Tuesday, January 17, 2017

How Not to Run a VC Entity

MIT had announced its Engine Initiative, an intent to have a $250 million fund to invest in start up based upon the technology coming from the Institute. I never saw this as a positive, in fact it can have great down side effects.

Today they announced the "Team" to oversee this effort. You really cannot make this up.

My first question would be:

"Have any of these people ever run a start up?"

I would strongly doubt it. Then when you see all of these people, first it costs money, lots of it to keep all these folks going. That drives up tuition.  Second, massive committees like this never get anything done. The Soviets had dozens of Five Year Plans, see where that landed them.

There is a wealth of VC entities just around the corner. Why do something like this. The assembly of this massive team clearly demonstrates that many have not a clue.

Monday, January 16, 2017

Problems with Peer Review

There has always been a potential problem with Peer Review. Namely the Reviewers are not always pristine. The latest example is extraordinary.

In the Annals of Internal Medicine an author harmed in the process writes:

Dr. Doctor,I am aware that you recently admitted to wrongly publishing, as your own, a scientific research paper that I had submitted to Annals of Internal Medicine. After serving as an external peer reviewer on our manuscript, you published that same manuscript in a different medical journal a few months later. You removed the names of the authors and the research site, replacing them with the names of your coauthors and your institution.It took 5 years from conceptualization of the study to publication of the primary analysis (1). This study was my fellowship project and required a lot of work. It took effort to find the right research team, design the study, raise the funds, get approvals, recruit and create materials for study participants, run the diet classes, conduct the study visits, compile and analyze the study data, and write the initial report. The work was funded by the U.S. government and my academic institution. The secondary analysis that you reviewed for Annals used specialized methods that took my colleagues many years to develop and validate. In all, this body of research represents at least 4000 hours of work. When you published our work as your own (2), you were falsely claiming credit for all of this work and for the expertise gained by doing it.As you must certainly know, stealing is wrong. It is especially problematic in scientific research. The peer-review process depends on the ethical behavior of reviewers. Physicians and patients depend on the integrity of the process. Such cases of theft, scientific fraud, and plagiarism cannot be tolerated because they are harmful and unethical. Those who engage in such behavior can typically expect their professional careers to be ruined: Loss of reputation, loss of employment, and ineligibility for future research funding are the norm. Coauthors are also collaborators in the fraud, and such losses potentially apply to them as well. All the previous publications of those who steal others' work become suspect, and it reflects poorly on their training institutions, current employers, collaborators, and mentors.
 
It seems that one of the Reviewers just took the paper and put names on it. Legally this may be a bit more than plagiarism, especially if it relates to Government funded work. 

I wonder how this one will turn out. Sorry for the original author!

Friday, January 13, 2017

Happy Friday 13th!

Friday the 13th of a January has always been an interesting day personally. So I look forward to the next few hours!

Cheers to all!

Tuesday, January 10, 2017

Disintermediation

Some thirty seven years ago I discovered disintermediation. Some call it "creative destruction". Simply it is the process whereby and existing channel of distribution, say selling shoes, gets changed. So we go from a system where to obtain a pair of shoes we go to a shoe maker, who measures our feet, asks us what type of leather we want and then after some long period we get our shoes.

In this world, which actually existed, we may have one or at best two pairs of shoes. First they are expensive and second shoemakers can just make so many.

Switch to Amazon. I can log on look for what I want and then get it delivered the same day. Also the price is such that I may have a dozen or more shoes. Athletic shoes, beach shoes, dress shoes, hiking boots, snow shoes, and a second or third pair of dress shoes. Lots of shoes.

What happened. Disintermediation. The distribution channel changed. The nexus between maker and consumer was dis-intermediated by multiple parties including Amazon.

Now go to the current Twitter President. And the Movie Elite. Back in the old days of cobblers, the Movie Elite had a hand in glove relationship, symbiotic as it was, with the Broadcast media. If it were NBC or ABC or whatever, some movie elite could make a statement about a politician and the networks would carry it and if the politician did not like it the best they could hope for was some Page 10 note commenting on such.

Now with Twitter, I don't use it so I am relying on the media, true, fake and otherwise that iut exists, the movie elite and the media elite get dis-intermediated. Like the old cobbler, they get shouted down by the person with some 140 characters!

These folks have not yet realized that the game has changed. Communications channels are ever more fluid and can be rapidly dis-intermediated. RT knows this better than China Daily. Trump knows this better than the Elites.

It will be interesting to see how this changes. Oh and yes, since I have never seen a football game and have no idea about this martial arts thing, I boxed as a young man, but only until my nose was broken three times, I have no Ox to be gored in this fight. One player brings all the power of the Elites, the other brings Twitter. So who do you think will win?

