial metrics good leading indicators of financial performance? Maybe.
Nonfinancial-metrics During the '90s and early 00's we heard a lot about Kaplan and Norton's Balanced Scorecard. A key concept was the use of nonfinancial management metrics such as customer satisfaction, employee engagement, and openness to innovation. This was thought to encourage actions that increased a company’s long-term value, rather than maximizing short-term financials.

The idea has taken hold, and nonfinancial metrics are often used in designing performance management systems and executive compensation plans. But not everyone is a fan: Some argue this can actually be harmful; for instance, execs might prioritize customer sat over other performance areas. Recent findings in the MIT Sloan Management Review look at whether these metrics truly are leading indicators of financial performance.

The Evidence. Business journal: Are Nonfinancial Metrics Good Leading Indicators of Future Financial Performance?

Data: Collected from American Customer Satisfaction Index, ExecuComp, and Compustat and analyzed with econometrics: panel data analysis.

Relationship: Nonfinancial metrics → predict → Financial performance

From the authors: "We found that there were notable variations in the lead indicator strength of customer satisfaction in a sample of companies drawn from different industries. For instance, for a chemical company in our sample, customer satisfaction’s lead indicator strength was negative; this finding is consistent with prior research suggesting that in many industries, the expense required to increase customer satisfaction can’t be justified. By contrast, for a telecommunications company we studied, customer satisfaction was a strong leading indicator; this finding is consistent with evidence showing that in many service industries, customer satisfaction reduces customer churn and price sensitivity. For a professional service firm in our sample, the lead indicator strength of customer satisfaction was weak; this is consistent with evidence showing that for such services, measures such as trust provide a clearer indication of the economic benefits than customer satisfaction.... Knowledge of whether a nonfinancial metric such as customer satisfaction is a strongly positive, weakly positive, or negative lead indicator of future financial performance can help companies avoid the pitfalls of using a nonfinancial metric to incentivize the wrong behavior."

#: customer_satisfaction nonfinancial balanced_scorecard CEO_compensation performance_management

3. Reliable evidence about p values.
Daniël Lakens (@lakens) puts it very well, saying "One of the most robust findings in psychology replicates again: Psychologists misinterpret p-values." This from Frontiers in Psychology.

4. Satisficers are happier.
Fast Company's article sounds at first just like clickbait, but they have a point. You can change how you see things, and reset your expectations. The Surprising Scientific Link Between Happiness And Decision Making.

Evidence & Insights Calendar:

September 19-21; Boston. FierceBiotech Drug Development Forum. Evaluate challenges, trends, and innovation in drug discovery and R&D. Covering the entire drug development process, from basic research through clinical trials.

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 20-22; Newark, New Jersey. Advanced Pharma Analytics. How to harness real-world evidence to optimize decision-making and improve patient-centric strategies.


Photo credit: Fat cat by brokinhrt2 on Flickr.

18 August 2016

Science of CEO success?, drug valuation kerfuffle, and event attribution science.

  Fingerpointing


1. Management research: Alchemy → Chemistry?
McKinsey's Michael Birshan and Thomas Meakin set out to "take a data-driven look" at the strategic moves of newly appointed CEOs, and how those moves influenced company returns. The accompanying podcast (with transcript), CEO transitions: The science of success, says "A lot of the existing literature is quite qualitative, anecdotal, and we’ve been able to build a database of 599 CEO transitions and add a bunch of other sources to it and really try and mine that database hard for what we hope are new insights. We are really trying to move the conversation from alchemy to chemistry, if you like."

The research was first reported in How new CEOs can boost their odds of success. McKinsey's evidence says new CEOs make similar moves, with similar frequency, whether they're taking over a struggling company or a profitable one (see chart). For companies not performing well, Birshan says the data support his advice to be bold, and make multiple moves at once. Depending how you slice the numbers, both external and internal hires fared well in the CEO role (8).

  CEO-science-success

Is this science? CEO performance was associated with the metric excess total returns to shareholders, "which is the performance of one company over or beneath the average performance of its industry peers over the same time period". Bottom line, can you attribute CEO activities directly to excess TRS? Organizational redesign was correlated with significant excess TRS (+1.9 percent) for well-performing companies. The authors say "We recognize that excess TRS CAGR does not prove a causal link; too many other variables, some beyond a CEO’s control, have an influence. But we do find the differences that emerged quite plausible." Hmm, correlation still does not equal causation.

