The Binary Circumstance

From The New York Times [reg. req.]:

With all the tools available to modern medicine — the blood tests and M.R.I.’s and endoscopes — you might think that misdiagnosis has become a rare thing. But you would be wrong. Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.

As shocking as that is, the more astonishing fact may be that the rate has not really changed since the 1930’s. “No improvement!” was how an article in the normally exclamation-free Journal of the American Medical Association summarized the situation.

This is the richest country in the world — one where one-seventh of the economy is devoted to health care — and yet misdiagnosis is killing thousands of Americans every year.

How can this be happening? And how is it not a source of national outrage?

You mean the real world isn’t like House on Fox?

Under the current medical system, doctors, nurses, lab technicians and hospital executives are not actually paid to come up with the right diagnosis. They are paid to perform tests and to do surgery and to dispense drugs.

There is no bonus for curing someone and no penalty for failing, except when the mistakes rise to the level of malpractice. So even though doctors can have the best intentions, they have little economic incentive to spend time double-checking their instincts, and hospitals have little incentive to give them the tools to do so.

“You get what you pay for,” Mark B. McClellan, who runs Medicare and Medicaid, told me. “And we ought to be paying for better quality.”

There are some bits of good news here. Dr. McClellan has set up small pay-for-performance programs in Medicare, and a few insurers are also experimenting. But it isn’t nearly a big enough push. We just are not using the power of incentives to save lives. For a politician looking to make the often-bloodless debate over health care come alive, this is a huge opportunity.

There’s also an enormous amount of money to be made by doctors, hospitals, labs and drug companies keeping people chronically ill rather than curing them. Once cured, the patients don’t need those services any more.

Not only is there little or no incentive to diagnose correctly, there is even less incentive to actually cure patients.

Patients who require chronic care and patients who because of misdiagnosis are being made sicker by the treatments rack up some pretty big medical bills. Healthy people don’t.

An article from The Wall Street Journal about the future of blogging gives some interesting numbers.

Blog measurement is another mess. The latest word from Dave Sifry, CEO of the blog search engine Technorati, is that there are some 28.4 million blogs and the blogosphere is doubling in size every 5.5 months. Eye-popping figures like that have been thrown around a lot recently, but folks making revolutionary claims about blogging won’t like other Technorati numbers: Less than half of those blogs are still getting posts three months after their creation, and less than 10% — just 2.7 million — are updated at least weekly. That means of Technorati’s blogs, more than 90% are either abandoned or updated too rarely to merit the name — nothing kills reader interest or visits more quickly and thoroughly than a stale blog.

Still, 2.7 million active blogs is impressive. But how should we measure their audience? Technorati does so by looking at incoming links, which is the closest thing the blog world has to an industry standard, but doesn’t tell the whole story — not with search engines and news aggregators shooting blog posts out into the general fray of the Net.

I’ve been doing my blog for more than 2 years and have produced over 1900 posts. There have been more than 1,000 comments. Of bloggling I say, “I wish I knew how to quit you.”
This article discusses spam with particular attention to blog comment spam, which every blog author is all too familiar with, as well as splogs, which are rapidly generated blogs which are spam in and of themselves and are designed to drive traffic to other sites.

Peter Shinbach recently threw in the towel and shut down Bach Door, his online-communications blog.

The public relations executive from Birmingham, Michigan, was fed up with so-called comment spam. Returning from a weeklong vacation, he found a slew of comments on his blog that had nothing to do with communications: They were posts from spammers promoting gambling sites and prescription drugs.

“I’m not in this to spend hours a week cleaning up the mess spammers leave behind,” Shinbach says. Ironically, the surge in spam to his blog coincides with a decrease in spam to his inbox: Shinbach says that his desktop antispam software and his ISP’s spam filters together block about 95 percent of junk e-mail sent to his account.

Every time I log into my blog I must delete several spam comments which are usually for prescription drugs, mortage loans, payday advance loans, and gambling. Fortunately, WordPress puts them in a moderation que so they never make it to my site and I can delete them in bulk.

It’s very annoying though.

Comment spam is one of the new forms. Another is the splog–short for spam blog, a blog that is created purely for marketing purposes.

