Counterintuitivity

Those who claim, such as Kathleen Parker, that fame killed Whitney Houston, must mean that if her first album had bombed she would be alive today.

How provable is that thesis? How sufficient is the evidence? How relevant, how accurate, how logical is the support offered. Better yet, how could such a thesis be proved by anyone?

Comments encouraged.

Anyone still interested in the polio story will want to know that the last reported case of polio infection was just more than one year ago and did not result in permanent paralysis. Since January of 2011, no case of polio has been reported in India. The story is a major triumph for the world health community, the WHO, the Bill and Melinda Gates Foundation, and the millions of members of Rotary International who have devoted their efforts to polio eradication for years.

New cases of polio are ongoing in Pakistan, Afghanistan, and Nigeria (and a recent outbreak in China marks the first time polio has been seen there in a decade), but for the first time India is not the site of new cases nor an exporter of the virus.

Related stories from several sources:

From Forbes Magazine Bill Gates on India’s First Polio-Free Year

From Times of India
WHO Lauds India’s Polio-Free Drive

The Google search page

From Medical News Today India Polio Free for One Year

From NPR India Marks a Year Free of Polio

CAN A CHEESEBURGER BE A PLACEBO?
This is really hard to believe. You’re all familiar with the placebo effect, I imagine. Patients engaged as subjects in a study to test the effectiveness of a new medication routinely receive one of two regimens: half get the actual medicine; half get a placebo that looks like the real thing but contains no medication. If the medicine is effective, of course, the half that got it get better. But just as often, the half that took the placebo also achieve some improvement in their condition because they believed they were taking medication that could cure them.

It has always been assumed that the patients’ belief that they were receiving curative doses contributed to their healing. But a new study suggests that even patients who are told they’re receiving the placebo can be cured. Let me say that again. Study participants who are told they’re taking useless pills nonetheless gain a therapeutic benefit from participating in the study.

Which prompts me to ask, if participation is the key and the pill is useless, couldn’t I swallow a button instead of a pill and still be cured? Or better yet, couldn’t I eat a cheeseburger each time I was supposed to take a pill?

Here’s the story from the December 27, 2010 New York Times.

A FOOTBALL STADIUM FOR AN ONLINE UNIVERSITY?
Buying Legitimacy: How A Group Of California Executives Built An Online College Empire
Huffington Post March 10, 2011
by Chris Kirkham

CLINTON, Iowa — Inside the red brick campus of Ashford University, perched on a bluff above the Mississippi River, the door marked “President’s Office” remains perpetually shut. Telephone calls to the university’s head are swiftly transferred to a corporate office some 2,000 miles away, in San Diego.

A new, 500-seat football stadium adorns the campus, and is featured prominently in Ashford’s promotional literature, though the university has no football team. Signs around campus proudly read “Founded 1918” and “90 Years Strong,” despite the fact that Ashford — one of the nation’s fastest-growing for-profit colleges — has existed for less than a decade.

The perplexing campus landscape here in Iowa amounts to an elaborate stage set for a lucrative, online education empire that uses these trappings to sell itself to students as a traditional college experience. That strategy was the brainchild of the corporation behind Ashford: Bridgepoint Education Inc., a publicly traded venture started by a group of former executives from the University of Phoenix, a name now synonymous with for-profit higher education and the controversial marketing practices that have brought the industry crosswise with federal regulators.

Six years ago, Bridgepoint purchased what was then called Franciscan University of the Prairies, a near-bankrupt, 300-student college that for decades had been run by a local order of Franciscan nuns. The school delivered a crucial commodity: legal accreditation. That enabled Ashford’s students to tap federal financial aid dollars, the source of nearly 85 percent of the university’s revenues — more than $600 million in the last academic year. Ashford now counts nearly 76,000 students, 99 percent of whom take classes online.

Link to the full story, including video tours of the campus less than 1% of the student body ever see in person.

NUKES IN JAPAN
I find it hard to imagine anything more counterintuitive than the likelihood of a nuclear catastrophe in Japan.

The only place in the world that has suffered nuclear attack is Japan. The only people on earth who have ever been fired on by nuclear weapons were Japanese. The country on earth that should be most terrified of nuclear power is Japan. The country on earth most vulnerable to earthquake is Japan. The most dangerous place to site a nuclear power plant is wherever earthquakes are likely. WTF are nuclear power plants doing in Japan?