Examine the evidence. The report's end notes answer some key questions: Can you observe or measure whether a CEO inspires the top team? Probably not (1). Where do you draw the line between a total re-org and a management change? They define 'management reshuffle' as 50+% turnover in first two years (5). But we have other questions: How were these data collected and analyzed? Some form of content analysis would likely be required to assign values to variables. How were the 599 CEOs chosen as the sample? Selection bias is a concern. Were some items self-reported? Interviews or survey results? Were findings validated by assigning a second team to check for internal reliability? External reliability?


2. ICER + pharma → Fingerpointing.
There's a kerfuffle between pharma companies and the nonprofit ICER (@ICER_review). The Institute for Clinical and Economic Review publishes reports on drug valuation, and studies comparative efficacy. Biopharma Dive explains that "Drugmakers have argued ICER's reviews are driven by the interests of insurers, and fail to take the patient perspective into account." The National Pharmaceutical Council (@npcnow) takes issue with how ICER characterizes its funding sources.

ICER has been doing some damage control, responding to a list of 'myths' about its purpose and methods. Its rebuttal, Addressing the Myths About ICER and Value Assessment, examines criticisms such as "ICER only cares about the short-term cost to insurers, and uses an arbitrary budget cap to suggest low-ball prices." Also, ICER's economic models "use the Quality-Adjusted Life Year (QALY) which discriminates against those with serious conditions and the disabled, 'devaluing' their lives in a way that diminishes the importance of treatments to help them."


Cupid-lesser-known-arrow

3. Immortal time bias → Overstated findings.
You can't get a heart transplant after you're dead. The must-read Hilda Bastian writes on Statistically Funny about immortal time bias, a/k/a event-free time or competing risk bias. This happens when an analysis mishandles events whose occurrence precludes the outcome of interest - such as heart transplant outcomes. Numerous published studies, particularly those including Kaplan-Meier analyses, may suffer from this bias.


4. Climate change → Weird weather?
This week the US is battling huge fires and disastrous floods: Climate change, right? Maybe. There's now a thing called event attribution science, where people apply probabilistic methods in an effort to determine whether an extreme weather resulted from climate change. The idea is to establish/predict adverse impacts.


Evidence & Insights Calendar:

September 20-22; Newark, New Jersey. Advanced Pharma Analytics. How to harness real-world evidence to optimize decision-making and improve patient-centric strategies.

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded in 2013 by the Agency of Health Quality and Assessment (AQuAS), RAND Europe, and Alberta Innovates.


Photo credit: Fingerpointing by Tom Hilton.

04 August 2016

Health innovation, foster teens, NBA, Gwyneth Paltrow.

Foster_care_youth

1. Behavioral economics → Healthcare innovation.
Jaan Sidorov (@DisMgtCareBlog) writes on the @Health_Affairs blog about roadblocks to healthcare innovation. Behavioral economics can help us truly understand resistance to change, including unconscious bias, so valuable improvements will gain more traction. Sidoro offers concise explanations of hyperbolic discounting, experience weighting, social utility, predictive value, and other relevant economic concepts. He also recommends specific tactics when presenting a technology-based innovation to the C-Suite.

2. Laptops → Foster teen success.
Nobody should have to type their high school essays on their phone. A coalition including Silicon Valley leaders and public sector agencies will ensure all California foster teens can own a laptop computer. Foster Care Counts reports evidence that "providing laptop computers to transition age youth shows measurable improvement in self-esteem and academic performance". KQED's California Report ran a fine story.

For a year, researchers at USC's School of Social Work surveyed 730 foster youth who received laptops, finding that "not only do grades and class attendance improve, but self-esteem and life satisfaction increase, while depression drops precipitously."

