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Graphs can help people arrive at data-supported conclusions. However, graphs might also induce bias by shifting the amount of evidence needed to make a decision, such as deciding whether a treatment had some kind of effect. In 2 experiments, we manipulated the early base rates of treatment effects in graphs. Early base rates had a large effect on a signal detection measure of bias in future graphs even though all future graphs had a 50% chance of showing a treatment effect, regardless of earlier base rates. In contrast, the autocorrelation of data points within each graph had a larger effect on discriminability. Exploratory analyses showed that a simple cue could be used to correctly categorize most graphs, and we examine participants’ use of this cue among others in lens models. When exposed to multiple graphs on the same topic, human judges can draw conclusions about the data, but once those conclusions are made, they can affect subsequent graph judgment.
This chapter analyzes challenges to AI decision-making based on anti-discrimination in the US, the UK, and Australia. Machine learning algorithms can be trained on datasets that contain human bias, thus resulting in predictions that are tainted with unfair discrimination. Anti-discrimination claims involve challenging the inputs of decision-making, such as the data or source code, and arguing that the flawed algorithm or data inputted into the AI system leads to discriminatory outcomes.
This book is about the science and ethics of clinical research and healthcare. We provide an overview of each chapter in its three sections. The first section reviews foundational knowledge about clinical research. The second section provides background and critique on key components and issues in clinical research, ranging from how research questions are formulated, to how to find and synthesize the research that is produced. The third section comprises four case studies of widely used evaluations and treatments. These case examples are exercises in critical thinking, applying the questions and methods outlined in other sections of the book. Each chapter suggests strategies to help clinical research be more useful for clinicians and more relevant for patients.
In order to examine our three questions, we need objective research methods. Estimating whether a treatment can work, does work, and has value requires a wide range of research strategies. Evidence establishing that a treatment works under controlled conditions does not necessarily assure benefits when the intervention is applied in clinical practice. This chapter considers the development of a research protocol, and biases that might be attributable to participant recruitment, enrollment, retention, and dissemination of findings. In practice, establishing the value of a treatment should consider an examination of the existing literature, development of thorough research plans, recognition of the strengths and weaknesses of the chosen research methods, and integration of study results within a wider body of knowledge. We challenge beliefs in a hierarchy of methods that assumes some methods, such as the RCT, are free from bias.
Gastroesophageal reflux disease is a common condition that can be controlled with proton pump inhibitors such as omeprazole. We examine randomized controlled trials (RCTs) of omeprazole and find stronger evidence of efficacy among RCTs with industry support than without. The participants in these trials were unlike most people who take proton pump inhibitors, raising questions about the external validity of RCTs. Furthermore, use of these medicines is associated with short- and longer-term adverse effects. Healthy behavior change, such as weight loss, holds promise as an alternative to proton pump inhibitors.
After reviewing a wide range of topics, we conclude that good science requires greater efforts to manage biases and to promote the ethical conduct of research. An important problem is the belief that randomized controlled trials (RCTs) are exempt from systematic bias. Throughout the book, we acknowledge the importance of RCTs, but also emphasize that they are not immune from systematic bias. A second lesson concerns conflict of interest, which must always be taken seriously. Most large RCTs are sponsored by for-profit pharmaceutical companies. We identify leverage points to address these problems. These include cultivating equipoise – the position that research investigators enter a study with the understanding that either a positive, negative, or null result is of value. We return to several other themes prominent throughout this book, including the reporting of research findings and serious problems with our system of peer review. The book concludes with recommendations for reducing conflicts of interest, improving transparency, and reimagining the peer review system.
Research is about asking and answering questions. One of the most important investments of time for a research investigator should occur before the study starts. This chapter considers the importance of well-defined research questions that have clear boundaries and scope. The specifics of the research methodologies such as sample size and data analysis are essential for high-quality research. Yet less emphasis is placed on the importance of the research question, the feasibility of the study, and the social impact of the investigation. This chapter argues that clinical research should be person- and community-centered. The population, intervention, comparator, outcome, and timeframe (PICOT) framework encompasses content that may be informative for those who use health care. The feasible, interesting, novel, ethical, and relevant (FINER) framework comes closer to focusing on questions and outcomes of importance to study participants. We offer a BASES (biases, awareness, social, equilibrium, specificity) model that builds on the FINER and PICOT systems to place greater emphasis on social context.
Contemporary science depends heavily on peer review. Usually without compensation, experts evaluate the reliability and quality of work contributed by other scientists. The system of peer review now confronts serious challenges. The volume of scientific work that requires peer scrutiny has grown exponentially, placing pressure on reviewers’ availability. Academic publishing has been challenged by two trends. First, uncompensated peer reviewers are less willing to offer evaluations. The rate of declining invitations to review has dramatically increased. Second, commercial publishers charge authors exorbitant fees to publish their work. Younger authors, and those from less wealthy countries, can’t afford these charges. We offer several remedies to address these problems. These include reevaluating the relationships between universities or scholarly societies and for-profit publishing houses. An alternative system might return publishing to university libraries and scholarly societies. The system would be funded by the hundreds of millions of dollars that academia currently transfers to commercial enterprises.