The only species of life on the planet that would contemplate (let along follow through on) a plan so patently suicidal as to locate a nuclear reactor in the place most likely to be rocked by earthquake is homo sapiens. The translation for “homo sapiens”? Wise man, or knowing man.

I’m certainly not the only, nor the first, writer to object to the whole idea of nuclear power plants, but I’m proud to be among them. My argument against them is quite simple. 1) They can release as much radioactivity into the atmosphere as nuclear bombs. 2) We should avoid massive releases of radioactivity. 3) The chance of a meltdown is small but measurable. 4) The more plants we build, the more we increase the odds of a meltdown. 5) Eventually (and especially if we build them where earthquakes are likely) one will fail and melt down, and the containment building will be so compromised it can no longer contain anything. 6) As bad as they are, coal burning plants never release radioactivity.

Here’s how Greenpeace feels about it at the moment.

Bad Economy keeps couples together

It seems illogical, but a bad economy might keep couples from divorcing. Of course, the legal process of divorce can be expensive, what with all the legal fees, but it’s also very difficult to split assets if a couple can’t expect to put their house on the market and sell it. Couples used to stay together “for the kids.” Now they may be staying together for the house. What other connections might there be between the national economy and the marriage or divorce rates?

Defending the 33 Round Magazine

It’s hard to imagine, in the aftermath of the Tucson shooting of Congresswoman Giffords and six others, that anyone would write a defense of a Glock with a 33-round clip like the one Jared Loughner fired that horrible day. But Stephen Hunter must have had our class in mind when he decided to think out loud, and very counterintuitively, in the Sunday Washington Post.

Academically Adrift
There may be no better place to improve writing skills and make big advances in critical thinking and reasoning than an American college, but if Richard Arum, the author of Academically Adrift is right, that’s a sad state of affairs. “Commitment to these skills appears more a matter of principle than practice, as the subsequent chapters in this book document. The end result is that many students are only minimally improving their skills in critical thinking, complex reasoning, and writing during their journeys through higher education,” says the author.

According to one study, one possible reason for a decline in academic rigor and, consequentially, in writing and reasoning skills, is that the principal evaluation of faculty performance comes from student evaluations at the end of the semester. Those evaluations, Arum says, tend to coincide with the expected grade that the student thinks he or she will receive from the instructor.

Wikileaks Proves US Actually Quite Competent
Well, at least according to Leslie Gelb. His column in The Daily Beast says, in part: “The Wikileakers dumped a vast pile of secrets to prove that the United States was selfish, stupid and wicked–but their revelations proved just the opposite. When you remove the gossip and obvious trivia that mesmerized the press, you clearly see what the Wikileakers never expected: A United States seriously and professionally trying to solve the most dangerous problems in a frighteningly complicated world, yet lacking the power to dictate solutions.”

The whole topic of digital media influencing governments in the wide open newsmaking, news-influencing culture we live in is full of mystery and discontinuity. If any of it interests you, I’ll be happy to help you find a specific bit to focus on. Here’s one: Facebook Revolution

I try to keep my politics in check in the classroom and just be upset about everything no matter which side of the House it comes from, so I apologize that the article this post links to has Republicans in the title and wants to pick a fight with a political party. I promise I’m equally offended by both parties and would post it if it blamed Democrats for being insane too.

In their purported effort to slash the national budget and restore us to fiscal sanity a year ago, the Republican budget plan proposed to cut $1.6 billion from the Environmental Protection Agency which, it claimed, is smothering our fragile economy with job-killing legislation. In part, the cuts were deliberately designed to curtail EPA programs to encourage renewable energy.

At the same time, the budget proposal defended and left intact $4 billion in subsidies to the oil and gas producing companies. Why? Ending the subsidies would amount to tax increases which would cost American jobs.

Pro Publica carried the story, but you can find it elsewhere too and, of course, it’s not really news now and wasn’t news a year ago. We’ve been subsidizing the enormously profitable oil companies for decades in our hurry to burn everything on earth.

Is it possible long exposure to “procedural TV shows” like CSI has tainted jurors’ expectations? Do citizens sitting on juries expect investigators to have DNA results in 20 minutes, or to employ extremely high-tech methods to catching and convicting every criminal who comes to trial?

An investigation by NPR, PBS Frontline and ProPublica titled “Post Mortem” has exposed how death investigation in America is nothing like what you see on TV. That shouldn’t be too surprising; still, prosecutors complain that shows like CSI make it more likely that jurors will expect ultra-high-tech tests before they’re willing to convict suspects.