3. Analytical meritocracy → Better NBA outcomes.
The Innovation Enterprise Sports Channel explain how the NBA draft is becoming an analytical meritocracy. Predictive models help teams evaluate potential picks, including some they might have overlooked. Example: Andre Roberson, who played very little college ball, was drafted successfully by Oklahoma City based on analytics. It's tricky combining projections for active NBA teams with prospects who may never take the court. One decision aid is ESPN’s Draft Projection model, using Statistical Plus/Minus to predict how someone would perform through season five of a hypothetical NBA career. ESPN designates each player as a Superstar, Starter, Role Player, or Bust, to facilitate risk-reward assessments.

4. Celebrity culture → Clash with scientific evidence.
Health law and policy professor Timothy Caulfield (@CaulfieldTim) examines the impact of celebrity culture on people's choices of diet and healthcare. His new book asks Is Gwyneth Paltrow Wrong About Everything?: How the Famous Sell Us Elixirs of Health, Beauty & Happiness. Caulfield cites many, many peer-reviewed sources of evidence.

Evidence & Insights Calendar:

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded in 2013 by the Agency of Health Quality and Assessment (AQuAS), RAND Europe, and Alberta Innovates.

February 22-23; London UK. Evidence Europe 2017. How pharma, payers, and patients use real-world evidence to understand and demonstrate drug value and improve care.

Photo credit: Foster Care Counts.

27 July 2016

Business coaching, manipulating memory for market research, and female VCs.

Hoosiers_coach

1. Systematic review: Does business coaching make a difference?
In PLOSOne, Grover and Furnham present findings of their systematic review of coaching impacts within organizations. They found glimmers of hope for positive results from coaching, but also spotted numerous holes in research designs and data quality.

Over the years, outcome measures have included job satisfaction, performance, self-awareness, anxiety, resilience, hope, autonomy, and goal attainment. Some have measured ROI, although this one seems particularly subjective. In terms of organizational impacts, researchers have measured transformational leadership and performance as rated by others. This systematic review included only professional coaches, whether internal or external to the organization. Thanks @Rob_Briner and @IOPractitioners.

2. Memory bias pollutes market research.
David Paull of Dialsmith hosted a series about how flawed recall and memory bias affect market research. (Thanks to @kristinluck.)

All data is not necessarily good data. “We were consistently seeing a 13–20% misattribution rate on surveys due in large part to recall problems. Resultantly, you get this chaos in your data and have to wonder what you can trust.... Rather than just trying to mitigate memory bias, can we actually use it to our advantage to offset issues with our brands?”

The ethics of manipulating memory. “We can actually affect people’s nutrition and the types of foods they prefer eating.... But should we deliberately plant memories in the minds of people so they can live healthier or happier lives, or should we be banning the use of these techniques?”

Mitigating researchers' memory bias. “We’ve been talking about memory biases for respondents, but we, as researchers, are also very prone to memory biases.... There’s a huge opportunity in qual research to apply an impartial technique that can mitigate (researcher) biases too....[I]n the next few years, it’s going to be absolutely required that anytime you do something that is qualitative in nature that the analysis is not totally reliant on humans.”

3. Female VC --> No gender gap for startup funding.
New evidence suggests female entrepreneurs should choose venture capital firms with female partners (SF Business Times). Michigan's Sahil Raina analyzed data to compare the gender gap in successful exits from VC financing between two sets of startups: those initially financed by VCs with only male general partners (GPs), and those initially financed by VCs that include female GPs. “I find a large performance gender gap among startups financed by VCs with only male GPs, but no such gap among startups financed by VCs that include female GPs.”

4. Sharing evidence about student outcomes.
Results for America is launching an Evidence in Education Lab to help states, school districts, and individual schools build and use evidence of 'what works' to improve student outcomes. A handful of states and districts will work closely with RFA to tackle specific data challenges.

Background: The bipartisan Every Student Succeeds Act (ESSA) became law in December 2015. ESSA requires, allows, and encourages the use of evidence-based approaches that can help improve student outcomes. Results for America estimates that ESSA's evidence provisions could help shift more than $2B US of federal education funds in each of the next four years toward evidence-based, results-driven solutions.

Evidence & Insights Calendar:

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded in 2013 by the Agency of Health Quality and Assessment (AQuAS), RAND Europe, and Alberta Innovates.

