The Healer

Will Saletan’s dated but still fantastic profile of 2012 Nobel Prize winner Shinya Yamanaka is worth reading:

Shinya Yamanaka, a scientist at Kyoto University, loved stem-cell research. But he didn’t want to destroy embryos. So he figured out a way around the problem. In a paper published five years ago inCell, Yamanaka and six colleagues showed how “induced pluripotent stem cells” could be derived from adult cells and potentially substituted, in research and therapy, for embryonic stem cells. Today, that discovery earned him a Nobel Prize, shared with British scientist John Gurdon. But the prize announcement and much of the media coverage missed half the story. Yamanaka’s venture wasn’t just an experiment. It was a moral project.

Harvey Brooks in a Flow-Chart

Harvey Brooks’s classic “The Resolution of Technically Intensive Public Policy Disputes” suggested a way we can separate experts’ technical judgments from their values:

“Differences among experts resulting from disagreements over the burden of proof might be “smoked out” by requiring each side in a controversy to specify in advance what type of experiment or evidence or analysis would convince them to alter their policy position on a controversial issue…force each side to understand more clearly the bases of its technical judgments and the extent to which those judgments depend…on prior desired policy outcomes, value premises, or [their] biases or implicit value preferences …By shifting the focus of the debate to the real issue, this approach could make the discussion more accessible to the general public. And even if the issue were highly polarized…and the parties were unwilling to stipulate what evidence would sway them, clarification of that fact would help illuminate the debate and isolate the more polarized positions from broader public support-possibly the first step toward an ultimate resolution of the issue “

We can all benefit from this approach. Here is my synthesis of the above in flow-chart form:

 

A lesson in irony

i⋅ro⋅ny: Making broad, vague generalizations about Republicans and science in the same essay where you tout your nuance and complexity:

The point is that science and liberalism alike are rooted in a style of thinking that is nuanced, complex, tolerant of uncertainty. — Chris Mooney

I work with the customers so the engineers don’t have to

Sorry for the longer than usual blogging hiatus. But three weeks ago I started a new job at a small software company in Palo Alto, CA. It’s still very surreal for me to think I now work in corporate America. As recently as August I was sure I would remain in policy my whole life. Only a fortuitous sequence of events changed my outlook. I’m absolutely loving it so far and don’t mind the long hours.

If you want to know know what I do (and didn’t get the reference in the title), the video above pretty much summarizes it.

Unfortunately, this youthful enthusiasm and hard work means blogging will take a bit of a break. I figure it will be at least another week or two before I figure out my schedule and thinks slow down a bit.

To not completely leave you empty-handed, here’s Daniel Engber’s fantastic essay on the flawed use of mice in biomedical research:

When Mattson made that point in Atlanta, and suggested that the control animals used in labs were sedentary and overweight as a rule, several in the audience gasped. His implication was clear: The basic tool of biomedicine—and its workhorse in the production of new drugs and other treatments—had been transformed into a shoddy, industrial product. Researchers in the United States and abroad were drawing the bulk of their conclusions about the nature of human disease—and about Nature itself—from an organism that’s as divorced from its natural state as feedlot cattle or oven-stuffer chickens.

Maps of Science

David Bruggeman highlighted this pretty graphic from Wired showing connections between research fields:

David believes such maps can help policy-makers identify potential connections between clumps of research. I’m a bit skeptical they’ll ever be used in this way. But there’s nothing wrong with creating something just because it’s pretty to look at!

Nurses, doctors, and doctorates

Apparently some nurses now want to be called doctors:

With pain in her right ear, Sue Cassidy went to a clinic. The doctor, wearing a white lab coat with a stethoscope in one pocket, introduced herself.

“Hi. I’m Dr. Patti McCarver, and I’m your nurse,” she said. And with that, Dr. McCarver stuck a scope in Ms. Cassidy’s ear, noticed a buildup of fluid and prescribed an allergy medicine.

It was something that will become increasingly routine for patients: a someone who is not a physician using the title of doctor.

Dr. McCarver calls herself a doctor because she returned to school to earn a doctorate last year, one of thousands of nurses doing the same recently. Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title “doctor,” but also the money, power and prestige that often comes with it.

As more nurses, pharmacists and physical therapists claim this honorific, physicians are fighting back. For nurses, getting doctorates can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients. But so far, the new degrees have not brought higher fees from insurers for seeing patients or greater authority from states to prescribe medicines.