What prosecutors call The CSI Effect makes it increasingly difficult to get convictions in the courtroom, they say.

The producers of the CSI series think jurors are too sophisticated to expect computer programs to deliver the detailed and instantaneous results their programs sometimes portray. Still, many legal experts insist jurors often confuse fact with fiction. They feel pressure to convince juries they’ve employed every available high-tech forensic test before they can convince jurors the defendant is guilty.

What do you think? Can this question be researched with credible results?

Ah, the stuff we burn! Take fossil fuels, for example. Why do we continue to burn them after all we know about how they strangle the planet? Because they’re still so cheap. Yes, even when it costs $500 a month to heat our houses, burning what we find below the earth’s crust is still cheaper than anything else we’ve discovered to heat space. Or is it? If we factor the actual cost of all the consequences of burning fossil fuels, the health costs and the environmental costs, nobody could possibly afford to shoulder his share of the burden. We don’t pay for those costs in our utilities bills. And until we do, oil and gas and coal will seem cheap.

The same is true for cars versus public transportation. Is it cheaper to drive to New York City than to take the train? It sure seems so, no matter what gas costs this week. But that highway wasn’t free; clearing it of snow isn’t free; patrolling it with state troopers isn’t free; the real cost of gasoline would break anybody’s budget if we really paid its true cost at the pump, and so on. Until we pay the true costs of commodities, we have no clear concept of what’s really “cheap.”

So, what if cigarettes cost $222 a pack? Maybe they actually do cost $222 a pack, but the cost isn’t collected by the Wawa cashier. Maybe if somebody offered to pay a smoker $222 for every pack she didn’t smoke, she’d find the motivation to quit? Freakonomics sheds some light on these questions.

From there, if you wish, you can quickly link to a more general discussion of the Economy of Desire. Any way you enter the counterintuitive world of freakonomics, you’ll find plenty of unexpected causes and effects.

Still not happy with your research topic? These may get you thinking:

CLEAN GIRLS GET SICKER?
There’s a growing body of research showing that children exposed to lots of germs early in life are less likely to develop allergies, asthma or autoimmune disorders as they grow up. But now there’s a new twist on the theory, known as the hygiene hypothesis in scientific circles, and it’s about little girls in cute little dresses.

In an article in the peer-reviewed journal Social Science and Medicine, Sharyn Clough, a philosopher of science at Oregon State University who studies research bias, says young girls are held to a higher standard of cleanliness than young boys, a discrepancy that could help explain later health differences. Girls are expected to stay squeaky clean while boys are encouraged to play outside, Clough argues. And that might explain why women have higher rates of certain illnesses.

Read the story here.

CANCER-DETECTING DOGS
The article about Dr. Adcock’s failure-prone radiology team may have made you nervous about undiagnosed tumors, but fortunately, there’s a four-legged diagnostician living in your doghouse who’s almost never wrong and works for kibble!

Here’s the link.

BETTER EMPLOYMENT NUMBERS WITHOUT NEW JOBS
The problem with following the unemployment numbers in the news is that they don’t actually track the number of unemployed. Instead, they track the number of people who are “actively seeking employment.” To make matters worse, they decide how many are seeking employment on the basis of how many have registered with the government for unemployment benefits and are providing evidence of their job searches. Any downward change in that number is considered “less unemployment.” I hope you can see the flaws in the Definition and Category claims here. One small article that will get you started thinking about this topic is about a year old but certainly still relevant to today’s numbers.

THE REAL HOME-FIELD ADVANTAGE
Just last night I heard a basketball broadcaster refer to a player’s likelihood of getting a referee’s sympathy by saying: “Well, he’s on the road. He has to know he isn’t going to get that call.” I was immediately reminded of a post I wrote last year about home-field advantage in all sports.

Tobias (Toby) Moskowitz was on the radio then, being interviewed about common misconceptions in sports. He said something like this:

Home field advantage isn’t about relaxing at home while the visitors have to travel to a distant city. It’s not about playing on the frozen tundra to which you’re accustomed while your opponent has to tough out the unfamiliar conditions. It isn’t about the support you feel from thousands of cheering fans clad in your team colors.

It’s the referees. They’re more likely to make calls in favor of the home team. Or so Moskowitz and his team of researchers have concluded, after years of study. These and other common sense but not often cited observations debunk sports myths you may have used to win arguments all your life. They could be a great prompt to your own research into any number of misconceptions about your favorite game, sport, or team.

