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Racial Bias in Pulse Oximetry Measurement | NEJMThus, in two large cohorts, Black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry as White patients. Given the widespread use of pulse oximetry for medical decision making, these findings have some major implications, especially during the current coronavirus disease 2019 (Covid-19) pandemic. Our results suggest that reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia. It is important to note that not all Black patients who had a pulse oximetry value of 92 to 96% had occult hypoxemia. However, the variation in risk according to race necessitates the integration of pulse oximetry with other clinical and patient-reported data.
Yale study shows class bias in hiring based on few seconds of speech | YaleNewsThe researchers based their findings on five separate studies. The first four examined the extent that people accurately perceive social class based on a few seconds of speech. They found that reciting seven random words is sufficient to allow people to discern the speaker’s social class with above-chance accuracy. They discovered that speech adhering to subjective standards for English as well as digital standards — i.e. the voices used in tech products like the Amazon Alexa or Google Assistant — is associated with both actual and perceived higher social class. The researchers also showed that pronunciation cues in an individual’s speech communicate their social status more accurately than the content of their speech. The fifth study examined how these speech cues influence hiring. Twenty prospective job candidates from varied current and childhood socioeconomic backgrounds were recruited from the New Haven community to interview for an entry-level lab manager position at Yale. Prior to sitting for a formal job interview, the candidates each recorded a conversation in which they were asked to briefly describe themselves. A sample of 274 individuals with hiring experience either listened to the audio or read transcripts of the recordings. The hiring managers were asked to assess the candidates’ professional qualities, starting salary, signing bonus, and perceived social class based solely on the brief pre-interview discussion without reviewing the applicants’ job interview responses or resumes. The hiring managers who listened to the audio recordings were more likely to accurately assess socioeconomic status than those who read transcripts, according to the study. Devoid of any information about the candidates’ actual qualifications, the hiring managers judged the candidates from higher social classes as more likely to be competent for the job, and a better fit for it than the applicants from lower social classes. Moreover, they assigned the applicants from higher social classes more lucrative salaries and signing bonuses than the candidates with lower social status.
The Influence of Industry Sponsorship on the Research Agenda: A Scoping ReviewCorporate interests can drive research agendas away from questions that are the most relevant for public health. Strategies to counteract corporate influence on the research agenda are needed, including heightened disclosure of funding sources and conflicts of interest in published articles to allow an assessment of commercial biases. We also recommend policy actions beyond disclosure such as increasing funding for independent research and strict guidelines to regulate the interaction of research institutes with commercial entities.
Clinical Trials of Therapy versus Medication: Even in a Tie, Medication wins | The BMJThe medical community strives to make decisions based on evidence, but as this case illustrates we have unfortunately arrived at a point where taking the conclusions of clinical trials at face value is apparently a sign of naivette. Conflicts of interest may play an important role in the reporting of scientific findings. The problem is not limited to just a couple of isolated cases but involves the entire culture of medicine that has developed over the past ten years. Put bluntly, the scientific machinery is broken. There is no easy fix, but surely patients deserve better.
Clinical Trials of Therapy versus Medication: Even in a Tie, Medication wins | The BMJHowever, disclosure of the relationship would not have changed the troubling end result: A researcher with a history of being funded by SSRI makers completes a 'gold-standard' federally-funded study of post stroke SSRI use, which is published in one of the most prestigious medical journals in the world, and is given a forum in the national media to tell the general public that anyone who has had a stroke, whether or not they have been diagnosed with depression, should start a prophylactic regimen of Lexapro ...even though non-medical approaches perform just as well.
