"All the news that's fit to print."

Results Unproven, Robotic Surgery Wins Converts - nytimes.com

Old joke: Severity scale for lies: lies, damn lies, and statistics. In my areas of professional endeavor, when I execute comparative studies I'll use commonly excepted statistical methods like 2-sample t-tests, which in turn require certain technical prerequisites like, is the population's behavior I'm studying normal (you know, that old college friend of ours, the bell curve)? Am I comparing populations which can be sorted by the variables I've selected to partition them by? Of course as the health care reform continues to simmer, the usual suspects (Our editorial policy does not affect our news editing functions. No really.  Stop laughing.) appear with their helpful information to educate the public with. Stuff does get technical, but out and out misrepresentation doesn't help. Here's a data set which, if it was normal, would look like a diagonal line:

What does this mean?  Well, most statistical methods assuming a "normal" probability distribution will probably give you a questionable conclusions on questions like, "Does treatment "A" effect my process the same way as treatment "B"?", or "What is the probability of making what we call a Type I error (the thing I have said is true is actually false)?".  More importantly, what does this have to do with "The Paper of Record".  Notice the Times is talking to physicians who utilize manual surgical methods for relieving prostrate restrictions of the male urethra and the recent popularity of Intuitive Surgical's DaVinci system with urologist patients (1.  Study participants should not bias your conclusions).  Further, the Times produces data saying clinical outcomes between manual methods and more instrumented methods are not statistically different.  The implication is "idiot" patients are being sold by clever marketing campaigns which consume more healthcare dollars, while delivering few real benefits.  What the Times buries in the article is the fact the Medicare data used confounds robot surgical systems and endoscopic surgery.  They both use instruments, and they both work with small incisions, but the robotic system is much more precise.  Does this matter?  It needs to be validated by actual clinical outcome studies (which take time), but I suspect the answer from the anecdotal record is yes (not to mention the reduced postop recovery time).

The interesting thing about the article is it seems to unjustifiably conclude we don't need this "expensive", "unproven" medical device.  Does this article seem to prepare the ground for the Times support of health care reform (which focuses on basic medical services we want to get for "free")?  I'll let you reach your own conclusions, but I'm a cynic with most media reports these days.

And if my prostrate doubles or triples in size, I'll probably look for a urologist who has an extensive track record with the DaVinci machine.

"Where do they go?"

The Weekend Interview with Temple Grandin: Life Among the 'Yakkity Yaks' - WSJ.com

Interesting article (also an interesting HBO movie simply called, Temple Grandin), about a young woman suffering from autism who went on to earn advanced degrees in agricultural sciences. Today her chute and mechanism designs to handle cattle in feed lots and slaughter houses are widely employed throughout the country. She teaches at Colorado State today, and is also sought after as a speaker on autism. My interest in her reflects her acute awareness of visual patterns, and her capability to utilize her unique individual perception to model systems. This, of course leads back to the question of "What is intelligence?". How do we see things? How do we recognize things? Temple had very little use, or interest in social relationships, and yet took her unique perspective and capabilities to engineer devices that met a variety of requirements better than their predecessors (some requirements weren't even recognized by their users).

I think part of this achievement reflected a freedom from the tyranny of majority suppositions. Temple simply observed from within the edifice of her own mind. Once she could model the behaviors she was interested in, it was a much smaller jump to design devices intended to complement them. Perspectives, to be useful, are not limited to a majority view.

"his heart was going like mad and yes I said yes I will Yes. "

Quote above is from Molly Bloom's soliloquy in chapter 18 of James Joyce's "Ulysses". I guess it's a nice counterpoint and historical bookend to John Meyer's reported Playboy interview this past week on his varied sexual exploits. I like John Meyer's music, but his Tweets seem to attract more attention for his apparently undisciplined commentary (which I guess is a form of some discipline in terms of his consistent behavior) then any insight into his art. I'm at a loss to explain our attraction to monied outrageousness, label its practitioners as celebrities, and then grasp at translations of their twisted thoughts and pronouncements for some type of insight. I suspect John, his denials to the contrary, is simply an attendee at his own personal “all you can eat” buffet. Does he derive any satisfaction from his own experiences? Who knows? I suspect his representation of some type of postmodern courtship is more of a “tweet level” justification for his personal hedonism than anything else.

As for the rest of us, the question of what we are pursuing never seems to be totally clear. Is it a desire for companionship, a coupling with our “soul mate”, or a loss of self in some pleasurable hormone mediated carnality? Maybe it’s a little bit of all these things, with the true origins lost in misty memories of our own adolescence. Maybe we wake up one morning and find ourselves in a deep sea of emotional and physical intimacy, whose depth and breadth we could not have understood, or suspected, when we entered these waters so many years ago. Maybe we’re glad for some degree of meaning and significance beyond ourselves, glad simple fortune allowed us to participate in this old dance with a good partner, and thankful for an opportunity to somehow stretch the bounds of this mortal frame and for short durations simply “be”, free of even a consciousness of our own finite nature.

I guess I'd rather sign up with Molly than John.

Would you like a little more tea?

A "Tea Party" convention was held in Nashville a few weeks ago, and I was impressed by the fiscal conservatism and calls for legislative transparency which seemed to characterize the majority focus of the six hundred attendees. Of course, there was also the Tom Tancredo rant on civic literacy (which seemed to run off the track shortly after he started with the references to illiterate foreign socialists putting Barack Obama in the White House), the “Birthers” (who believe Obama shouldn’t be in the White House because he isn’t really a native born US citizen and Hawaii officials are conspiring to hide the birth certificate), and the “Truthers” (who believe 9/11 was also some type of government conspiracy, or at least government “white wash” of the actual events). I’d like to think these folks were a really minority position in this nascent movement, but the truth is they were obviously there in some number. Glen Beck, interviewing Rick Perry’s Republican “Tea Party” primary opponent Debra Medina, concluded the interview real quickly once Debra aired her belief some of the “Truther” accusations needed to be investigated thoroughly (where’s Oliver Stone when you need him). Hopefully Ms. Medina’s polling will go into decline going forward.

I like fiscal conservatism and legislative transparency, but really could do without the conspiracy nuts (no objective evidence of anything other than their own delusions), or outright bigots. Still, as a First Amendment absolutist, I really do want these people to speak so the movements they attempt to represent can disown them (the early conservative movement in the Republican party in the 50’s and 60’s was forced to do the same thing with the KKK and John Birch folks who needed to be identified as repulsive to real conservatives). What proportion of “Tea Party” folks are represented by present day “repulsive” extremists? My gut guess is 10 to 20%. Still, I hope the majority disowns these folks in a timely fashion. The country’s voters deserve more than a choice between “liberal” and “liberal-light”.

Consequences schmonsequences... as long as I'm rich.

The consequences of the great American real estate gamble continue to accumulate. In formerly booming real estate markets, like southern Florida, prices have again started to decline. The interesting thing is a sizeable proportion of the population and media seems to expect the federal government to remedy what, basically, were bad purchase decisions by individual buyers. Of course this seems to parallel a number of recently stated public expectations where we expect profits to be private and losses to be socialized. Whether this approach is healthy for civic society, or our country, remains to be seen.

Contracts, from my perspective, represent a codified public trust between individuals, or groups, whose only relationship may be the commercial transaction they jointly participate in. Is it really the duty of the federal government to isolate us from the negative consequences of those relationships and contracts we voluntarily enter? Would this destroy the power of markets to discipline both buyers and sellers (specifically caveat emptor). More importantly, would we want a federal government with such powers?