Economic models typically allow for “free disposal” or “reversibility” of information, which implies non-negative value. Building on previous research on the “curse of knowledge” we explore situations where this might not be so. In three experiments, we document situations in which participants place positive value on information in attempting to predict the performance of uninformed others, even when acquiring that information diminishes their earnings. In the first experiment, a majority of participants choose to hire informed—rather than uninformed—agents, leading to lower earnings. In the second experiment, a significant number of participants pay for information—the solution to a puzzle—that hurts their ability to predict how many others will solve the puzzle. In the third experiment, we find that the effect is reduced with experience and feedback on the actual performance to be predicted. We discuss implications of our results for the role of information and informed decision making in economic situations.
This book provides a comprehensive analysis of biases inherent in contemporary clinical research, challenging traditional methodologies and assumptions. Aimed at students, professionals, and science enthusiasts, the book delves into fundamental principles, research tools, and ethics. It is organized in three sections: The first section covers fundamentals including framing clinical research questions, core research tools, and clinical research ethics. The second section discusses topics relevant to clinical research, organized according to their relevance in the development of a clinical study. Chapters within this section examine the strengths and limitations of traditional and alternative methods, ethical issues, and patient-centered consequences. The third section presents four in-depth case examples, illustrating issues across diverse health conditions and treatments: gastroesophageal reflux disease, hypercholesterolemia, screening for breast cancer, and depression. This examination encourages readers to critically evaluate the methodologies and assumptions underlying clinical research, promoting a nuanced understanding of evidence production in the health sciences.
This chapter addresses some of the classic problems of historical analysis, focusing on the ways in which the intellectual options that the complex history of the discipline can help historians address the challenges those problems pose. It presents a discussion of the problems of objectivity, bias, and judgment in history. It focuses on historians’ necessarily paradoxical yet coherent conception of their own relationship to history – of which they are, according to the logic of the discipline itself, both students and products. It suggests that postmodern theory about the nature of historical knowledge both recapitulates and deepens this fundamental historicist position. It discusses the standards of evidentiary support and of logical argumentation that historians use to evaluate the plausibility and productivity of historical interpretations. Finally, this chapter explores once again the unique pedagogical usefulness of History as a discipline that is irreducibly and necessarily perspectival, interpretive, and focused on standards of inquiry rather than on the production of actionable outcomes.
To the known causes of overconfidence in decisions and judgments, we reveal another source that derives from a bias during the act of decision making. While this bias, the predecisional distortion of information, is well studied, its impact on overconfidence is not. We demonstrate how the distortion of information creates overconfidence in those professionals often regarded as singularly overconfident, entrepreneurs. When these professionals use a sequence of relevant information to make an accept-reject decision about a business opportunity, a cycle of confidence-distortion-confidence builds unjustified confidence in the chosen action – and does so whether that action is to accept or reject the venture. Overconfidence is a well-recognized cause of flawed decision making. Our work demonstrates the paradoxical converse of this claim, that flawed decision making can be a cause of overconfidence.
This scoping review of conceptualizations of fundamentalism scrutinizes the concept's domain of application, defining characteristics, and liability to bias. We find fundamentalism in four domains of application: Christianity, other Abrahamic religions, non-Abrahamic religions, and non-religious phenomena. The defining characteristics which we identify are organized into five categories: belief, behavior, emotion, goal, and structure. We find that different kinds of fundamentalisms are defined by different characteristics, with violent and oppressive behaviors, and political beliefs and goals being emphasized for non-Christian fundamentalisms. Additionally, we find that the locus of fundamentalism studies is the Global North. Based on these findings, we conclude that the concept is prone to bias. When conceptualizing fundamentalism, three considerations deserve attention: the mutual dependency between the domain of application and the specification of defining characteristics; the question of usefulness of scientific concepts; and the connection between conceptual ambiguity and the risk of bias in the study of fundamentalism.
There is a large literature evaluating the dual process model of cognition, including the biases and heuristics it implies. However, our understanding of what causes effortful thinking remains incomplete. To advance this literature, we focus on what triggers decision-makers to switch from the intuitive process (System 1) to the more deliberative process (System 2). We examine how the framing of incentives (gains versus losses) influences decision processing. To evaluate this, we design experiments based on a task developed to distinguish between intuitive and deliberative thinking. Replicating previous research, we find that losses elicit more cognitive effort. Most importantly, we also find that losses differentially reduce the incidence of intuitive answers, consistent with triggering a shift between these modes of cognition. We find substantial heterogeneity in these effects, with young men being much more responsive to the loss framing. To complement these findings, we provide robustness tests of our results using aggregated data, the imposition of a constraint to hinder the activation of System 2, and an analysis of incorrect, but unintuitive, answers to inform hybrid models of choice.
