MetaMed: Evidence-Based Healthcare
In a world where 85% of doctors can't solve simple Bayesian word problems...
In a world where only 20.9% of reported results that a pharmaceutical company tries to investigate for development purposes, fully replicate...
In a world where "p-values" are anything the author wants them to be...
...and where there are all sorts of amazing technologies and techniques which nobody at your hospital has ever heard of...
...there's also MetaMed. Instead of just having “evidence-based medicine” in journals that doctors don't actually read, MetaMed will provide you with actual evidence-based healthcare. Their Chairman and CTO is Jaan Tallinn (cofounder of Skype, major funder of xrisk-related endeavors), one of their major VCs is Peter Thiel (major funder of MIRI), their management includes some names LWers will find familiar, and their researchers know math and stats and in many cases have also read LessWrong. If you have a sufficiently serious problem and can afford their service, MetaMed will (a) put someone on reading the relevant research literature who understands real statistics and can tell whether the paper is trustworthy; and (b) refer you to a cooperative doctor in their network who can carry out the therapies they find.
MetaMed was partially inspired by the case of a woman who had her fingertip chopped off, was told by the hospital that she was screwed, and then read through an awful lot of literature on her own until she found someone working on an advanced regenerative therapy that let her actually grow the fingertip back. The idea behind MetaMed isn't just that they will scour the literature to find how the best experimentally supported treatment differs from the average wisdom - people who regularly read LW will be aware that this is often a pretty large divergence - but that they will also look for this sort of very recent technology that most hospitals won't have heard about.
This is a new service and it has to interact with the existing medical system, so they are currently expensive, starting at $5,000 for a research report. (Keeping in mind that a basic report involves a lot of work by people who must be good at math.) If you have a sick friend who can afford it - especially if the regular system is failing them, and they want (or you want) their next step to be more science instead of "alternative medicine" or whatever - please do refer them to MetaMed immediately. We can’t all have nice things like this someday unless somebody pays for it while it’s still new and expensive. And the regular healthcare system really is bad enough at science (especially in the US, but science is difficult everywhere) that there's no point in condemning anyone to it when they can afford better.
I also got my hands on a copy of MetaMed's standard list of citations that they use to support points to reporters. What follows isn't nearly everything on MetaMed's list, just the items I found most interesting.
Applied Rationality Workshops: Jan 25-28 and March 1-4
The Center for Applied Rationality is running two more four-day workshops: Jan 25-28 and March 1-4 in the SF bay area. Like the previous workshop, these sessions are targeted at ambitious, analytic people who have broad intellectual interests, and who care about making real-world projects work. Less Wrong veterans and Less Wrong newcomers alike are welcome: as discussed below, we are intentionally bringing together folks with varied backgrounds and skill bases.
Workshop details:
Ritual 2012: A Moment of Darkness
This is the second post of the 2012 Ritual Sequence. The Introduction post is here.
This is... the extended version, I suppose, of a speech I gave at the Solstice.
The NYC Solstice Weekprior celebration begins bright and loud, and gradually becomes somber and poignant. Our opening songs are about the end of the world, but in a funny, boisterous manner that gets people excited and ready to sing. We gradually wind down, dimming lights, extinguishing flames. We turn to songs that aren’t sad but are more quiet and pretty.
And then things get grim. We read Beyond the Reach of God. We sing songs about a world where we are alone, where there is nothing protecting us, and where we somehow need to survive and thrive, even when it looks like the light is failing.
We extinguish all but a single candle, and read an abridged version of the Gift We Give to Tomorrow, which ends like this:
Once upon a time,
far away and long ago,
there were intelligent beings who were not themselves intelligently designed.
Once upon a time,
there were lovers, created by something that did not love.
Once upon a time,
when all of civilization was a single galaxy,
A single star.
A single planet.
A place called Earth.
Once upon a time.
And then we extinguish that candle, and sit for a moment in the darkness.
This year, I took that time to tell a story.
It’s included in the 2012 Ritual Book. I was going to post it at the end of the sequence. But I realized that it’s actually pretty important to the “What Exactly is the Point of Ritual?” discussion. So I’m writing a more fleshed out version now, both for easy reference and for people who don’t feel like hunting through a large pdf to find it.
It’s a bit longer, in this version - it’s what I might have said, if time wasn’t a constraint during the ceremony.
A year ago, I started planning for tonight. In particular, for this moment, after the last candle is snuffed out and we’re left alone in the dark with the knowledge that our world is unfair and that we have nobody to help us but each other.
I wanted to talk about death.
My grandmother died two years ago. The years leading up to her death were painful. She slowly lost her mobility, until all she could do was sit in her living room and hope her family would come by to visit and talk to her.
2012 Survey Results
Thank you to everyone who took the 2012 Less Wrong Survey (the survey is now closed. Do not try to take it.) Below the cut, this post contains the basic survey results, a few more complicated analyses, and the data available for download so you can explore it further on your own. You may want to compare these to the results of the 2011 Less Wrong Survey.