The cumulative effect of reporting and citation biases on the apparent efficacy of treatments: the case of depressionFigure 1 demonstrates the cumulative impact of reporting and citation biases. Of 105 antidepressant trials, 53 (50%) trials were considered positive by the FDA and 52 (50%) were considered negative or questionable (Fig. 1a). While all but one of the positive trials (98%) were published, only 25 (48%) of the negative trials were published. Hence, 77 trials were published, of which 25 (32%) were negative (Fig. 1b). Ten negative trials, however, became ‘positive’ in the published literature, by omitting unfavorable outcomes or switching the status of the primary and secondary outcomes (Fig. 1c). Without access to the FDA reviews, it would not have been possible to conclude that these trials, when analyzed according to protocol, were not positive. Among the remaining 15 (19%) negative trials, five were published with spin in the abstract (i.e. concluding that the treatment was effective). For instance, one article reported non-significant results for the primary outcome (p = 0.10), yet concluded that the trial ‘demonstrates an antidepressant effect for fluoxetine that is significantly more marked than the effect produced by placebo’ (Rickels et al., 1986). Five additional articles contained mild spin (e.g. suggesting the treatment is at least numerically better than placebo). One article lacked an abstract, but the discussion section concluded that there was a ‘trend for efficacy’. Hence, only four (5%) of 77 published trials unambiguously reported that the treatment was not more effective than placebo in that particular trial (Fig. 1d). Compounding the problem, positive trials were cited three times as frequently as negative trials (92 v. 32 citations in Web of Science, January 2016, p < 0.001, see online Supplementary material for further details) (Fig. 1e). Among negative trials, those with (mild) spin in the abstract received an average of 36 citations, while those with a clearly negative abstract received 25 citations. While this might suggest a synergistic effect between spin and citation biases, where negatively presented negative studies receive especially few citations (de Vries et al., 2016), this difference was not statistically significant (p = 0.50), likely due to the small sample size. Altogether, these results show that the effects of different biases accumulate to hide non-significant results from view.
What you don't look for can't hurt your share price...Only nine of 185 randomized clinical trials and 23 of 259 non-randomized studies and patient reports of methylphenidate in children and adolescents with ADHD reported assessment of psychotic symptoms.
Changes in publication criteriaResearch sponsored by the pharmaceutical industry is facing a number of challenges. Questions have been raised about the mismatch between the research agendas of the pharmaceutical industry and consumers of research.56 Meta-analysts are confronted with the problems of duplicate publication of data from company funded trials and the withholding of data.49,57,58 Leading medical journals recently decided to establish more rigorous criteria for the acceptance of research sponsored by industry; this is a step in the right direction towards increasing the credibility of studies paid for by drug companies.58 The revised CONSORT statement should also help improve the quality of clinical research.59,60 In addition, authors and editors should consider including a statement concerning prior beliefs of the investigators about the uncertainty of the treatments that are reported. Finally, all clinical trials should be registered prospectively as the only way to prevent publication bias.61 The proposal to do so which was put forward in 198662 has been periodically renewed,63–65 but to this date has not been implemented.
Under challenge: Girls' confidence level, not math ability hinders path to science degrees -- ScienceDailyThe research team found perception gaps are even wider at the upper levels of mathematics ability -- among those students with the most talent and potential in these fields. Boys are significantly more confident in challenging mathematics contexts than otherwise identically talented girls. Specifically, boys rated their ability 27 percent higher than girls did. Perceived ability under challenge was measured using a nationally representative longitudinal study that followed 10th grade students over a six-year period until two years after high school. A series of questions in the 10th and 12th grade surveys asked students to indicate their level of agreement with statements such as "I'm certain I can understand the most difficult material presented in math texts."
The Paradox of Disclosure - The New York TimesMy latest research, published last month in the Proceedings of the National Academy of Sciences, reveals that patients with localized prostate cancer (a condition that has multiple effective treatment options) who heard their surgeon disclose his or her specialty bias were nearly three times more likely to have surgery than those patients who did not hear their surgeon reveal such a bias. Rather than discounting the surgeon’s recommendation, patients reported increased trust in physicians who disclosed their specialty bias. Remarkably, I found that surgeons who disclosed their bias also behaved differently. They were more biased, not less. These surgeons gave stronger recommendations to have surgery, perhaps in an attempt to overcome any potential discounting they feared their patient would make on the recommendation as a result of the disclosure.
The media doesn't see its own pampered blindness.Despite claiming to “know” Mr. Jobs after “scores of hours in private conversations,” Mr. Mossberg of ReCode said in his column: “I know very little about his relationship with his daughter Lisa.”
