The Takeaways: Week 17 of 2022

Amazon digital media, faxing in healthcare, an update out of one of my favorite data sources, the Survey of Earned Doctorates, and a look into what it could take to take an algorithm for predicting missed medical appointments to production - even after its predictive power was validated.

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Tim Carmody, Amazon Chronicles. The Earnings Drumbeats Are Calling (April 27, 2022)

Okay, here’s the problem: Prime has gotten so big and bloated that it risks becoming confusing to customers who might want something relatively straightforward like (ugh) watching shows on Freevee and shopping at Walmart or Tesco instead. It also risks drawing further attention from government regulators, who see problems with Amazon using its strong position in shipping to do things that look, let’s say, less than fully competitive both on the retail and digital media fronts. It’s not exactly Windows shipping with Internet Explorer, but it’s closer to Windows shipping with Internet Explorer than everyone would like.

Ben Leonard, Politico Future Pulse. Interview with Micky Tripathi, national coordinator for Health IT at the Department of Health and Human Services (April 27, 2022)

Q: When do you think the fax machine is going to be out of health care?

A: It’s going to be a long time, because these technologies have long tails. If you look at the history of the phone system, we started having modern switching technology in the early 1900s. The last party line system was taken down in the 1970s. That’s one aspect. I think the other aspect is that faxing is still highly usable in lots of ways.

That’s the challenge for us: How do we get to our other forms of technology to be able to mimic the convenience and the flexibility of faxing? That’s what’s going to allow the replacement of it.

Olivia Webb, Acute Condition. Incentive structures to save us all from pathogens (April 29, 2022)

At the same time, the world has suffered an “antibiotic discovery void,” with the no novel classes of antibiotics discovered since the 1980s.

This gap is at least in part because many companies are wary of investing in antibiotic research. Any novel antibiotics would have to be held as a back-up for the most recalcitrant pathogens. As such, there’s a very limited market for new antibiotics. The case of Achaogen is striking. The company developed a new antibiotic, Zemdri, which became the first antibiotic designated by the FDA as a “breakthrough therapy.” The World Health Organization added Zemdri to its list of essential drugs. And then, lacking the revenue to do additional clinical trials and market the drug, the company went bankrupt.

Articles

Scott Jaschik, Inside Higher Ed. Study: Humanities graduate education is shrinking (April 29, 2022)

Master’s degrees in the humanities, of which 16,057 were awarded in 1988, rose to 32,584 in 2012, the year they peaked. In 2020, they fell to 26,566, the report said. The number of doctoral degrees awarded also rose and fell during that time. There were 3,110 doctoral degrees in the humanities in 1998. The number rose steadily to 6,010 in 2015 but fell to 5,483 in 2020.

Mohana Ravindranath, STAT. AI can predict missed appointments. How can hospitals use that data for better care? (April 28, 2022)

Missed appointments are a common problem at health systems. And they’re a particularly attractive target for machine learning researchers, who can use patient datasets to get a handle on what’s causing patients to miss out on needed care. In new research published this month, a group of researchers at Boston Children’s crunched more than 160,000 hospital appointment records from almost 20,000 patients for clues. Their model found patients who had a history of no-shows were more likely to miss future appointments, as were patients with language barriers and those scheduled to see their provider on days with bad weather.

They’re predictions that, in theory, could help a health system target interventions to the patients at highest risk of missing their appointments and offer them whatever help they need making it in. But even though Boston Children’s leaders helped develop and test the model, the health system isn’t yet sold on taking it out of pilot mode and actually putting it into practice.

“What I really loved about this was the thought experiment about what things might show up as actually predictive,” said Kathleen Conroy, clinical chief at Children’s Hospital Primary Care Center within Boston Children’s Hospital and a co-author of the study. “Even if they are theoretically actionable, what would you even be willing to do with that information and how would you put that through a family-centered lens?”