Forge Wednesday Roundup - January 20, 2021

January 20, 2021

In today’s Roundup: reflecting on a year’s worth of machine learning; FDA releases action plan for medical AI; genetic anomaly linked to autism; honey detectives turn to NMR machines; WHO Director General issues call for global equity in COVID vaccine access; health burden of excess heat falls on poor, minority neighborhoods; despite assurances, Facebook algorithm still funneling people toward political groups; the durable appeal of conspiracy theories; where should federal pandemic data reside?; family medicine docs turn away from pharma; much more:

Honey dripping from a piece of honeycomb. Image credit: Archana GS via Pexels.
Image credit: Archana GS via Pexels
  • Sticky situation: first the food scammers came for olive oil, now for honey – but honey detectives are fighting back against syrupy adulterations with high-tech approaches, as this Wired article by Jonathan Ungoed-Thomas and Jonathan Leake describes: “Nuclear Magnetic Resonance (NMR) is the technology that could change everything. It works by bathing samples in a powerful magnetic field, causing the atoms to resonate. The resonant frequencies of the nuclei in the atoms are then converted into peaks or spectra on a graph, generating a unique magnetic ‘signature’ for each sample….In the case of honey, the technique is used to compare the molecular profile of a sample ‘honey’ with the NMR database of genuine honeys to establish authenticity.”
  • Poynter’s Kristen Hare has thoughtfully served up some language-geek catnip for us here at Forge Communications Headquarters-in-Exile: a handy AP Style usage guide to get you through inauguration without committing any gaffes or solecisms.

  • “…the algorithm’s ability to reduce unexplained disparities is rooted in the racial and socioeconomic diversity of the training set. Because algorithmic severity measures better capture underserved patients’ pain, and severity measures influence treatment decisions, algorithmic predictions could potentially redress disparities in access to treatments like arthroplasty.” An article in Nature Medicine by Pierson and colleagues features a welcome inversion on the too-familiar theme of algorithmic bias: an algorithm designed to ameliorate inadequate pain management in patients from underserved groups.
  • At his blog, Sebastian Ruder rounds up ten of the most notable developments in machine learning and natural language processing from 2020.
  • “One possible reason for approval in Europe before the USA might be the potentially relatively less rigorous evaluation of medical devices in Europe. The substantial number of approved devices highlight the need to ensure rigorous regulation of these devices. Currently, there is no specific regulatory pathway for AI/ML-based medical devices in the USA or Europe.” An article just published in Lancet Digital Health by Muehlematter and colleagues contrasts differences in regulations and attitudes toward medical devices based on AI and machine learning in Europe versus the US…
  • …just as the FDA publishes an Action Plan for regulation of AI/ML-based “Software as a Medical Device” (SaMD) that includes a summary of responses to an earlier discussion paper solicited through a public docket and other fora: “One of the greatest benefits of AI/ML in software resides in its ability to learn from real-world use and experience, and its capability to improve its performance. FDA’s vision is that, with appropriately tailored total product lifecycle-based regulatory oversight, AI/ML-based Software as a Medical Device (SaMD) will deliver safe and effective software functionality that improves the quality of care that patients receive.”
  • Vanderbilt statistician Frank Harrell uses a re-analysis of the ORCHID randomized trial that evaluated hydroxychloroquine vs placebo for treatment of COVID as a jumping-off point for a lesson in longitudinal ordinal analysis.
  • A preprint by Lee and colleagues available from arXiv describes the use of software designed to track student attention during online college classes and provide tailored feedback to professors and students, all while purportedly safeguarding students’ personal data and complying with European GDPR data protection requirements (H/T @arXiv_Daily).