Monday, January 9, 2017

They are at it Again!

Prostate Cancer is a multifaceted malignancy. BRCA2 genes can make the result explosive and lead to rapid death. Many however are indolent. Knowing how to select which is which has not yet been achieved.

In a recent article a physical writes in Health Affairs:

The indolent nature of many prostate cancers has heightened concerns that harms from treatment may outweigh those from the disease and has resulted in a growing consensus in favor of less aggressive screening and treatment. We sought to understand the population-level impact of this consensus on the treatment of prostate cancer. Using national Medicare data for the period 2007–12, we assessed treatment rates among men with newly diagnosed prostate cancer. We identified both population-based rates (which are sensitive to changes in diagnosis and treatment patterns) and rates among diagnosed men (which are sensitive only to changes in treatment patterns). We also assessed trends in treatment among men with a high risk of noncancer mortality, who are unlikely to benefit from treatment. Population-based treatment rates declined by 42 percent, while rates among diagnosed men declined by only 8 percent. Treatment rates among men with the highest noncancer mortality risk and regional variation were unchanged. These results suggest that decreasing rates of diagnosis, changing attitudes, and guidelines calling for reduced prostate-specific antigen screening, not changes in practice patterns among specialists treating diagnosed men, drove the decline in population-based treatment rates. Compared to policies that emphasize volume, those that emphasize value in specialty care have the potential to exert stronger effects on practice patterns. 

Read the last sentence carefully. Value. It is like Quality. It has not absolute meaning and it would appear that as it is in the eye of the beholder and not the patient, well you guess it. That was the core of the ACA. Not any per-existing condition, but who gets to decide who lives and who dies.

Now read Science Daily which reflects on this article:

The researchers recommend new payment models or other policies that emphasize value of care over volume, which might provide more incentive for specialists to choose observation over treatment. They also urge participation in quality improvement initiatives, such as the Michigan Urological Surgery Improvement Collaborative, which strive to provide high quality, evidence-based care.
In addition, research continues to uncover new clues to identify which men are at highest risk of aggressive prostate cancer and could most benefit from screening and treatment. "That's really the concern here. We know prostate cancer is a deadly disease in some men. We need better tools to identify which men should be screened and among those diagnosed, which men should be treated aggressively. This is still a black box. It's that uncertainty that leads to different approaches to treatment based on how different physicians view the risk. If we get better predicting who's at highest risk, we can more accurately tailor screening and treatment," 

The statement is in my opinion grossly arrogant. The physician gets to decide if the patient should be treated? Really? What about the patient. After all he has paid for this. So we just let him die because some academic decides to do so. 

Why does the ACA need to be repealed and redone? Life versus Death, the patient versus the system.

China and Trump

The current Administration seems fixated on the power of RT to influence Americans. Then there is such sites as China Daily which lays bare threats and uncertainty.

China Daily states:

...professor and chair of the department of political science at the University of St. Thomas in Houston, Texas, said: "Trump is about to create a very difficult period in China-US relations, one that may rival that of the 1950s and 60s. I am deeply concerned that Trump is rapidly moving US foreign policy toward a deep Cold War mindset regarding China. "My profound fear is that Trump has surrounded himself with anti-China hardliners who have little experience with or expertise on China, have rarely, if ever, visited the country, and have little understanding beyond textbooks and oped pieces of the nuances and subtleties of China's history, culture, and political system."

I am not aware of this Professor of what appears to be a small Catholic college in Texas, but it seems that he has become a statement maker for the Regime. Surprised no Harvard, Stanford, Yale or Princeton types.

In contrast the article continues:

...deputy director of research at the School of Regional and International Studies at the Far Eastern Federal University in Vladivostock, Russia, said the exchange of goodwill between Trump and Moscow signals subtle changes in Russia's ties with China. According to public opinion surveys, Russia was the only country to prefer Trump over Hillary Clinton, the Democratic Party's presidential candidate. "Since 2012, ties between Moscow and Beijing have been expanding and deepening, especially in the political-military domain," Lukin said. If Moscow normalizes relations with Washington, "the Sino-Russian partnership will continue, with the emphasis shifting to economics and trade", he added.

How much of this is game playing and muscle stretching and how much reflects a fundamental change is yet to be played out. China and Russia have had a tenuous relationship at best over the decades. You cannot buy anything Made in Russia at Walmart but there are still tons of Made in China.

It is surprising that the organ that the Chinese use to send out a message  use Academics so far from the base. Vladivostok is not Moscow, but it is quite reputable. Houston is not Cambridge yet it is no where close to Vladivostok.

One should ask; what this message means and to whom was it directed?