Some spammers create dozens, if not hundreds, of splogs that link to the spammer’s Web site, helping to artificially inflate its ranking in Google and other search engines. Another type of splog seeks to get visitors to click ads that link to sites that pay the splogger referral fees.

Derek Gordon, spokesperson for Technorati, a blog-resource Web site, estimates that 10 to 15 percent of the 70,000 new blogs created daily are splogs. CipherTrust’s Judge says he expects that percentage to grow in 2006. These shady blogs have become a serious headache for companies, such as Google, Microsoft, and Yahoo, that offer free blog services. Many are fighting back with software designed to identify splogs, similar to programs that identify e-mail spam.

Bloggers plagued by comment spam can also get help from sites such as SplogSpot and Splog Reporter, which collect information on such content to help network administrators filter it out.

I’m not sure what the future of blogging is or how it related to my own future.

For me it has been primarily a way to sort things out in my own head and well as share information I think is useful with others.

It’s sure not a way to make money.

I’m thinking of moving my site toward less frequent posting but more in-depth articles. I find that when I have a question about something, I read a lot about it to get a better understanding. Those links could all be compiled into a single post (page) that remains on the Internet as a resource for others. It’s also a way for me to bookmark useful information and build upon it myself.

Long ago, I stopped linking to most other blogs because 1) they usually didn’t link back and 2) their posts have a short-term relevance. I’m much more interested in information that changes my life and changes the lives of others, specifically, factual knowledge that makes me and others more rational.

It is in my rational self-interest to live in a world where people are better informed and committed to understanding the basic premise of my rational philosophy which is the Binary Circumstance, that things either exist or they don’t. All knowledge is about things that exist. Knowledge is, in fact, correctly distinguishing between existence and nonexistence. You can’t know anything about things that aren’t there.

Groups in California are challenging that state’s $3 billion program to dole out dollars for stem cell research.

HAYWARD, Calif. - The financial future of California’s $3 billion human embryonic stem cell research institute went on trial Monday as taxpayer groups tried to block the state-funded research.

Two lawsuits seek to invalidate the law that created the California Institute of Regenerative Medicine, which is authorized to hand out an average of $300 million in research grants annually. The lawsuits claim the agency violates a constitutional mandate that the state control spending of taxpayer dollars.

Robert Taylor, who represents the People’s Advocate and National Tax Limitation Foundation, told a judge that the 29 members who oversee the institute and the people they appoint to research committees don’t report directly to the state.

[…]

When voters approved Proposition 71 in November 2004, creating the institute, stem cell scientists anticipated new traction to a field hamstrung by federal limitations on funding.

The Bush administration caps the federal funding at about $25 million annually and has imposed strict research guidelines that scientists say limit advances.

Proposition 71 authorized the institute to dole out an average of $300 million in research grants each year over the next 10 years. But 15 months later, the agency has yet to hand out a dime because of its legal troubles.

The lack of funding has prompted the schools to scale back their immediate plans to expand stem cell research and has hampered recruiting. The sought-after research team of Neal Copeland and Nancy Jenkins turned down an offer from Stanford University and accepted positions at a government-supported lab in Singapore.[boldface added]

I do find it very troubling that “scientists” seem to think that they have a right to force others to support their research and are so willing to work for governments that raise research money with guns.

There is no scientific evidence that such a right exists except in the minds of those who make it up. So why do scientists believe in it?

I guess for the same reason that religious people believe in God.

It’s interesting that housing sales are slowing more in the east but still increasing in the west.

WASHINGTON - Sales of new homes fell for the second time in three months in January, providing further evidence that the nation’s five-year housing boom is slowing.

The Commerce Department reported Monday that sales of new single-family homes dropped by 5 percent to a seasonally adjusted annual rate of 1.233 million units last month.

That was a bigger drop than analysts had been expecting and provided support to the view that the housing market, after setting sales records for five straight years, is slowing under the impact of rising mortgage rates.

The 5 percent January drop in sales followed a revised 3.8 percent increase in December and was the biggest setback since a 7 percent drop in November.

Despite the fall in sales, the median price of a new home was up in January to $238,100, compared with $229,000 in December. The median is the point where half the homes sold for more and half for less. The January figure was the highest since an all-time high of $243,900 set in October.

[…]

Bucking the national trend, sales in the West posted an 11.3 percent increase in January after a 6.3 percent gain in December.