I guess the lack of a similar discussion around PhD space physicists only proves how unimportant my field really is. In all seriousness, I’m interested in seeing more details of the quoted studies. Is it really true that nurses are “perfectly capable of recognizing a vast majority of patient problems?”

If the dental field is any analogue, I know that my teeth are often cleaned just fine by a dental hygienist. Apart from fields like neurosurgery, I suspect much of medicine is similar.

The blogosphere cont.

To offer some final thoughts on the blogosphere, here’s Freddie yet again:

I guess I just wish that the blogosphere (and forgive the collective indictment) at least demonstrated interest in the question, “how are we making knowledge?” Taken as a whole, I don’t think that there’s a coherent epistemology of blogging out there, even in the most elementary or general sense. For all of the navel-gazing that bloggers undertake, they appear uninterested in the fundamental questions of what value blogs are creating and what systems of accountability there are for ensuring that truth claims are actually true.

Freddie is begging the question here. Since when did creating knowledge become the primary goal? Even academic blogs I’m familiar with care more about knowledge dissemination than creation per se. The political blogosphere seems more interested in analysis and affecting public discourse than anything else.

It’s just so academic to think that creating better knowledge will somehow solve our problems, and that anyone even tangentially involved in the enterprise should care first about this task. But even if the blogosphere did develop a coherent epistemology, I’m not sure how much good it would do. The academy has a finely honed epistemology, and it still produces a lot of bad work that no one really cares about.

Good knowledge does not always equal useful or worthwhile knowledge. Knowledge in any form is not always the goal. The blogosphere implicitly recognizes these facts, and that’s a good thing.

On the blogosphere and readers’ responsibilities

While I try to stay within the confines of science studies, Freddie DeBoer’s latest missive warrants a response. Not content to simply critique the flaws in Matt Yglesias’s prediction on the decline of the university, Freddie felt it necessary to attack the blogosphere writ-large:

As it happens, pay blogging has actually been on the uptick, as Yglesias himself has pointed out– with reference to evidence, making this post vastly more valuable than his recent ones on college. If he treated them in that way, I wouldn’t mind the conjecture, but that’s not the case. There is no indication in these posts that Yglesias takes one more seriously than the other, or that he recognizes the value of empirical evidence and the poverty of speculative claims about the future. This is a really good example of what I was recently complaining about on Balloon Juice, the conspicuous lack of epistemological distinctions and accountability in the blogosphere. Yglesias is essentially making things up here, whereas he was responsibly reading empirical data when it came to the blogging boom. Yet there’s no consistent system of knowledge generation that privileges the latter over the former, and no accountability to be found within blogging to correct his poor reasoning.

That last sentence is a bit strange. In this very post, Freddie spends 500-odd words serving up the kind of blogospheric accountability he insists doesn’t exist. Matt swung and missed here, and Freddie quickly pounced. This is what is supposed to happen.  Precisely because so many people can read and pick apart sloppy arguments, we shouldn’t worry so much when bad ones are advanced.

The blogosphere was never intended to replace longform journalism or peer-review, which almost by definition are coherent and well-researched while limited in scope and time-consuming. The blogosphere reverses these qualities. In the past three days alone, Matt has authored thirty-three posts. Surely Freddie doesn’t expect every  one of them to reference the latest NBER report. Matt does what anyone who every day writes thousands of words on topics as diverse as evolution, social insurance, political rhetoric, bank regulation, Islam, war in Iraq, the Danish elections, and monetary policy would do.  Some posts (perhaps too few) are rigorous, well-thought out and draw from established scholarship while some are not. So it’s a bit much to claim Matt doesn’t “recognize the value of empirical evidence.” More likely, this piece was composed within 10 minutes and we shouldn’t take it that seriously.

By requiring excellence in every post, Freddie neglects his duties as a blog reader while narrowing the richness of what the blogosphere offers. Blogs demand more of their readers exactly because they demand so little of their writers. Readers should know what they’re getting into before they engage with the medium. Don’t visit blogs if you want carefully constructed prose that references the latest Science paper.

Restricting the one venue where informed analysis happily co-exists with  partial and even complete ignorance won’t necessarily improve the blogosphere. It will make for watered-down journalism.

Is there no place to think out loud? To offer visceral predictions? To describe the vague impressions we all have that we know aren’t grounded in evidence? And if the blogosphere cannot fulfill this role, where should it exist?

