Seth's Blog

In a previous post I criticized the book Testing Treatments. Two of the authors, Paul Glasziou and Iain Chalmers, have responded. I have replied to their response. They did not respond to the main point of my post, which is that the preferences and values of their book — called evidence-based medicine — hinder innovation.

Sure, care about evidence. Of course. But don’t be an evidence snob.

• Non-traditional science. Interview with Michael Nielsen, a physicist.
• Nassim Taleb argues with a drug company employee about big pharma  (on Facebook)
• Too many medical tests. Quite right!
• Paleo versus Vegan. I think this illustrates that data matters.

Thanks to Dave Lull and Alex Chernavsky.

• Super-old Ashkenazi Jews. Did they live to be more than a hundred “in spite of” their “bad habits” (eating steak & pork chops, smoking, refusal of Lipitor) or because of those habits? Small amounts of smoking could easily be beneficial due to (or illustrating) hormesis.
• Does Hollywood have a sense of humor? In the new movie about  noted anti-Communist J. Edgar Hoover, Hoover’s love interest is played by Armie Hammer, grandson of Armand Hammer, who worked for the Soviet Union as a money launderer. Edward Jay Epstein writes about Hammer and the Soviet Union in this excellent Kindle book.
• An advantage of ebooks, not yet realized, is easy updates. When the book is improved — for example, mistakes fixed — you get a new copy. In an even better Kindle book, Epstein writes about the diamond industry. The vast difference between the purchase price of a diamond and its resale value may be the advertising industry’s greatest achievement. Recent events caused Epstein to add a new chapter. The book was easy for Epstein to update but unfortunately earlier purchasers did not get the new version.
• Michel Cabanac, who did some of the research behind the Shangri-La Diet, has written a book about his life’s work: how we self-regulate via pleasure. During a meal, for example, exactly the same food becomes less pleasant. When it becomes unpleasant, we stop eating. When we are hot, cold water is more pleasant than when we are cold. The secret to weight loss, Cabanac realized, is making exactly the same food less pleasant — an insight few weight-loss writers understand.

A month ago I bought three identical tea pots to compare tea side by side. I hoped to take advantage of the Willat Effect (side-by-side comparisons create connoisseurs) to become a tea connoisseur.

It worked. Side-by-side tea comparisons are fun, easy, and have taught me a lot. When I drink tea I notice more and like it more. I do about three comparisons per day. I blogged about the first results here. The most useful idea about these comparisons came from Carl Willat himself: Compare the same tea brewed differently (e.g., different amounts of tea, different brewing times, different water temperatures). Most of my comparisons vary amount of tea or brewing time.

These many  comparisons have had several effects: (more…)

This is the best response to the 2008 financial crisis I have seen: An op-ed by Nassim Taleb that says end banker bonuses. They encourage risk-taking with other people’s money.

Separation of risk-taking from consequences (you gamble, if you lose, other people pay) is an ancient problem. The Chinese government would be wise to take a page from Hammurabi’s code, which Taleb quotes:

If a builder builds a house for a man and does not make its construction firm, and the house which he has built collapses and causes the death of the owner of the house, that builder shall be put to death.

During the Szechuan earthquake, hundreds of schoolchildren died when their schools collapsed. Surrounding buildings did not collapse. It turned out the schools were badly built. No builder was  punished, much less put to death.

At the end of his op-ed, Taleb puts it very clearly and simply: “bonuses and bailouts should never mix“.

Thanks to Dave Lull.

More Large areas of medicine consist of the doctor or someone else gambling with your health.

An especially clear example is surgery. Surgeon are paid per operation. The more operations they do, the more money they make. If an operation kills you, the surgeon is still paid. No penalty for a bad outcome. Wonderful for the surgeon, terrible for the rest of us. The more corrupt the surgeon, the more surgery they will recommend. Taleb’s idea suggests that surgeons pay a fine if a patient dies. The size of fines a surgeon would be willing to pay for bad outcomes would be helpful information for patients, who must decide what to do.

Drugs and medical devices are more subtle examples. You pay upfront for the drug or device, which are always expensive. They often have bad side effects, for which, of course, you pay. The drug company or device maker loses nothing. Wonderful for them, bad for the rest of us.