A few notes about the site mechanics

I have been thinking about the gamification of psychiatry and the rise of mental health apps as a means to motivate behaviours that improve mental health and flourishing. I put together some indications and left a diagram here for my good friends Anne Osognosia and Alex Ithemyia who want to upgrade elements of their mental health based on my personal experience rather than population-based evidence.

Initially I wanted to create a skill tree of sorts and may return to it if some people with app-building experience and an interest in this raise their hands. That would be for evidence-based skills rather than this proof of concept.

If it's worth saying, but not worth its own post (even in Discussion), then it goes here.

Notes for future OT posters:

1. Please add the 'open_thread' tag.

2. Check if there is an active Open Thread before posting a new one. (Immediately before; refresh the list-of-threads page before posting.)

3. Open Threads should be posted in Discussion, and not Main.

4. Open Threads should start on Monday, and end on Sunday.

Community

The Center For Applied Rationality (CFAR) checklist is a heuristic for assessing the admissibility of one's own testimony. 

What of the challenge of evaluating the testimony of others?

Slapping the label of a bias on a situation?

Arguing at the object level by provision of evidence to the contrary?

This risks Gish Gallop. For those who prefer to pick their battles, I commisioned this post of my time, a structural intervention into the information ecosystem.

We need not event the wheel, for legal theorists have researched this issue for years, while practitioners and courts have identified heuristics useful to lay people interested in this field. 

Precedent 

The Daubert standard provides a rule of evidence regarding the admissibility of expert witnesses' testimony during United States federal legal proceedings. Pursuant to this standard, a party may raise a Daubert motion, which is a special case of motion in limine raised before or during trial to exclude the presentation of unqualified evidence to the jury. The Daubert trilogy refers to the three United States Supreme Court cases that articulated the Daubert standard:

-https://en.wikipedia.org/wiki/Daubert_standard

Further reading on the case is available here on Google Scholar

Practice

How can this be applied in practice? 

What is the first principle of skepticism. It's effectively synonymous: 'question'

What question? This isn't the 5 W's of primary school, after all.

I have summarized critical questions to a reading here to get the ball rolling:

Issues to consider when contesting and evaluating expert opinion evidence

 

A. Relevance (on the voir dire)

I accept that you are highly qualified and have extensive experience, but how do we know that your level of performance regarding . . . [the task at hand — eg, voice comparison] is actually better than that of a lay person (or the jury)?

What independent evidence... [such as published studies of your technique and its accuracy] can you direct us to that would allow us to answer this question?

What independent evidence confirms that your technique works?

Do you participate in a blind proficiency testing program?

Given that you undertake blind proficiency exercises, are these exercises also given to lay persons to determine if there are significant differences in results, such that your asserted expertise can be supported?

B. Validation 

Do you accept that techniques should be validated?

Can you direct us to specific studies that have validated the technique that you used?

What precisely did these studies assess (and is the technique being used in the same way in this case)?

Have you ever had your ability formally tested in conditions where the correct answer was known? (ie, not a previous investigation or trial)

Might different analysts using your technique produce different answers?

Has there been any variation in the result on any of the validation or proficiency tests you know of or participated in?

Can you direct us to the written standard or protocol used in your analysis?

Was it followed?

C. Limitations and errors

Could you explain the limitations of this technique?

Can you tell us about the error rate or potential sources of error associated with this technique?

Can you point to specific studies that provide an error rate or an estimation of an error rate for your technique?

How did you select what to examine?

Were there any differences observed when making your comparison . . . [eg, between two fingerprints], but which you ultimately discounted? On what basis were these discounted?

Could there be differences between the samples that you are unable to observe?

Might someone using the same technique come to a different conclusion?

Might someone using a different technique come to a different conclusion?

Did any of your colleagues disagree with you?

Did any express concerns about the quality of the sample, the results, or your interpretation?

Would some analysts be unwilling to analyse this sample (or produce such a confident opinion)?

...

D Personal proficiency 

...

Have you ever had your own ability... [doing the specific task/using the technique] tested in conditions where the correct answer was known?

If not, how can we be confident that you are proficient?

If so, can you provide independent empirical evidence of your performance?

E Expressions of opinion 

...

Can you explain how you selected the terminology used to express your opinion? Is it based on a scale or some calculation?

If so, how was the expression selected?

Would others analyzing the same material produce similar conclusions, and a similar strength of opinion? How do you know?

Is the use of this terminology derived from validation studies?

Did you report all of your results?

You would accept that forensic science results should generally be expressed in non-absolute terms?

More

When we anticipate the future, we the opportunity to inhibit our behaviours which we anticipate will lead to counterfactual outcomes. Those of us with sufficiently low latencies in our decision cycles may recursively anticipate the consequences of counterfactuating (neologism) interventions to recursively intervene against our interventions.

