Gödel

Journey to the Edge of Reason by Stephen Budiansky — ruthless logic | Financial Times

Ever since I read of how Gödel’s work has rendered decades of work by Bertrand Russell and others void, Gödel has fascinated me. Not that I can follow the raw proofs. But his work speaks of a wonderful Platonic world that is hard not to fall in love with. Two quotes: the first is new to me, the second, sadly not.

Einstein sponsored his US citizenship, which Gödel almost torpedoed by telling the judge that he had found a logical inconsistency in the constitution that would allow a person to establish a dictatorship in America.

His end, when it came, was tragic. His paranoia grew and he became convinced that his food was being poisoned. When this had happened earlier in his life, his wife had managed to taste test and spoon feed him to health but this time she too was ill and in January 1978, he died in hospital, curled into a foetal position and weighing only 65 pounds.

Infected blood scandal: government knew of contaminated plasma ‘long before it admitted it’ | Contaminated blood scandal | The Guardian

From the Guardian.

Among the victims of the contaminated blood scandal, which is the subject of a public inquiry, were 1,240 British haemophilia patients, most of whom have since died. They were infected with HIV in the 1980s through an untreated blood product known as Factor VIII.

In 1983, Ken Clarke, then a health minister, denied any threat was posed by Factor VIII. In one instance, on 14 November 1983, he told parliament: “There is no conclusive evidence that Aids is transmitted by blood products.”

However, documents discovered at the national archives by Jason Evans, whose father died after receiving contaminated blood and who founded the Factor 8 campaign, paint a contrasting picture.

In a letter dated 4 May 1983, Hugh Rossi, then a minister in the Department of Health and Social Security (DHSS), told a constituent: “It is an extremely worrying situation, particularly as I read in the weekend press that the disease is now being transmitted by blood plasma which has been imported from the United States.”

(HIV screening for all blood donated in the UK only began on 14 October 1985.)

Rossi’s letter was considered damaging enough for the government to seek to prevent its release in 1990 during legal action over the scandal, by which time Clarke was health secretary.

In another letter uncovered by Evans, dated 22 March 1990, a Department of Health official wrote to government lawyers saying it wanted to withhold Rossi’s letter, despite admitting the legal basis for doing so was “questionable”.

Clarke has a legal background. There is a large logical gap between between denying ‘any threat’ and the statement that there is ‘no conclusive evidence’. The Department of Health would be better named the Department without Integrity. Recent events suggest things are no better now. It didn’t all start with Johnson.

Australian regulator pursues essay mills through courts | Times Higher Education (THE)

Professor Coaldrake named “industrial-scale cheating” as one of the “emerging big threats” that the Tertiary Education Quality and Standards Agency (Teqsa) would have to address. “We’re dealing with an incredibly fast-paced sort of industry here, and one that does present a profound challenge to us collectively,” he told the Needed Now in Teaching and Learning conference.

As I have said before, it is an industrial-scale model of higher education that facilitates such criminal activity. Parasites do indeed understand their hosts better than the hosts themselves: it is how they keep one step ahead.

Great fleas have little fleas upon their backs to bite ’em, And little fleas have lesser fleas, and so ad infinitum. And the great fleas themselves, in turn, have greater fleas to go on; While these again have greater still, and greater still, and so on

Augustus de Morgan

From today’s New York Times.

Adam Shatz · Palestinianism · LRB 6 May 2021

Some words from Edward Said, quoted in Adam Shatz’s review of Places of Mind: A Life of Edward Said by Timothy Brennan. Ever more timely.

Victimhood, alas, does not guarantee or necessarily enable an enhanced sense of humanity,’ he said. ‘To testify to a history of oppression is necessary, but it is not sufficient unless that history is redirected into intellectual process and universalised to include all sufferers.’ He went on:

It does not finally matter who wrote what, but rather how a work is written and how it is read. The idea that because Plato and Aristotle are male and the products of a slave society they should be disqualified from receiving contemporary attention is as limited an idea as suggesting that only their work, because it was addressed to and about elites, should be read today. Marginality and homelessness are not, in my opinion, to be gloried in; they are to be brought to an end, so that more, and not fewer, people can enjoy the benefits of what has for centuries been denied the victims of race, class or gender.