A person standing on a rocky peak, silhouetted against a starry sky. A beam of light from a headlamp seems to be aimed toward the Milky Way. Image credit: Štefan Štefančík via Unsplash
Image credit: Štefan Štefančík via Unsplash
  • “The analysis revealed that tandem-repeat mutations are significantly more common in people who have ASD than in their unaffected siblings, with mutations more likely to cause the repeat to expand than to contract… Many of the expansions occurred in DNA regions that drive the expression of genes involved in fetal brain development.” An article in Nature by Anthony J. Hannan introduces work by Mitra and colleagues identifying an association between the frequency of a genetic anomaly known as tandem repeat mutations and the likelihood of having autism spectrum disorder.
  • Physicists and engineers aside, anyone who saw the movie Gravity should have some basic appreciation for what a big problem a collision can be for things moving at orbital velocities. In this video interview by The Verge’s William Poor, we meet someone who’s trying to do something about it: “Moriba Jah is a researcher at the University of Texas at Austin who’s on a mission to make the stakes of orbital congestion abundantly clear. He built a visualizer called AstriaGraph that displays the positions of all actively-tracked objects in the sky. He also designed a real-time graph that shows just how close objects get to one another as they whip around the planet, sometimes 15 times faster than a bullet.”
  • “Would a virus by any other name spread so fast? As scientists identify more and more potentially worrying variants of the coronavirus SARS-CoV-2, they are grappling with just what to call them. At a 12 January World Health Organization (WHO) meeting devoted to coronavirus variants, health officials and researchers started hashing out a new naming system.” Nature’s Ewen Callaway reports on mounting problems that stem from confusion about how to name newly-discovered COVID variants (or, by extension, variants for any epidemic pathogen).
  • “The widespread reported use of face masks combined with physical distancing increases the odds of SARS-CoV-2 transmission control. Self-reported mask-wearing increased separately from government mask mandates, suggesting that supplemental public health interventions are needed to maximise adoption and help to curb the ongoing epidemic.” A large national cross-sectional survey study reported by Rader and colleagues in Lancet Digital Health provides additional data in support of mask-wearing as means of controlling COVID transmission.
  • NPR’s Pien Huang profiles the clinicians and public health experts who are working to overcome vaccine hesitancy in the Black community – a phenomenon rooted in a history of exploitative treatment and racist neglect: “So how can medical and public health leaders work to overcome this hesitancy? To start with, acknowledge the historical reasons for black mistrust of medicine, say researchers and Black physicians working to reach their own communities.”
  • “Early in the COVID-19 pandemic, it emerged that many people infected with the SARS-CoV-2 virus were losing their sense of smell — even without displaying other symptoms….Almost a year later, some still haven’t recovered these senses, and for a proportion of people who have, odours are now warped: unpleasant scents have taken the place of normally delightful ones.” Nature’s Michael Marshall reports on recent research into one of COVID’s more striking side effects (and also an early symptom of infection): the sudden loss of taste and smell.
  • “Poor communities are bearing the brunt of sickening heat in [Florida and Arizona]…Federal data capturing most emergency room visits and hospitalizations in Arizona and Florida reveal higher rates of heat-related illnesses in areas with less income. The data, never before made public at the ZIP code level, also show that the highest rates of heat-related illnesses are in neighborhoods with a history of racial segregation.” At Public Integrity, reporters Sofia Moutinho and Elisabeth Gawthrop present granular data that geographically pinpoints racial and socioeconomic inequities that threaten to become deadly amid a warming climate.

  • “In the real world, there are bold signs that warn us of danger – whether its [sic] a red “no entry” sign on a road or an exclamation mark which shouts: keep clear. It’s time key players like Facebook, Google and Twitter considered how a simple tweak to their designs might just help people spot danger online too.” An article at The Conversation by Fiona Carroll examines some potential design-based solutions that can help rein in the spread of online misinformation.
    Road signs saying DO NOT ENTER and WRONG WAY in the midst of a desert landscape. Image credit: Tim Mossholder via Unsplash
    Image credit: Tim Mossholder via Unsplash
  • “…contrary to Facebook’s claims, The Markup found the platform continued to recommend political groups to its users throughout December. We found 12 political groups among the top 100 groups recommended to the more than 1,900 Facebook users in our Citizen Browser project, which tracks links and group recommendations served to a nationwide panel of Facebook users. Our data shows Facebook also continued to recommend political groups throughout January, including after it renewed its promise not to on Jan. 11.” An investigation by The Markup reveals that Facebook has continued to steer users toward political content despite its assurances that it would be ceasing this practice, which has previously been implicated in the spread of misinformation.
  • Undark taps three academic experts on misinformation - Jeremy Blackburn, Robert W. Gehl, and  Ugochukwu Etudo – for their opinions on the efficacy and appropriateness of “deplatforming” as a means for curbing online hate speech: “…these actions restrict the ability of individuals and communities to communicate with each other and the public. Deplatforming raises ethical and legal questions, but foremost is the question of whether it’s an effective strategy to reduce hate speech and calls for violence on social media.”
  • “Fraudsters impersonating respected academics approached the journal, which is published by Springer Nature, to suggest an idea for a themed issue on ‘the role of nanotechnology and internet of things in healthcare’. The imposters generated fake email addresses that mimicked those of real universities to add credibility to their claims.” At Chemistry World, Jamie Durrani describes an incredibly brazen attempt to circumvent a journal’s peer review system and publish a raft of shoddy papers by impersonating reputable scientists.
  • “One reason that conspiracy theories find fertile ground in the human mind has to do with epistemology — the philosophy of how we know what we know (or think we do). Because any individual can know only a tiny sliver of the world firsthand, we have no choice but to accept a great deal of information we can’t verify for ourselves….The assumptions and cognitive shortcuts we use to decide what’s true make sense most of the time, but they also leave the door open for bad information, including conspiracy theories.” Conspiracy theories – many of which were on full view over the past few weeks – often seem completely ludicrous to those outside the bubble. So why do they persist and grow? At Knowable, Greg Miller explores the possible reasons that the appeal of conspiracy theories remains so stubbornly intractable (H/T @charlesweijer).
  • Retraction Watch reports on suspicions raised by the withdrawals of a pair of manuscripts under review at a journal, both of which used identical language in the withdrawal note – a detail that may point to the use of a “paper mill” to churn out poor-quality research articles.
  • “Early in the pandemic, many health experts — in the U.S. and around the world — decided that the public could not be trusted to hear the truth about masks. Instead, the experts spread a misleading message, discouraging the use of masks. Their motivation was mostly good. It sprung from a concern that people would rush to buy high-grade medical masks, leaving too few for doctors and nurses…But the message was still a mistake.” The New York Times’ David Leonhardt explains why careful scientific hedging runs the risk of backfiring with the public.

