It was probably the most expensive tweet in history. A 21-word missive from Hillary Clinton on Monday wiped more than $40bn off the value of US pharmaceutical and biotech stocks.

 FT story over ‘outrageous’ ‘price gouging’ by some drugmakers. Then there is study 329 [direct link to this aside] 

“I don’t think you stop growing until they start shovelling the dirt in.”

Ah, that is what the med ed crowd call life-long learning. As with  his guitar playing, Keith Richard leaves the right gaps between the notes.

Guardian Interview.   [direct link to this aside] 

No money for ice for drinking water. I got this via my brother. When you have a health care system that works like this, you don’t have a health care system. Period. The other question for us academics, is to open up all that data suggesting that centres of excellence are not centres of excellence. Any dissociation, sinks us — or is hypocrisy. I seem to remember saying something similar at an interview awhile back.

The budget-cutters are coming – and research has no place to hide. Well, I do not know, but short termism is not just for the banks. Alison Wolf (not the author of this cited article) talks a lot of sense, and her view is that Higher Ed finances do not have a very rosy future over the next decade.

Claus Moser, statistician and culture-lover, died on September 4th, aged 92. I have a soft spot here, as it was Moser and Kalton’s book, Survey Methods in Social Investigation, that was my bible for survey research [when I was taught these things]. The article highlights that whilst he certainly did not think of himself as a mathematical statistician, I loved the discipline about sampling he preached, and how without it, your inferences are limited. Not that many medical educationalists seem to be too worried about such niceties.

Blackcurrant tango commercial.I got this via Bruce Charlton. Now that is what I call funny.

“He mocks the millions of dollars schools squander on golden parachutes for coaches with losing records. And he explores the far reaches of the infrastructure necessary to sustain big-time college football, like the “walkers” who escort players to classes to ensure they attend.” Gives me an idea…

Economist

“It’s not just about technology.”

“What matters is the underlying pedagogy.”

“You can’t beat one-to-one human interaction.”

“It’s all a fad.”

“It’s just the attempt of the now not so nascent ed-tech industry commercialise and take over highered.”

“Its all about privatisation, and reducing pay and conditions of academics.”

“Fundamentals of learning haven’t changed for 200 (2000?) years.”

“When was technological advancement last useful? The abacus, paper, Gutenberg, the blackboard, the school bus…”

Well, I think all of the above have some truth to them. But I think change in highed and teaching (as well as learning) will depend heavily on tech. It is not all that matters, but it is central. As are costs. It is just that as Nicolas Carr pointed out of business many years ago, the comparative advantage of tech or IT will only be there early on. After that, it is a utility, like electricity.

What I think: “What we do offline, will depend on what we do online.”

“I feel much better but fearfully exhausted from examining the extraordinary outpourings of my own students who return my own words to me in grotesque shape, a duly humbling experience, though excellent for one’s self-esteem, but severely shaking to one’s general faith in the rationality of man.”

Isaiah Berlin, writing home after spending a semester in 1949 teaching undergraduates at Harvard.

As posted by John Naughton. [direct link to this aside] 

I am at the ESDR 2015 in Rotterdam. Strange sort of place, I haven’t been here before, but I guess there was a lot of war damage (the exact details of which have subsequently been explained to me by a Dutch colleague, Marcel Jonkman). Many parts of the city look like a toy town with buildings that I first saw in comic books when I was a kid. I find it hard to imagine it being a home — but then I don’t live here. On the other hand, lots of nice bars and coffee shops; and bikes. And the Dutch always seem so friendly, and possess a great sense of humour (meaning I tend to laugh, when they laugh).

As for the meeting, well… Leo Szilard, suggested many years ago that presenters should just stand up and announce their conclusions, in a sentence or two. If the audience think the conclusions reasonable, they should quickly then sit down again. On the other hand (and he was a physicist), if the conclusions sounded unreasonable, then they would need to spend time justifying their thinking (or their data). In biology, or medicine, this approach is problematic. Treatment X works better than treatment Y? Not much to say, except that this argument illustrates why so much of scientific conferences no longer consist of science. Second, even biology has so many myriad pathways that it is so hard to frame experiments as tests of hypotheses, rather than stamp collecting. Biology is just messy, and I remain amazed that we can discover anything useful at all. But we can, and we do.