The main principles underpinning measurement for healthcare improvement are outlined in this Element. Although there is no single formula for achieving optimal measurement to support improvement, a fundamental principle is the importance of using multiple measures and approaches to gathering data. Using a single measure falls short in capturing the multifaceted aspects of care across diverse patient populations, as well as all the intended and unintended consequences of improvement interventions within various quality domains. Even within a single domain, improvement efforts can succeed in several ways and go wrong in others. Therefore, a family of measures is usually necessary. Clearly communicating a plausible theory outlining how an intervention will lead to desired outcomes informs decisions about the scope and types of measurement used. Improvement teams must tread carefully to avoid imposing undue burdens on patients, clinicians, or organisations. This title is also available as Open Access on Cambridge Core.
Chapter 3 presents localized peace enforcement theory. It first discusses the challenges facing individuals involved in a communal dispute. Reflecting on these obstacles to peaceful dispute resolution, the chapter outlines a formal micro-level theory of dispute escalation between two individuals from different social groups who live in the same community. It explains how international intervention shapes escalation dynamics. The chapter then shifts the focus to local perceptions of intervener impartiality, which the theory posits are a key determinant of whether a UN intervention succeeds in preventing the onset of violence. The identifies the importance of multilateralism, diversity, and the nonuse of force as critical factors shaping local perceptions and, as a result, UN peacekeeping effectiveness. Critically, the theory does not suggest that UN peacekeepers will always succeed, or that all kinds of UN peacekeepers will succeed. Indeed, perceptions of UN peacekeepers vary depending on the troop-contributing country and the identity of the civilians involved in the dispute. The chapter closes with a discussion of the most important hypotheses derived from the theory.
This paper provides results on a form of adaptive testing that is used frequently in intelligence testing. In these tests, items are presented in order of increasing difficulty. The presentation of items is adaptive in the sense that a session is discontinued once a test taker produces a certain number of incorrect responses in sequence, with subsequent (not observed) responses commonly scored as wrong. The Stanford-Binet Intelligence Scales (SB5; Riverside Publishing Company, 2003) and the Kaufman Assessment Battery for Children (KABC-II; Kaufman and Kaufman, 2004), the Kaufman Adolescent and Adult Intelligence Test (Kaufman and Kaufman 2014) and the Universal Nonverbal Intelligence Test (2nd ed.) (Bracken and McCallum 2015) are some of the many examples using this rule. He and Wolfe (Educ Psychol Meas 72(5):808–826, 2012. https://doi.org/10.1177/0013164412441937) compared different ability estimation methods in a simulation study for this discontinue rule adaptation of test length. However, there has been no study, to our knowledge, of the underlying distributional properties based on analytic arguments drawing on probability theory, of what these authors call stochastic censoring of responses. The study results obtained by He and Wolfe (Educ Psychol Meas 72(5):808–826, 2012. https://doi.org/10.1177/0013164412441937) agree with results presented by DeAyala et al. (J Educ Meas 38:213–234, 2001) as well as Rose et al. (Modeling non-ignorable missing data with item response theory (IRT; ETS RR-10-11), Educational Testing Service, Princeton, 2010) and Rose et al. (Psychometrika 82:795–819, 2017. https://doi.org/10.1007/s11336-016-9544-7) in that ability estimates are biased most when scoring the not observed responses as wrong. This scoring is used operationally, so more research is needed in order to improve practice in this field. The paper extends existing research on adaptivity by discontinue rules in intelligence tests in multiple ways: First, an analytical study of the distributional properties of discontinue rule scored items is presented. Second, a simulation is presented that includes additional scoring rules and uses ability estimators that may be suitable to reduce bias for discontinue rule scored intelligence tests.
Lord developed an approximation for the bias function for the maximum likelihood estimate in the context of the three-parameter logistic model. Using Taylor's expansion of the likelihood equation, he obtained an equation that includes the conditional expectation, given true ability, of the discrepancy between the maximum likelihood estimate and true ability. All terms of orders higher than n−1 are ignored where n indicates the number of items. Lord assumed that all item and individual parameters are bounded, all item parameters are known or well-estimated, and the number of items is reasonably large. In the present paper, an approximation for the bias function of the maximum likelihood estimate of the latent trait, or ability, will be developed using the same assumptions for the more general case where item responses are discrete. This will include the dichotomous response level, for which the three-parameter logistic model has been discussed, the graded response level and the nominal response level. Some observations will be made for both dichotomous and graded response levels.
Rationale and the actual procedures of two nonparametric approaches, called Bivariate P.D.F. Approach and Conditional P.D.F. Approach, for estimating the operating characteristic of a discrete item response, or the conditional probability, given latent trait, that the examinee's response be that specific response, are introduced and discussed. These methods are featured by the facts that: (a) estimation is made without assuming any mathematical forms, and (b) it is based upon a relatively small sample of several hundred to a few thousand examinees.
Some examples of the results obtained by the Simple Sum Procedure and the Differential Weight Procedure of the Conditional P.D.F. Approach are given, using simulated data. The usefulness of these nonparametric methods is also discussed.
Samejima has recently given an approximation for the bias function for the maximum likelihood estimate of the latent trait in the general case where item responses are discrete, generalizing Lord's bias function in the three-parameter logistic model for the dichotomous response level. In the present paper, observations are made about the behavior of this bias function for the dichotomous response level in general, and also with respect to several widely used mathematical models. Some empirical examples are given.