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Stanford apologizes after vaccine allocation leaves out medical residents

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Re: Stanford apologizes after vaccine allocation leaves out medical residents

#161
post #12

The labor of medical residents is something hospital systems exploit during normal times, but that exploitation has severely deepened during the pandemic. At the hospital my partner works at, respiratory therapists and nurses got a $10k bonus for working during COVID; the residents got nothing despite working insane hours in ICU, routinely working more than the legally mandated 90 hours per week. Just because doctors…

I can name 3 other local hospital systems in my city that have vaccinated administrative & C-suite/VP level staff before doctors, nurses, and other frontline employees.

What's stopping you?

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#162

Evidence like this suggest that medical leadership for the most part care very little about house officers (residents), and that is pretty universal. Our institution built a new billion dollar hospital and did not include call rooms. Great job.

Exactly. Residents in the United States are deeply in debt and can't quit, and the resulting quality of working conditions is sadly predictable: https://jakeseliger.com/2012/10/20/why-you-should-become-a-n...

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#163

> "[A]lgorithms are made by people and the results ... were reviewed multiple times by people," You got that right. The way they talk about "an algorithm did it" makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something. We'll be seeing more and more of this of course. "We can't be blamed, it was an algorithm! We can't be blamed for trusti…

Standing on the shoulders of Giants, I would like to suggest the term 'Distributed Bureaucracy' to reflect when an algorithm you didn't even know existed determines your allocation of resources.

And the thing here is, vaccine distribution in a single institution clearly wouldn't need an elaborate algorithm. But yeah, creating an algorithm and then throwing up your hands to say "who knew!" is very convenient.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#164

Earlier quoted context omitted.

The residents who didn't get it: those working 80+ hrs/week in the emergency room, in the ICU, intubating patients, operating on patients, etc etc etc Some people I know of who got it instead: Radiologists who primarily work from home. Administrative roles with relatively low (or no) patient interaction. Not saying those people shouldn't get vaccinated -- just that if you were asked to come up with a priority list, i…

Thanks for the info, that stinks for sure. I hope they get it right now that they are revisiting the issue. I have a soft spot for that hospital, my first child was born there.

They are trying.

For what its worth, faculty across multiple departments (including those radiologists) stepped up and declined their scheduled vaccine appointments until residents get vaccinated first.

It's a big place made up of mostly smart (and good) people. A lot of outrage is at the administration's poor planning, failure to respond quickly the problem, and subsequent excuse-making.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#165

Earlier quoted context omitted.

I am not a native speaker and I don't think I understand the quote. What should "money laundering for bias mean"?

Since computers are unbiased, the idea is that machine learning is also unbiased. However, that's not true and, if anything, it actually re-enforces a lot of bias. I've never done any, but my understanding is that machine learning is just correlation. It's good at figuring out "what", but not "why". Consider training an algorithm to recognize horses by feeding it millions of pictures of horses. Eventually, the algori…

I share your concerns. I am of the opinion that we shouldn't be using machine learning algorithms to make decisions of consequence in people's lives without filtering those decisions through human operators. You can use machine learning to assist these human operators and empower them to do much more work than without the technology. But at the end of the day, you still have someone to hold responsible, and you still have checks on the ML doing something profoundly unethical.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#166
Nobody is catching that residents are almost universally 25-35 years old, which puts them in an extremely low risk category for serious illness.

Which sucks, but is 100% the most efficient way to prevent deaths. Giving the vaccines to older workers first is correct.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#167
post #133

Earlier quoted context omitted.

I don't think I was assuming anything in particular about the intents. it's a rather important thing not to check on actual data, including residents in the sample, isn't it? they just never bothered to test the algorithm, didn't even review the results it spit out, before delivering the results as a plan? (it is quite possible indeed they didn't, I'm not saying that is a coverup for some other motive, I'm saying tha…

"Designed"? They had a meeting and discussed what criteria they should use, someone documented that, and someone else wrote some Excel.

You were there?

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#168

Earlier quoted context omitted.

"Machine learning is like money laundering for bias" https://twitter.com/pinboard/status/744595961217835008

I am not a native speaker and I don't think I understand the quote. What should "money laundering for bias mean"?

“Money laundering” is taking criminal money (maybe marked currency or something) and trading them out for “clean” currency that can’t be tracked.

Imagine a dataset about healthcare outcomes. You want to know whether airlifting a patient is good or bad, so you train a machine learning model to predict mortality given airlifting a patient versus not airlifting them. Turns out a lot more of the airlifted patients died, and the model picks up on that, deciding that airlifting is dangerous.

Obviously, we’re airlifting the patients who are in the most dire circumstances, and that’s why they die more, but maybe the model doesn’t have the context/circumstance variables to see that, or maybe it’s just regularized and thinks those context variables are noise. So the bias of “airlift = bad” gets stuck in the model, but then people defend it as mathematically precise so it can’t be biased like a person can. They say that the model just reflects reality, pretending the model or data is wrong is blindly rejecting reality for the sake of political correctness.

It’s worse with really human stuff like recidivism because the context variables that might be useful (like the patient’s dire circumstances) tend to be very human and complex and they’re unlikely to be captured in a simple form. Even if they were, interpreting them might require human level AI. By analogy, it is frequently impossible (or just too hard to be worth it) for current technology’s ML to tell from the data we feed it that the patients being airlifted were most near death to begin with.

So you end up with an algorithm biased against airlifting patients getting defended as mathematically bulletproof.

Re: Stanford apologizes after vaccine allocation leaves out medical residents

#169
post #146

Earlier quoted context omitted.

How would you expect the computer programmer analogy be completed? I legitimately don’t know what a reasonable answer would be.

The takeaway is the model has bias. It’s up to humans to decide what to do with that information. Depending on the input “homemaker” may be a technically reasonable output. Should we use such a model to suggest career paths to high school students? Or should we reevaluate the methodology?

Who cares about ML when we already do that:

https://www.slideshare.net/yuyomajadero/jobs-occupations-pro...

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