Firewalling the Optimal from the Rational
Followup to: Rationality: Appreciating Cognitive Algorithms (minor post)
There's an old anecdote about Ayn Rand, which Michael Shermer recounts in his "The Unlikeliest Cult in History" (note: calling a fact unlikely is an insult to your prior model, not the fact itself), which went as follows:
Branden recalled an evening when a friend of Rand's remarked that he enjoyed the music of Richard Strauss. "When he left at the end of the evening, Ayn said, in a reaction becoming increasingly typical, 'Now I understand why he and I can never be real soulmates. The distance in our sense of life is too great.' Often she did not wait until a friend had left to make such remarks."
Many readers may already have appreciated this point, but one of the Go stones placed to block that failure mode is being careful what we bless with the great community-normative-keyword 'rational'. And one of the ways we do that is by trying to deflate the word 'rational' out of sentences, especially in post titles or critical comments, which can live without the word. As you hopefully recall from the previous post, we're only forced to use the word 'rational' when we talk about the cognitive algorithms which systematically promote goal achievement or map-territory correspondences. Otherwise the word can be deflated out of the sentence; e.g. "It's rational to believe in anthropogenic global warming" goes to "Human activities are causing global temperatures to rise"; or "It's rational to vote for Party X" deflates to "It's optimal to vote for Party X" or just "I think you should vote for Party X".
If you're writing a post comparing the experimental evidence for four different diets, that's not "Rational Dieting", that's "Optimal Dieting". A post about rational dieting is if you're writing about how the sunk cost fallacy causes people to eat food they've already purchased even if they're not hungry, or if you're writing about how the typical mind fallacy or law of small numbers leads people to overestimate how likely it is that a diet which worked for them will work for a friend. And even then, your title is 'Dieting and the Sunk Cost Fallacy', unless it's an overview of four different cognitive biases affecting dieting. In which case a better title would be 'Four Biases Screwing Up Your Diet', since 'Rational Dieting' carries an implication that your post discusses the cognitive algorithm for dieting, as opposed to four contributing things to keep in mind.
Welcome to Less Wrong! (July 2012)
If you've recently joined the Less Wrong community, please leave a comment here and introduce yourself. We'd love to know who you are, what you're doing, what you value, how you came to identify as a rationalist or how you found us. You can skip right to that if you like; the rest of this post consists of a few things you might find helpful. More can be found at the FAQ.
Tips for Starting Group Houses
I've lived in several intentional communities and have been one of the creators of two that I've lived in. After recently securing Zendo, I wrote up some tips to a friend who is thinking about starting another Berkeley house, which Nisan pointed out might be valuable to share with the community at large, so here it is guys! These tips apply most to shared rental places, as opposed to bought property, although the stuff about vision applies to pretty much any joint venture that people embark on with shared leadership, such as group housing, event planning, and start-ups. The part about using padmapper.com and acting quickly applies a lot to Berkeley in particular, because the housing market in this city is especially messed up with rent control and thus finding good places is particularly difficult. We found our place over a month in advance of move in, and it was about $200-300 cheaper/room than similar places in the vicinity/class we were looking at that showed up during the same timeframe. Using these techniques is how we got it — I called within an hour of the posting thanks to being on email when I got the padmapper alert, set up an appointment to see the property manager right away, and while I was there in person, another person made her an offer of a downpayment on the spot. I'm pretty certain that its because of my pro-activeness and handing her a big stack of rental agreements and credit reports that we got this place rather than the several other interested parties. Many thanks to Kevin Fischer, Louie Helm, and Eliezer Yudkowsky for helping me with the rental search and acquisition information!
Tips:
- Arrange meetings with people a week or two in advance over Doodle.com to find dates/times that work for large groups. You might not be able to accomodate everyone even doing that and might need to pick the day that the largest number of people can make it. You can do things like record calls or have people Skype in or do a conference line.
- Get credit reports from everyone. There are services for free reports.
- Download the standard application form and have everyone fill it out, so that you can deliver both credit reports and applications on the spot when you go to check a place out.
- Use padmapper.com to track the areas you're interested in. Contact places asap — good places will go in a single day sometimes.
- Make sure your group has a unified vision about what they want. If one person wants a pretty place, and one person wants a cheap place, they will block each other and you won't ever reach consensus. Not having a unified vision, and not realizing this, is where the majority of would-be co-housing communities fail. If there's something you want people to have as a house culture, make sure thats in agreement too. I personally requested that people be willing to chip in for a maid and hot tub and maintain a paleo 2.0 kitchen, and these things have all been adopted. Vision can include anything from over-arching life goals to never having dishes cluttering the sink. Explore what you really care about and make sure that everyone explicitly agrees to whatever goals are set and that no one is silently dissatisfied.
The problem with too many rational memes
Like so many of my posts, this one starts with a personal anecdote.