This may be difficult for some. Try modelling that decision cycle as a nano-scale approximation of time travel. One relevant paradox from popular culture is the farther future paradox described in the tv cartoon called Family Guy.

Watch this clip: https://www.youtube.com/watch?v=4btAggXRB_Q

Relating the satire back to our abstraction of the decision cycle, one may ponder:

What is a satisfactory stopping rule for the far anticipation of self-referential consequence?

That is:

(1) what are the inherent harmful implications of inhibiting actions in and of themselves: stress?

(2) what are their inherent merits: self-determination?

and (3) what are the favourable and disfavourable consequences as x point into the future given y number of points of self reference at points z, a, b and c?

see no ready solution to this problem in terms of human rationality, and see no corresponding problem in artificial intelligence, where it would also apply. Given the relevance to MIRI (since CFAR doesn't seem work on open-problems in the same way)

I would like to also take this opportunity to open this as an experimental thread for the community to generate a list of ''open-problems'' in human rationality that are otherwise scattered across the community blog and wiki. 

Bertrand Russell, well aware there were health risks of smoking, defended his addiction in a videotaped interview. See if you can spot his fallacy! 

Today on SBS (radio channel in Australia) I heard reporters breaking the news that Nature article reports that Cancer is largely due to choices. I was shocked by what appeared to be gross violations of cultural norms around the blaming of victims. I wanted to investigate further since science reporting is notoriously inaccurate.

The BBC reports:

Earlier this year, researchers sparked a debate after suggesting two-thirds of cancer types were down to luck rather than factors such as smoking.

The new study, in the journal Nature, used four approaches to conclude only 10-30% of cancers were down to the way the body naturally functions or "luck".

"They can't smoke and say it's bad luck if they have cancer."

-Dr Yusuf Hannun, the director of Stony Brook

-http://www.bbc.com/news/health-35111449

The BBC article is roughly concordant with the SBS report. 

I've had a fairly simple relationship with cigarettes. I've smoked others' cigarettes a few times, while drinking. I bought my first cigarette to try soon after I turned of age and discarded the rest of the packet. One of my favourite memories is trying a vanilla flavoured cigar. I still feel tempted to it again whenever I smell a nice scent, or think about that moment. Though now, I regularly reject offers to go to local venues and smoke hookah. Even after my first cigarette, I felt the tug of nicotine and tobacco. Though, I'm unusually sensitive to eve the mildest addictive substances, so that doesn't suprise me in respective. What does suprise me, is that society is starting to take a ubiquitous but increasingly undeniable health issue seriously despite deep entanglement with long standing way of doing things, political ideologues, individual addictions and addiction-driven political behaviour and shareholder's pockets.

Though the truth claim of the article isn't that suprising. The dangers of smoking are publicised everywhere. Emphasis mine:

13 die every day in Victoria as a result of smoking.

Tobacco use (which includes cigarettes, cigars, pipes, snuff, chewing tobacco) is the leading preventable cause of death and illness in our country. It causes more deaths annually than those killed by AIDS, alcohol, automobile accidents, murders, suicides, drugs and fires combined.

So I decided to learn more about the relationship between society and big tobacco, and government and big tobacco to see what other people interested in influencing public policy and public health can learn (effective altruism policy analytics, take note!) about policy tractability in suprising places.

Here's what might make for tractable public policy for public health interventions

Proof of concept

Governments are great at successfully suing the shit out of tobacco. And, big tobacco takes it like a champ:

It started with United State's states experimenting with suing big tobacco. Eventually only a couple of states hadn't done it. Big Tobacco and all those attorney generals gathered and arranged huge ass settlement that resulted in the disestablishment of several shill research institutes supporting big tobacco and big payouts to sponsor anti-smoking advocacy groups (which seem politically unethical, but consequentially good, but I suppose that's a different story). However, what's important to note here is the experimentation within US states culminating with the legitimacy of normative lawfare. It's called 'Diffusion theory' and is described here.

Wait wait wait. I know what you're thinking, non-US LessWrongers - another US centric analysis that isn't too transportable. No. I'm not American in any sense, it's just that the US seems to be a point of diffusion. What's happening regarding marajuana in the US now seems to mirror this in some sense, but it's ironically pro-smoking. That illustrates the cause-neutrality of this phenomenon.

That settlement wasn't the end of the lawfare:

On August 17, 2006, a U.S. district judge issued a landmark opinion in the government's case against Big Tobacco, finding that tobacco companies had violated civil racketeering laws and defrauded consumers by lying about the health risks of smoking.

In a 1,653 page ruling, the judge stated that the tobacco industry had deceived the American public by concealing the addictive nature of nicotine plus had targeted youth in order to get them hooked on cigarettes for life. (Appeals are still pending). 