Perhaps Matt should have started: “Hey guys, this post is less meticulous than some of my others. Take it with a grain of salt.” Perhaps such caveats would better delineate the good from the bad. But perhaps readers should recognize armchair theorizing when they see it.

Writers rightly expect their readers to bear some responsibility in the transaction. In the blogosphere, even more so.

Women’s quest for romance and their scientific pursuits

UPDATE: In the comments, Marci send this link that goes into some detail on the flaws in the study. It’s a bit long, but well worth the read if you have time. Thanks Marci!

The girlfriend sent me this link and demanded a hat-tip (hot-tip?) for being a woman and in science:

The studies, funded in part by the National Science Foundation, were undertaken to determine why women, who have made tremendous progress in education and the workplace over the past few decades, continue to be underrepresented at the highest levels of STEM.

The research is described in the article, “Effects of Everyday Romantic Goal Pursuit on Women’s Attitudes toward Math and Science,” to be published in the September issue of Personality and Social Psychology Bulletin.

Lead author Lora E. Park, PhD, UB associate professor of psychology and her co-authors, found converging support for the idea that when romantic goals are activated, either by environmental cues or personal choice, women — but not men — show less interest in STEM and more interest in feminine fields, such as the arts, languages and English.

Two quick points. First, the myriad studies I’ve seen along these lines rarely offer constructive suggestions on what I should do to change things. It is clearly a problem that women are often socialized away from science…but how should I change my behavior? And will it make a difference?

Second, such work should be complemented with deeper reporting and in-depth case studies. Numbers are important, but they don’t tell everything. Individuals don’t exist in general trends, and the girls who end up turning to arts and English made (at least partially) a conscious decision to do so. I’d like to hear from some of them and in their own words why they turned away from science. I suspect that that they don’t perceive their decision to be the tragedy that we do.

As TNC has argued repeatedly in the context of black Americans, it’s easy to look at this type of research, combine it with a few armchair statistics on women in science, and conclude that women turning away from science is nothing but a problem to be fixed. While on one level I agree with the characterization, it’s important not to rob people of agency and the capacity to decide for themselves.

Modern science is really hard

Down in the comment weeds of a recent Roger Pielke Jr post, I came across a great Megan McArdle piece on, among other things, the difficulty of translational research. It is, quite simply, very hard to take a bioscience discovery and turn it into a useful drug. Here is former NIH director Elias Zerhouni:

When he arrived at Sanofi, “I thought the solution would be simple,” Zerhouni said at a recent R&D press event attended by the Health Blog. He thought the answer to the company’s R&D woes was to make it more creative and more nimble, like a small biotech.

But he realized that small biotechs are no more successful than large drug makers at coming up with new drugs. “At the end of the day, there’s a gap in translation,” he said.

Zerhouni’s observation reminded me of this graph of the productivity slowdown in pharmaceutical R&D. I wonder how much of this trend can be attributed to “all the low-hanging facts having been found.“

Along those lines, here is Atul Gawande commenting on medicine today:

We are at a cusp point in medical generations. The doctors of former generations lament what medicine has become. If they could start over, the surveys tell us, they wouldn’t choose the profession today. They recall a simpler past without insurance-company hassles, government regulations, malpractice litigation, not to mention nurses and doctors bearing tattoos and talking of wanting “balance” in their lives. These are not the cause of their unease, however. They are symptoms of a deeper condition—which is the reality that medicine’s complexity has exceeded our individual capabilities as doctors.

The core structure of medicine—how health care is organized and practiced—emerged in an era when doctors could hold all the key information patients needed in their heads and manage everything required themselves. One needed only an ethic of hard work, a prescription pad, a secretary, and a hospital willing to serve as one’s workshop, loaning a bed and nurses for a patient’s convalescence, maybe an operating room with a few basic tools. We were craftsmen. We could set the fracture, spin the blood, plate the cultures, administer the antiserum. The nature of the knowledge lent itself to prizing autonomy, independence, and self-sufficiency among our highest values, and to designing medicine accordingly. But you can’t hold all the information in your head any longer, and you can’t master all the skills. No one person can work up a patient’s back pain, run the immunoassay, do the physical therapy, protocol the MRI, and direct the treatment of the unexpected cancer found growing in the spine. I don’t even know what it means to “protocol” the MRI.