There was a nice keynote by Cédric Blanpain on tumour heterogeneity. I once claimed to know something about this, but since I was reading in this area, technology has moved on. Nonetheless, at the risk of sounding like somebody who always says there is nothing new under the sun, I think many of the key questions that people were framing 25 years ago, still remain unanswered: how do we deal with molecular heterogeneity (and the drivers of tumour heterogeneity), and how do we therapeutically get round this issue? Is there a bigger problem in cancer?

As for the Szilard approach, the ESDR have tried, and it works. Short one or two sentence statements, ending with ‘if you want to find out why, visit my poster’. Neat. And posters can be fun.

Everywhere I look I see stuff about how ‘unreliable’ much science might be. For instance see here, here and here. In truth most of this is about the recent paper on the lack of reproducibility of some outputs [irony intended] in psychology journals. John Ionnnidis writes:

Multiple lines of evidence suggest this is a recipe for disaster, leading to a scientific literature littered with long chains of irreproducible results. 

I do not have much original to add to this debate, but find none of it very surprising. Go back and read the ‘Double Helix’, or look at how David Hubel and Torsten Wiesel described how they changed the world.  I  think of it in the following terms.

If people use probability management as the sole marker of truth, you have left science — that is science as the attempt to discover the deeper structures that underpin reality — behind. Science is about reliable knowledge, and if what you do is not reliable, you have not been doing science. There is a lot of activity that is going on that that is not science. Much is  Cargo cult science; much is testing; much is effectively the D of R+D where we are playing and abusing Type 1 and Type 2 errors (Neyman Pearson errors, rather than Fisher); much  the sort of thing any large logistics or commercial company does, but they probably have more humility. And it is why I have argued that much medical research (sic) could be usefully outsourced to Amazon: its logistics, stupid. ( see for instance, Of supermarkets and medical science: getting the product lines right). The Feynman quote that I recall was: “When, during the Challenger enquiry, Richard Feynman was told that the chance of an error in a certain process was 1:105, he retorted, “if a man tells me the chance of failure is 1 in 10^5 I know he is full of crap”.

Science relies on truth seeking; integrity; and honesty. It is not just a career. You have to have an attitude to your subject. Arrogance before men; humility before your subject (Bronowski). Most good science is iterative. You want to see the world honestly because your next bit of work depends on how you have interpreted what you did yesterday. In one sense, you publish for yourself. The hardest judge must be you and your reputation, not some anonymous reviewer. Your peers are not the people who review your papers, but those people you do not know who decide  whether you are in the books 20 years later. Think of dietary observational epidemiology: how much will survive?

 When publication is no longer a matter of record, but of career advancement, we are doomed to endlessly inventing ways to discover who has been debasing our currency. Institutions matter, not so much the bricks and mortar ones, but the way science is organised. John Ziman foresaw the mess we are getting into in his book Real Science, and elsewhere:

What is more, science is no longer what it was when Merton first wrote about it. The bureaucratic engine of policy is shattering the traditional normative frame. Big science has become a novel way of life, with its own conventions and practices. What price now those noble norms? Tied without tenure into a system of projects and proposals, budgets and assessments, how open, how disinterest- ed, how self-critical, how riskily original can one afford to be?

He was of course talking about Robert Merton’s essay (J. Legal and Political Sociology 1, 115–262; 1942). He went on to say:

 There is no going back to that world we have lost. Anyway, science has never had it so good as in this past half-century, and is still going great guns. But soon it will be offered a new contract with society. To renegotiate that contract with its eyes open, on even terms, science will need to understand itself much better. That understanding is going to require, not adherence to an obsolete ethos, but a sharp but sympathetic sociological self- analysis. That is the unfinished business that Merton’s little paper began.

This is where we are. We need to find such a new contract. Bruce Charlton had the right diagnosis a long time ago (Not even trying: the corruption of real science).

They all have smartphones, good laptops and experience exemplary content on all of these devices. Education needs to meet those expectations. This is really hard. Learning is not entertainment and often damaged when it becomes too glitzy. The stuff that’s produced within Blackboard looks like the stuff that was done on computers before these kids were born

Donald Clark. [direct link to this aside]