On Gawker’s Problem With Women — Matter — Medium“Nick has issues working with women in general. I think it’s sort of a semi-purposeful thing where he doesn’t understand how to talk to them and how to listen to them.” — Alex Pareene “Oh, that one is too silly for me to respond to.” — Nick Denton O
Google chairman gets called out for cutting off a woman while talking about diversity at SXSW"Given that unconscious bias research tells us that women are interrupted a lot more than men, I'm wondering if you are aware that you have interrupted Megan many more times," she asked, which immediately prompted a round of cheers and applause from the packed room. On her part, Smith, a former Google executive, seemed unfazed. "It's an interesting thing, unconscious bias," Smith said. "It's something we all have and it's something we have to really debug."
Bias in considering dataAmong the American subjects we tested, we found considerable support for banning the car when it was a German car being banned for American use: 78.4 percent thought car sales should be banned, and 73.7 percent thought the car should be kept off the streets. But for the subjects for whom the question was stated as whether an American car should be banned in Germany, there was a statistically significant difference: only 51.4 percent thought car sales should be banned, and just 39.2 percent thought the car should be kept off German streets, even though the car in question was presented as having exactly the same poor safety record.
We want XOXO to represent the broad spectrum of amazing and interesting people across art and tech, but we haven’t done enough to let everyone who cares about these ideas feel welcome. More than 80% of the people who’ve wanted to attend XOXO in the past are white, straight, cisgender, able-bodied dudes, and we want everyone who’s not in that category to know XOXO is for you too.
The professors said the news release on their research identified the funding source. As for the op-eds, Hakim said at first that the newspapers must have chosen not to include it. But he and Blackstone later said they weren't sure they had provided the information. "We believe we did," Hakim said. "It's not that important."
Both these (white British-born) successful candidates drew on the well-known Labovian structure for Anglo narratives (abstract, orientation, complicating action, resolution, evaluation, coda). As it so happens, this structure coincides with the structure of the evaluation form the interviewers have to fill in. That form is organized in a “STAR structure” where they are asked to record the candidate’s responses to Situation, Task, Action, and Result. Thus, “the normative Anglo narrative and the institution’s bureaucratic assessment form map on to each other precisely” (Roberts, 2013, p. 87). Candidates who produced stories about coping with monotonous work and who were able to reflect on the experience in order to project a credible, competent and flexible personality did well during the interview, and interviews could become quite informal and friendly. This opened further spaces for the candidate to present themselves as having “the right kind of personality.” By contrast, migrants often didn’t know what to make of questions such as “what would you tell me is the advantage of a repetitive job?” When they failed to produce an extended response, the interview usually became much more difficult: the interviewers became more controlling of the candidate’s talk and turns; there was more negativity and interviewers became less helpful and sympathetic; and the interviewers aligned more with formal participation roles and the interview became more formal and more institutionalized. Such conduct was a response to the candidate’s failure to produce the expected kind of discourse, but, crucially, it also served to make the interview much more difficult for them.
The opportunity for leadership in the journalism business, just happens to be same leadership opportunity as in all businesses. Leaders just need to start leading. One start would be to tear down, or at least modify the “Chinese wall” between content and the business side. No other non-monopoly industry lets product creators off the hook on how the business works. Before the journalistic purists burst a fountain pen, consider that there are intermediate points between “holier than holy” and “hopelessly corrupt” when it comes to editorial content. Paying attention to the business doesn’t equal warped coverage. It does equal a growing business. There are many businesses that balance incentives and conflicts all day long. Those businesses are able to hold the line on quality, and make great products. The point is, there isn’t just one way, but ought to be many ways to skin the cat in news.
WNET officials also once again refused to address questions about why they did not explicitly disclose Arnold’s funding of the pension programming. Pando previously reported that PBS only mentioned Arnold in a long list of funders at the beginning of a few PBS shows, but did not mention that Arnold was explicitly funding PBS’s pension series. In its new response, WNET pointed to just three generalized mentions as alleged proof that it disclosed their Arnold relationship. However, those officials had no comment about why they did not explicitly disclose to viewers the direct funding of the pension programming. They also did not address why they omitted any reference of Arnold in its promotional materials announcing the series. PBS rules prohibit corporate, political or ideological interests from financing programming that directly involves those interests’ agendas. According to PBS’s website, the rules do this to prevent the entire frame of said programming from “pre-ordaining” conclusions and systemically skewing coverage in an ideological direction. The “Pension Peril” series, funded by the anti-pension billionaire John Arnold, is a good example of how such skewing works to bias news coverage and suppress contextualizing facts.