20 July 2016

Evidence relativism, innovation as a process, and decision analysis pioneer.

Gold-panning

1. Panning for gold in the evidence stream.
Patrick Lester introduces his new SSIR article by saying "With evidence-based policy, we need to acknowledge that some evidence is more valid than others. Pretending all evidence is equal will only preserve the status quo." In Defining Evidence Down, the director of the Social Innovation Research Center responds to analysts skeptical of evidence hierarchies developed to steer funding toward programs that fit the "what works" concept.

Are levels valid? Hierarchies recognize different levels of evidence according to their rigor and certainty. These rankings are well-established in healthcare, and are becoming the standard for evidence evaluation within the Dept of Education and other US government agencies. Critics of this prevailing thinking (Gopal & Schorr, Friends of Evidence) want to ensure decision-makers embrace an inclusive definition of evidence that values qualitative research, case studies, insights from experience, and professional judgment. Lester contends that "Unfortunately, to reject evidence hierarchies is to promote is a form of evidence relativism, where everyone is entitled to his or her own views about what constitutes good evidence in his or her own local or individualized context.

Ideology vs. evidence. "By resisting the notion that some evidence is more valid than others, they are defining evidence down. Such relativism would risk a return to the past, where change has too often been driven by fads, ideology, and politics, and where entrenched interests have often preserved the status quo." Other highlights: "...supporting a broad definition of evidence is not the same thing as saying that all evidence is equally valid." And "...randomized evaluations are not the only rigorous way to examine systems-level change. Researchers can often use quasi-experimental evaluations to examine policy changes...."

2. Can innovation be systematic?
Everyone wants innovation nowadays, but how do you make it happen? @HighVizAbility reviews a method called Systematic Inventive Thinking, an approach to creativity, innovation, and problem solving. The idea is to execute as a process, rather than relying on random ideas. Advocates say SIT doesn't replace unbridled creativity, but instead complements it.

3. Remembering decision analysis pioneer Howard Raiffa.
Howard Raiffa, co-founder of the Harvard Kennedy School of Government and decision analysis pioneer, passed away recently. He was also a Bayesian decision theorist and well-known author on negotiation strategies. Raiffa considered negotiation analysis an opportunity for both sides to get value, describing it as The Science and Art of Collaborative Decision Making.

4. Journal impact factor redux?
In the wake of news that Thomson Reuters sold its formula, Stat says changes may finally be coming to the "hated" journal impact factor. Ivan Oransky (@ivanoransky) and Adam Marcus (@armarcus) explain that some evidence suggests science articles don't receive the high number of citations supposedly predicted by the IF. The American Society of Microbiologists has announced that it will abandon the metric completely. Meanwhile, top editors from Nature — which in the past has taken pride in its IF — have coauthored a paper widely seen as critical of the factor.

Photo credit: Poke of Gold by Mike Beauregard

19 July 2016

Are you causing a ripple? How to assess the impact of research.

Raindrops-in-a-bucket

People are recognizing the critical need for meta-research, or the 'science of science'. One focus area is understanding whether research produces desired outcomes, and identifying how to ensure that truly happens going forward. Research impact assessment (RIA) is particularly important when holding organizations accountable for their management of public and donor funding. An RIA community of practice is emerging.

Are you causing a ripple? For those wanting to lead an RIA effort, the International School on Research Impact Assessment was developed to "empower participants on how to assess, measure and optimise research impact with a focus on biomedical and health sciences." ISRIA is a partnership between Alberta Innovates, the Agency for Health Quality and Assessment of Catalonia, and RAND Europe. They're presenting their fourth annual program Sept 19-23 in Melbourne, Australia, hosted by the Commonwealth Scientific and Industrial Research Organisation, Australia’s national research agency.

ISRIA participants are typically in program management, evaluation, knowledge translation, or policy roles. They learn a range of frameworks, tools, and approaches for assessing research impact, and how to develop evidence about 'what works’.

Make an impact with your impact assessment. Management strategies are also part of the ISRIA curriculum: Embedding RIA systemically into organizational practice, reaching agreement on effective methods and reporting, understanding the audience for RIAs, and knowing how to effectively communicate results to various stakeholders.