Scorecasting by Tobias J. Moskowitz and L. Jon Wertheim.

“Scorecasting is both scholarly and entertaining, a rare double. It gets beyond the clichéd narratives and tried-but-not-necessarily-true assumptions to reveal significant and fascinating truths about sports.” —Bob Costas

The more mammograms a radiologist reads, the more obscure tumors she will find. Just so, I hope you’ll become better attuned to spotting counterintuitivities in everything you read as the semester proceeds.

Here are some you may have missed when I assigned you each to find and describe examples of counterintuitive thinking in the “Advertising Failures” reading about Dr. Adcock at Kaiser Permanente.

WHAT DO DATA REALLY MEAN?
Even thorough and meticulous data only leads to knowledge when it’s interpreted correctly. From the article: “Some researchers suggested, however, that other factors might have driven down the death rate. They questioned the soundness of the data. They warned that surgeons might be increasing their scores by avoiding higher-risk patients, a criticism that prompted the state to refine its system.”

Is it possible? Certainly. Doctors routinely refer patients to specialists for the benefit of the patients. They also routinely refer, it stands to reason, for their own benefit, to avoid being sued later for failing to spot illnesses they’re not qualified to diagnose. Might they overreact at times and refer patients they really could help themselves—tricky cases that require tough judgment calls—to protect their success rates? Would their improved scores mean they were suddenly better diagnosticians, or that they had learned to avoid failures?

DOES THE ADCOCK SYSTEM REDUCE CANCER DEATH?
One of you could do a followup. When the article first appeared, the answer was unclear. Kaiser Permanente Colorado keeps good records, as we know from the article. Have they been able to conclude that all the extra effort has saved lives in the long run? More diagnosis should save lives, right? Does it? From the article:

What that means, in the simplest terms, is that the Denver doctors are finding about 15 more cancers a year than they would have at their previous accuracy level. (Kaiser says it does not know if that improvement has affected its breast-cancer death rate.) In a country where 192,000 breast-cancer cases are diagnosed each year, that same increase in accuracy could mean finding upwards of 10,000 more annually.

DOES SCRUTINY IMPROVE PATIENT CARE?
From the article: “Even so, when experts talk about doctors’ skills, the discussion almost always circles back to the conundrum federal officials wrestled with when they wrote the mammography rules a decade ago: How to improve quality without diminishing access to care. If doctors start dropping out of mammography because they score badly in tests or performance audits, where will women go?“

Where indeed. It’s just about impossible in South Jersey to find an obstetrician/gynecologist to deliver your baby in a hospital. So many are sued that none can afford the malpractice insurance. Does that mean Philadelphia ob/gyns are less prone to failure? How does “holding the doctors accountable” through malpractice claims serve the pregnant women who can’t or won’t or don’t go to Philly?

Again from the article: “The balancing act gets trickier and trickier. New research is stoking concern about doctors’ competency. At the same time comes anguished talk about doctors driven away by skyrocketing malpractice rates and shrinking reimbursement.“

DOES PRACTICE MAKE PERFECT?
Doctor Adcock himself, surely the one man most likely to benefit from his particular approach to learning from his mistakes, expressed serious misgivings about its effectiveness for him.

From the article: “Then his latest scores came in, and he really started to worry. He was dumping more X-rays into an ambiguous pile, having failed to decide if they showed cancer or not. Holding his charts, he said, ‘I look at that and think, my goodness, have I forgotten how to read mammograms?”’

HOW DO YOU FIND A GOOD ONE?
This one really troubles me. Does the way we try to enforce accountability actually result in good judgment? We like to go online and read “real customer reviews” about everything from toaster ovens to vacation spots to wedding planners. Sometimes, we think we can outsmart the process by ignoring bad reviews from reviewers who aren’t credible or who have objections we don’t share. But can anything we learn from public records, or patient reviews, really help us choose a radiologist when our life is at stake? Are we competent to judge what we read?

Lawsuits against a doctor, even malpractice judgments against a doctor, might be evidence she’s extraordinarily capable. She’s the surgeon everybody goes to when nobody else can help; she’s the doctor others refer their toughest cases to; she’s the one who will take the chance of failing when every other doctor thinks the patient is a lost cause. So she loses more patients than anybody else. But she might be your best choice.

From the article: “Don’t judge doctors by the lawsuits they have lost for misreading mammograms. Even the best doctors will miss some cancers.”