A globe turned to show Africa, Europe, and part of Asia with a white heart shape painted across the face of the globe. Image credit: Brandi Ibrao via Unsplash
Image credit: Brandi Ibrao via Unsplash
  • “Even as they speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong…. Not only does this me-first approach leave the world’s poorest and most vulnerable people at risk, it’s also self-defeating. Ultimately, these actions will only prolong the pandemic, the restrictions needed to contain it, and human and economic suffering. Vaccine equity is not just a moral imperative, it is a strategic and economic imperative.” As the COVID vaccine rollout gathers speed in the US, the World Health Organization’s Director General Tedros Adhanom Ghebreyesus draws attention to the global health injustices that looms if issues of equity are ignored in prioritizing access to effective vaccines.“As the start of this year has reminded us, we still have a long way to go on our journey towards antiracism in the U.S. And so just as Dr. King asked over 50 years ago, I ask you today, where do we go from here? Are we willing to rest on the accomplishments of the past year? Or are we ready to run forward, with the lessons learned, towards equity and antiracism in medicine?” Writing for Forbes, University of Pittsburgh physician Utibe Essien explains how recent efforts to eliminate racism from healthcare can be sustained and expanded.
  • “…this Experian tool and tools like it—collectively called remote identity proofing—are used for all sorts of things they shouldn’t be: ‘The remote identity proofing (RIDP) process confirms an applicant’s identity based on their credit information,’ the Corporation for Enterprise Development report states. ‘This process has a success rate of only 78 percent, and applicants with little or no credit history and the millions of victims of identity theft cannot complete an RIDP.’” An investigative report by Motherboard’s Samantha Cole shows how the use of a credit-rating service for purposes of identify confirmation can create frustrating roadblocks for people trying to sign up for COVID vaccinations in New York.
  • “…what really happened is widely, wildly misunderstood. Although the CDC did not respond to multiple requests for comment on this story, internal communications show that the agency agreed to the change because of the limitations of its own system. And while the switch was rocky at first, over time the HHS system has become the most reliable source of federal pandemic data.” The Atlantic’s Alexis C. Madrigal provides a judicious review of the backstory and arguments for whether or not the Biden administration should reverse the Trump administration’s decision to funnel granular pandemic data through the Department of Health and Human Services rather than through the agency that had historically managed such information, the Centers for Disease Control and Prevention.
  • “This time, however, the most pressing problem isn’t the overpromising of supply….State health officials say the unpredictable shipments have led to chaos on the ground, including the inability to quickly use up all of the doses sent to them. The week-by-week system also makes it hard to plan for the second doses that everyone needs because they come three or four weeks after the initial dose.” An in-depth ProPublica report (and indeed, what other kind of ProPublica report is there?) by Caroline Chen, Isaac Arnsdorf, and Ryan Gabrielson explores the logistical problems stemming from Operation Warp Speed’s weekly “state-by-state” allotment approach to COVID vaccine distribution.
  • “Concerns about industry influence on the medical community gained steam about a decade ago, when two U.S. Senate committees investigated financial ties between some drug companies and physicians, particularly researchers at certain universities. The probes came amid widening scrutiny of various efforts to boost physician prescribing and make greater use of certain medical devices.” At STAT News, Pharmalot’s Ed Silverman reports (log-in required) on survey findings that demonstrate waning degrees of direct contact between family medicine residents and pharmaceutical company sales reps over a period of 12 years.