The 2016 program will cover both qualitative and quantitative analytical methods, along with a mixed design. It will include sessions on evaluating economic, environmental and social impacts. The aim is to expose participants to as many options as possible, including new methods, such as altmetrics. (Plus, there's a black tie event on the first evening.)

 

Photo credit: Raindrops in a Bucket by Smabs Sputzer.

 

13 July 2016

Academic clickbait, FCC doesn't use economics, and tobacco surcharges don't work.

Brady

1. Academics use crazy tricks for clickbait.
Turn to @TheWinnower for an insightful analysis of academic article titles, and how their authors sometimes mimic techniques used for clickbait. Positively framed titles (those stating a specific finding) fare better than vague ones: For example, 'smoking causes lung cancer' vs. 'the relationship between smoking and lung cancer'. Nice use of altmetrics to perform the analysis.

2. FCC doesn't use cost-benefit analysis.
Critics claim Federal Communications Commission policymaking has swerved away from econometric evidence and economic theory. Federal agencies including the EPA must submit cost-benefit analyses to support new regulations, but the FCC is exempted, "free to embrace populism as its guiding principle". @CALinnovates has published a new paper, The Curious Absence of Economic Analysis at the Federal Communications Commission: An Agency In Search of a Mission. Former FCC Chief Economist Gerald Faulhaber, PhD and Hal Singer, PhD review the agency’s "proud history at the cutting edge of industrial economics and its recent divergence from policymaking grounded in facts and analysis".

3. No bias in US police shootings?
There's plenty of evidence showing bias in US police use of force, but not in shootings, says one researcher. But Data Colada, among others, describes "an interesting empirical challenge for interpreting the shares of Whites vs Blacks shot by police while being arrested is that biased officers, those overestimating the threat posted by a Black civilian, will arrest less dangerous Blacks on average. They will arrest those posing a real threat, but also some not posing a real threat, resulting in lower average threat among those arrested by biased officers."

4. Tobacco surcharges don't work.
The Affordable Care Act imposes tobacco surcharges for smokers. But findings suggest the ACA has not led more people to stop smoking.

5. CEOs lose faith in forecasts.
Some CEOs say big-data predictions are failing. “The so-called experts and global economists are proven as often to be wrong as right these days,” claims a WSJ piece In Uncertain Times, CEOs Lose Faith in Forecasts. One consultant advises people to "rely less on forecasts and instead road-test ideas with customers and make fast adjustments when needed. He urges them to supplement big-data predictions with close observation of their customers."

6. Is fMRI evidence flawed?
Motherboard's Why Two Decades of Brain Research Could Be Seriously Flawed recaps research by Anders Eklund. Cost is one reason, he argues: fMRI scans are notoriously expensive. "That makes it hard for researchers to perform large-scale studies with lots of patients". Eklund has written elsewhere about this (Can parametric statistical methods be trusted for fMRI based group studies?), and the issue is being noticed by Neuroskeptic and Science-Based Medicine ("It’s tempting to think that the new idea or technology is going to revolutionize science or medicine, but history has taught us to be cautious. For instance, antioxidants, it turns out, are not going to cure a long list of diseases").

Evidence & Insights Calendar:

August 24-25; San Francisco. Sports Analytics Innovation Summit.

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded in 2013 by the Agency of Health Quality and Assessment (AQuAS), RAND Europe, and Alberta Innovates.

06 July 2016

Stand up for science, evidence for surgery, and cognitive computing for execs.

Understand evidence

1. Know someone who effectively promotes evidence?
Nominations are open for the 2016 John Maddox Prize for Standing up for Science, recognizing an individual who promotes sound science and evidence on a matter of public interest, facing difficulty or hostility in doing so.

Researchers in any area of science or engineering, or those who work to address misleading information and bring evidence to the public, are eligible. Sense About Science (@senseaboutsci) explains that the winner will be someone who effectively promotes evidence despite challenge, difficulty, or adversity, and who takes responsibility for public discussion beyond what would be expected of someone in their position. Nominations are welcome until August 1.