A few weeks ago, my boyfriend was invited to a community event through Meetup.com. The purpose of the meetup was to watch the movie The Elegant Universe and follow up with a discussion. As it turns out, this particular meetup was run by a man who I’ll call ‘Charlie’, the leader of some local Ottawa group designed to help new immigrants to Canada find a social support net. Which, in my mind, is an excellent goal.
Charlie turned out to be a pretty neat guy, too: charismatic, funny, friendly, encouraging everyone to share his or her opinion. Criticizing or shutting out other people’s views was explicitly forbidden. It was a diverse group, as he obviously wanted it to be, and by the end everyone seemed to feel pretty comfortable.
My boyfriend, an extremely social being whose main goal in life is networking, was raving by the end about what a neat idea it was to start this kind of group, and how Charlie was a really cool guy. I was the one who should have had fun, since I’m about 100 times more interested in physics than he is, but I was fuming silently.
Why? Because, at various points in the evening, Charlie talked about his own interest in the paranormal and the spiritual, and the books he’d written about it. When we were discussing string theory and its extra dimensions, he made a comment, the gist of which was ‘if people’s souls go to other dimensions when they die, Grandma could be communicating with you right now from another dimension by tapping spoons.’
Final straw. I bit my tongue and didn’t say anything and tried not to show how irritated I was. Which is strange, because I’ve always been fairly tolerant, fairly agreeable, and very eager to please others. Which is why, when my brain responded ‘because he’s WRONG and I can’t call him out on it because of the no criticism rule!’ to the query of ‘why are you pissed off?’, I was a bit suspicious of that answer.
I do think that Charlie is wrong. I would have thought he was wrong a long time ago. But it wouldn’t have bothered me; I know that because I managed to attend various churches for years, even though I thought a lot of their beliefs were wrong, because it didn’t matter. They had certain goals in common with me, like wanting to make the world a better place, and there were certain things I could get out of being a community member, like incredibly peaceful experiences of bliss that would reset my always-high stress levels to zero and allow me to survive the rest of the week. Some of the sub-goals they had planned to make the world a better place, like converting people in Third World countries to Christianity, were ones that I thought were sub-optimal or even damaging. But overall, there were more goals we had in common than goals we didn’t have in common, and I could, I judged, accomplish those goals we had in common more effectively with them than on my own. And anyway, the church would still be there whether or not I went; if I did go, at least I could talk about stuff like physics with awe and joy (no faking required, thinking about physics does make me feel awe and joy), and increase some of the congregation’s scientific literacy a little bit.
Then I stopped going to church, and I started spending more time on Less Wrong, and if I were to try to go back, I’m worried it would be exactly the same as the community meetup. I would sit there fuming because they were wrong and it was socially unacceptable for me to tell them that.
I’m worried because I don’t think those feelings are the result of a clearheaded, logical value calculation. Yeah, churches and people who believe in the paranormal waste a lot of money and energy, which could be spent on really useful things otherwise. Yes, that could be a valid reason to reject them, to refuse to be their allies even if some of your goals are the same. But it’s not my true rejection. My true rejection is that them being wrong is too annoying for me to want to cooperate. Why? I haven’t changed my mind, really, about how much damage versus good I think churches do for the world.
I’m worried that the same process which normalized religion for me is now operating in the opposite direction. I’m worried that a lot of Less Wrong memes, ideas that show membership to the ‘rationalist’ or ‘skeptic’ cultures, such as atheism itself, or the idea that religion is bad for humanity...I’m worried that they’re sneaking into my head and becoming virulent, that I'm becoming an undiscriminating skeptic. Not because I’ve been presented with way more evidence for them, and updated on my beliefs (although I have updated on some beliefs based on things I read here), but because that agreeable, eager-to-please subset of my brains sees the Less Wrong community and wants to fit in. There’s a part of me that evaluates what I read, or hear people say, or find myself thinking, and imagines Eliezer’s response to it. And if that response is negative...ooh, mine had better be negative too.
And that’s not strategic, optimal, or rational. In fact, it’s preventing me from doing something that might otherwise be a goal for me: joining and volunteering and becoming active in a group that does good things for the Ottawa community. And this transformation has managed to happen without me even noticing, which is a bit scary. I’ve always thought of myself as someone who was aware of my own thoughts, but apparently not.
Anyone else have the same experience?
Welcome to Less Wrong! (2012)
2011 Survey Results
A big thank you to the 1090 people who took the second Less Wrong Census/Survey.
Does this mean there are 1090 people who post on Less Wrong? Not necessarily. 165 people said they had zero karma, and 406 people skipped the karma question - I assume a good number of the skippers were people with zero karma or without accounts. So we can only prove that 519 people post on Less Wrong. Which is still a lot of people.
I apologize for failing to ask who had or did not have an LW account. Because there are a number of these failures, I'm putting them all in a comment to this post so they don't clutter the survey results. Please talk about changes you want for next year's survey there.
Of our 1090 respondents, 972 (89%) were male, 92 (8.4%) female, 7 (.6%) transexual, and 19 gave various other answers or objected to the question. As abysmally male-dominated as these results are, the percent of women has tripled since the last survey in mid-2009.
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