The idea that education is ‘best advanced by focusing principally on our own separateness, our own ethnic identity, culture and traditions’ struck him as a kind of apartheid pedagogy, implying that ‘subaltern, inferior or lesser races’ were ‘unable to share in the general riches of human culture’. Identity was ‘as boring a subject as one can imagine’; what excited him was the interaction of different identities and the promise – the ‘risk’ – of universality.

Jonathan Flint · Testing Woes · LRB 6 May 2021

Terrific article from Jonathan Flint in the LRB. He is an English psychiatrist and geneticist (mouse models of behaviour) based in UCLA, but like many, has put his hand to other domains (beyond depression). He writes about Covid-19:

Perhaps the real problem is hubris. There have been so many things we thought we knew but didn’t. How many people reassured us Covid-19 would be just like flu? Or insisted that the only viable tests were naso-pharyngeal swabs, preferably administered by a trained clinician? Is that really the only way? After all, if Covid-19 is only detectable by sticking a piece of plastic practically into your brain, how can it be so infectious? We still don’t understand the dynamics of virus transmission. We still don’t know why around 80 per cent of transmissions are caused by just 10 per cent of cases, or why 2 per cent of individuals carry 90 per cent of the virus. If you live with someone diagnosed with Covid-19, the chances are that you won’t be infected (60 to 90 per cent of cohabitees don’t contract the virus). Yet in the right setting, a crowded bar for example, one person can infect scores of others. What makes a superspreader? How do we detect them? And what can we learn from the relatively low death rates in African countries, despite their meagre testing and limited access to hospitals?

That we are still scrambling to answer these questions is deeply worrying, not just because it shows we aren’t ready for the next pandemic. The virus has revealed the depth of our ignorance when it comes to the biology of genomes. I’ve written too many grant applications where I’ve stated confidently that we will be able to determine the function of a gene with a DNA sequence much bigger than that of Sars-CoV-2. If we can’t even work out how Sars-CoV-2 works, what chance do we have with the mammalian genome? Let’s hope none of my grant reviewers reads this.

Medicine is always messier that people want to imagine. It is a hotchpotch of kludges. For those who aspire to absolute clarity, it should be a relief that we manage effective action based on such a paucity of insight. Cheap body-hacks sometimes work. But the worry remains.

Tyler Cowen says some interesting things in an article Why Economics is Failing US on Bloomberg. I don’t think his comments are limited to the economics domain.

Why Economics Is Failing Us – Bloomberg

Economics is one of the better-funded and more scientific social sciences, but in some critical ways it is failing us. The main problem, as I see it, is standards: They are either too high or too low. In both cases, the result is less daring and creativity.

Consider academic research. In the 1980s, the ideal journal submission was widely thought to be 17 pages, maybe 30 pages for a top journal. The result was a lot of new ideas, albeit with a lower quality of execution. Nowadays it is more common for submissions to top economics journals to be 90 pages, with appendices, robustness checks, multiple methods, numerous co-authors and every possible criticism addressed along the way.

There is little doubt that the current method yields more reliable results. But at what cost? The economists who have changed the world, such as Adam Smith, John Maynard Keynes or Friedrich Hayek, typically had brilliant ideas with highly imperfect execution. It is now harder for this kind of originality to gain traction. Technique stands supreme and must be mastered at an early age, with some undergraduates pursuing “pre-docs” to get into a top graduate school.

Sam Shuster, before I departed to Strasbourg, warned me in a similar vein, with reference to the Art of War by Sun Tzu:

Even the mystique of wisdom turns out to be technique. But if today must be learning technique, don’t leave the tomorrow of discovery too long.

I would say I heard the message but didn’t listen carefully enough. As befits an economist, Cowen warns us that there is no free lunch.

Terrific article from Andrew Curry. The graph shows medians, and 20 and 80 centiles His explanation is worth reading.

There was an article in the FT last week, commenting on an article in JAMA here. The topic is the use of AI (or, to be fair, other machine learning techniques) to help diagnose skin disease. Google will allow people to upload their own images and will, in turn, provide “guidance” as to what they think it is.