2. Evidence to improve surgical outcomes.
Based on Oxford, UK, the IDEAL Collaboration is an initiative to improve the quality of research in surgery, radiotherapy, physiotherapy, and other complex interventions. The IDEAL model (@IDEALCollab) describes the stages of innovation in surgery: Idea, Development, Exploration, Assessment, and Long-Term Study. Besides its annual conference, the collaborative also proposes and advocates for assessment frameworks, such as the recent IDEAL-D for assessing medical device safety and efficacy.

3. Could artificial intelligence replace executives?
In the MIT Sloan Management Review, Sam Ransbotham asks Can Artificial Intelligence Replace Executive Decision Making? ***insert joke here*** Most problems faced by executives are unique, not well-documented, and lack structured data, so they're not available to train an artificial intelligence system. What would be more useful would be analogies and examples of similar decisions - not a search for concrete patterns. AI needs repetition, and most executive decisions don't lend themselves to A/B testing or other research methods. However, some routine/small issues could eventually be handled by cognitive computing.

4. Can data be labeled for quality?
Jim Harris (@ocdqblog) describes must-haves for data quality. His SAS blog post compares consuming data without knowing its quality to purchasing unlabeled food. Possible solution: A data-quality 'label' could be implemented as a series of yes/no or pass/fail flags appended to all data structures. These could indicate whether all critical fields were completed, and whether specific fields were populated with a valid format and value.

Evidence & Insights Calendar:

August 24-25; San Francisco. Sports Analytics Innovation Summit.

September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded by the Agency of Health Quality and Assessment, RAND Europe, and Alberta Innovates.

30 June 2016

Brain training isn't smart, physician peer pressure, and #AskforEvidence.

Brain-Training

1. Spending $ on brain training isn't so smart.
It seems impossible to listen to NPR without hearing from their sponsor, Lumosity, the brain-training company. The target demo is spot on: NPR will be the first to tell you its listeners are the "nation's best and brightest". And bright people don't want to slow down. Alas, spending hard-earned money on brain training isn't looking like a smart investment. New evidence seems to confirm suspicions that this $1 billion industry is built on hope, sampling bias, and placebo effect. Arstechnica says researchers have concluded that earlier, mildly positive "findings suggest that recruitment methods used in past studies created a self-selected groups of participants who believed the training would improve cognition and thus were susceptible to the placebo effect." The study, Placebo Effects in Cognitive Training, was published in the Proceedings of the National Academy of Sciences.

It's not a new theme: In 2014, 70 cognitive scientists signed a statement saying "The strong consensus of this group is that the scientific literature does not support claims that the use of software-based 'brain games' alters neural functioning in ways that improve general cognitive performance in everyday life, or prevent cognitive slowing and brain disease."


Journal.pmed.1002049.t001

2. Ioannidis speaks out on usefulness of research.
After famously claiming that most published research findings are false, John Ioannidis now tells us Why Most Clinical Research Is Not Useful (PLOS Medicine). So, what are the key features of 'useful' research? The problem needs to be important enough to fix. Prior evidence must be evaluated to place the problem into context. Plus, we should expect pragmatism, patient-centeredness, monetary value, and transparency.


Antibiotic_use

3. To nudge physicians, compare them to peers.
Doctors are overwhelmed with alerts and guidance. So how do you intervene when a physician prescribes antibiotics for a virus, despite boatloads of evidence showing they're ineffective? Comparing a doc's records to peers is one promising strategy. Laura Landro recaps research by Jeffrey Linder (Brigham and Women's, Harvard): "Peer comparison helped reduce prescriptions that weren’t warranted from 20% to 4% as doctors got monthly individual feedback about their own prescribing habits for 18 months.

"Doctors with the lower rates were told they were top performers, while the rest were pointedly told they weren’t, in an email that included the number and proportion of antibiotic prescriptions they wrote compared with the top performers." Linder says “You can imagine a bunch of doctors at Harvard being told ‘You aren’t a top performer.’ We expected and got a lot of pushback, but it was the most effective intervention.” Perhaps this same approach would work outside the medical field.

4. Sports analytics taxonomy.
INFORMS is a professional society focused on Operations Research and Management Science. The June issue of their ORMS Today magazine presents v1.0 of a sports analytics taxonomy (page 40). This work, by Gary Cokins et al., demonstrates how classification techniques can be applied to better understand sports analytics. Naturally this includes analytics for players and managers in the major leagues. But it also includes individual sports, amateur sports, franchise management, and venue management.