I think the topic important, and I wrote a little editorial on this subject here a few years ago with the strikingly unoriginal title of Software is eating the clinic. For about 8-10 years I used to work in this field but although we managed to get ‘science funding’ from the Wellcome Trust (and a little from elsewhere), and published extensively, we were unable to take it further via commercialisation. As is often the case, when you fail to get funded, you may not know why. My impression was that people did not imagine that there was a viable business model in software in this sort of area (we were looking for funds around 2012-2015). Yes, seemed crazy to me then, too (and yes, I know, Google have not proven there is a business model). Some of the answers via NHS and Scottish funding bodies were along the lines of come back when you prove it works, and then we will then fund the research.😤

A few days back somebody interested in digital health asked me what I thought about the recent work. Below is a lightly edited version of my email response.

1. Long term automated systems will be used.
2. Tumours will be easier than rashes.
3. A rate-limiting factor is access to — and keeping — IPR of images.
4. The computing necessary is now a commodity and trivial in comparison with images and annotation of images
5. Regarding uncommon or odd presentations, computers are much more stupid than humans. Kids can learn what a table is with n<5 examples. Not so for machines. Trying to build databases of the ‘rare’ lesions will take a lot of time. It will only happen cheaply when the whole clinical interface is digital, ideally with automated total body image capture (a bit like a passport photo booth), and with metadata and the diagnosis added automatically.
6. In the short term, the Google stuff will increase referrals. They are playing the usual ’no liability accepted, we are Silicon Valley, approach’. They say they are not making a diagnosis, just ‘helping’. This is the same nonsense as 23and me. They offload the follow-up onto medics / health service. Somebody once told me that some of the commercial ‘mole scanners’ sent every patient to their GP to further investigate — and refer on to hospital —their suspicious mole. This is a business model, not a health service.
7. Geoffrey Hinton (ex Edinburgh informatics) who is one of the giants in this area of AI says in his talks that ‘nobody should train as a radiologist’. He is right and wrong. Yes, the error rate in modern radiology is very, very high — simply because they are reporting so many ‘slices’ in scans in comparison with old-fashioned single ‘films’ (e.g. chest X-ray). But single bits of tech in medicine are often in addition to what has previously happened rather that a replacement. In this domain, radiologists now do a lot more than just report films. So, you will still need radiologists but what they do will change. Humans are sentient beings and, given the right incentives, doctors are remarkably creative.
8. There is still a very narrow perspective on skin disease in the UK, with a continued denial of the necessity for expertise. Primary care dermatology by doctors — let alone nurses who know even less and do not have professional registration in this domain of expertise — is a mess. It requires perceptual skills, and not unreasonably, many GPs do not have this because they have to know so much across a broad area of medicine. The average GP will see 1 melanoma every ten years. I started my dermatology training in Vienna: there are more dermatologists in Vienna than the whole of the UK. Specialism, pace Adam Smith and the pin factory, is what underpins much of the power of capitalism — and medicine, too. (Note: in this regard, some of the comparisons in the JAMA paper are facile).
9. I think the machines will play a role and we are better with them than without them. But in the short term, demands on hospital practice will increase and waiting times will increase even further. This technology — in the short to medium term — will make things worse. At present, dermatology waiting times are worse than when I was a medical student (and this was true pre-Covid). You don’t need AI to know why.
   

If only we had been funded…. 😀. Only joking.

An article available online today in the Times Higher. The answer of course is:

Yes, but not as we know it, Jim.

The Times Higher has a good summary of what I am trying to get across.

Does the UK need a radical shake-up of its medical schools? asks Jonathan Rees, emeritus professor of dermatology at the University of Edinburgh. Currently, they have three roles, which pull them in different directions: educating students, providing clinical leadership, and conducting academic research. But medical researchers are drifting away from treating real patients, or even lecturing to students, to pursue the pure research that best serves their careers – and the league table positions of their universities. Medical schools should focus on teaching “foundational knowledge and intellectual skills” for three years, but then medics should complete their training as full employees, Rees argues.