5. Who writes the Internet, anyway? #AskforEvidence
Ask for Evidence is a public campaign that helps people request for themselves the evidence behind news stories, marketing claims, and policies. Sponsored by @senseaboutsci, the campaign has new animations on YouTube, Twitter, and Facebook. Definitely worth a like or a retweet.

Calendar:
September 13-14; Palo Alto, California. Nonprofit Management Institute: The Power of Network Leadership to Drive Social Change, hosted by Stanford Social Innovation Review.

September 19-23; Melbourne, Australia. International School on Research Impact Assessment. Founded in 2013 by the Agency of Health Quality and Assessment (AQuAS), RAND Europe, and Alberta Innovates.

23 June 2016

Open innovation, the value of pharmaceuticals, and liberal-vs-conservative stalemates.

Evidence_from_openinnovation

1. Open Innovation can up your game.
Open Innovation → Better Evidence. Scientists with an agricultural company tell a fascinating story about open innovation success. Improving Analytics Capabilities Through Crowdsourcing (Sloan Review) describes a years-long effort to tap into expertise outside the organization. Over eight years, Syngenta used open-innovation platforms to develop a dozen data-analytics tools, which ultimately revolutionized the way it breeds soybean plants. "By replacing guesswork with science, we are able to grow more with less."

Many open innovation platforms run contests between individuals (think Kaggle), and some facilitate teams. One of these platforms, InnoCentive, hosts mathematicians, physicists, and computer scientists eager to put their problem-solving skills to the test. There was a learning curve, to be sure (example: divide big problems into smaller pieces). Articulating the research question was challenging to say the least.

Several of the associated projects could be tackled by people without subject matter expertise; other steps required knowledge of the biological science, complicating the task of finding team members. But eventually Syngenta "harnessed outside talent to come up with a tool that manages the genetic component of the breeding process — figuring out which soybean varieties to cross with one another and which breeding technique will most likely lead to success." The company reports substantial results from this collaboration: The average rate of improvement of its portfolio grew from 0.8 to 2.5 bushels per acre per year.

 

Value frameworks context matters

 

2. How do you tie drug prices to value?
Systematic Analysis → Better Value for Patients. It's the age-old question: How do you put a dollar value on intangibles - particularly human health and wellbeing? As sophisticated pharmaceuticals succeed in curing more diseases, their prices are climbing. Healthcare groups have developed 'value frameworks' to guide decision-making about these molecules. It's still a touchy subject to weigh the cost of a prescription against potential benefits to a human life.

These frameworks address classic problems, and are useful examples for anyone formalizing the steps of complex decision-making - inside or outside of healthcare. For example, one cancer treatment may be likely to extend a patient's life by 30 to 45 days compared to another, but at much higher cost, or with unacceptable side effects. Value frameworks help people consider these factors.

@ContextMatters studies processes for drug evaluation and regulatory approval. In Creating a Global Context for Value, they compare the different methods of determining whether patients are getting high value. Their Value Framework Comparison Table highlights key evaluation elements from three value frameworks (ASCO, NCCN, ICER) and three health technology assessments (CADTH, G-BA, NICE).

 

Evidencebased-povertyprograms

3. Evidence overcomes the liberal-vs-conservative stalemate.
Evidence-based Programs → Lower Poverty. Veterans of the Bloomberg mayoral administration describe a data-driven strategy to reduce poverty in New York. Results for America Senior Fellows Robert Doar and Linda Gibbs share an insider's perspective in "New York City's Turnaround on Poverty: Why poverty in New York – unlike in other major cities – is dropping."

Experimentation was combined with careful attention to which programs succeeded (Paycheck Plus) and which didn't (Family Rewards). A key factor, common to any successful decision analysis effort: When a program didn't produce the intended results, advocates weren't cast aside as failures. Instead, that evidence was blended with the rest to continuously improve. The authors found that "Solid evidence can trump the liberal-versus-conservative stalemate when the welfare of the country’s most vulnerable people is at stake."

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