Victims who ask for help

I also stumbled upon some smokers attitudes to smoking and their, well, seemingly vexacious attitudes to big tobacco when looking up lawsuits and big tobacco. Here's a copy of the comments section on one website. It's really heartbreaking. It's a small sample size but just note their education too - suggesting a socio-economic effect. Note, this comments were posted publicly and are blatant cries for help. This suggests political will at a grassroots level that is yet under-catered for by services and/or political action. That's a powerful thing, perhaps - visible need in public forums addressed to those that are in the relevant space. Note that they commented on a class action website.

http://s10.postimg.org/61h7b1rp5/099090.png

Note some of the language:

 

"I feel like I'm being tortured"

You don't see that kind of language used in any effective altruism branded publications.

Villains

Somewhat famous documents exposing the tobacco industries internal motivations and dodginess seem to be quoted everywhere in websites documenting and justifyications of lawfare against the tobacco industry. Public health and personal dangers of smoking don't seem to have been the big catalyst, but rather a villainous enemy. I'm reminded of how the Stop the boats campaign which villainised people smugglers instead of speaking of the potential to save lives of refugees who fall overboard shitty vessals. I think to Open Borders campaigners associated with GiveWell's Open Philanthropy Project, the perception of the project as just about the most intractable policy prospect around (I'd say a moratorium on AI research is up there), but at the same time, non identification of a villain in the picture. That's not entirely unsuprising. I recall the hate I received when I suggested that people should consider prostituting themselves for effective altruism, or soliciting donations from the porn industry where donors struggle to donate since many, particularly relgious charities refuge to accept their donations. Likewise, it's hard to get rid of encultured perceptions of what's good and what's bad, rather then enumerating ('or checking, as Eleizer writes in the sequence) the consequences.

Relative merit

This is something Effective Altruist is doing.

William Savedoff and Albert Alwang recently identified taxes on tobacco as, “the single most cost-effective way to save lives in developing countries” (2015, p.1).

...

Tobacco control programs often pursue many of these aims at once. However, raising taxes appears to be particularly cost-effective — e.g., raising taxes costs $3 - $70 per DALY avoided(Savedoff and Alwang, p.5; Ranson et al. 2002, p.311) — so I will focus solely on taxes. I will also focus only on low and middle income countries (LMICs) because that is where the problem is worst and where taxes can do the most good most cost-effectively.

..

But current trends need not continue. We can prevent deaths from tobacco use. Tobacco taxation is a well-tested and effective means of decreasing the prevalence of smoking—it gets people to stop and prevents others from starting. The reason is that smokers are responsive to price increases,provided that the real price goes up enough

...

Even if these numbers are off by a factor of 2 or 3, tobacco taxation appears to be on par with the most effective interventions identified by GiveWell and Giving What We Can. For example, GiveWell estimates that AMF can prevent a death for $3340 by providing bed nets to prevent malaria and estimates the cost of schistosomiasis deworming at $29 - $71 per DALY.

 

There are a few reasons to balk at recommending tobacco tax advocacy to those aiming to do the most good with their donations, time, and careers.

 

• Tobacco taxes may not be a tractable issue

• Tobacco taxes may be a “crowded” cause area

• Unanswered questions about the empirical basis of cost-effectiveness estimates

• There may not be a charity to donate to

...
Smoking is very harmful and very common.  Globally, 21% of people over 15 smoke (WHO GHO)

 

-https://www.givingwhatwecan.org/post/2015/09/tobacco-control-best-buy-developing-world/

Attributing public responsibility AND incentivising independently private interest in a cause

The Single Best Health Policy in the World: Tobacco Taxes

The single most cost-effective way to save lives in developing countries is in the hands of developing countries themselves: raising tobacco taxes. In fact, raising tobacco taxes is better than cost-effective. It saves lives while increasing revenues and saving poor households money when their members quit smoking.

-http://www.cgdev.org/publication/single-best-health-policy-world-tobacco-taxes)

Tobacco lawsuits can be hard to win but if you have been injured because of tobacco or smoking or secondary smoke exposure, you should contact an attorney as soon as possible.

  If you have lung cancer and are now, or were formerly, a smoker or used tobacco products, you may have a claim under the product liability laws. You should contact an experienced product liability attorney or a tobacco lawsuit attorney as soon as possible because a statute of limitations could apply. 

-http://smoking-tobacco.whocanisue.com/

There's a whole bunch of legal literature like this: http://heinonline.org/HOL/LandingPage?handle=hein.journals/clqv86&div=45&id=&page=

that I don't have the background to search for and interpret. So, if I'm missing important things, perhaps it's attributable to that. Point them out please.

So that's my analysis: plausible modifiable variables that influence the tractability of the public health policy initiative: 

(1) Attributing public responsibility AND incentivising independently private interest in a cause

(2) Relative merit

(3) Villains

(4) Victims that ask for help

(5) Low scale proof of concept

Remember, lawfare isn't just the domain of governments. Here's an example of non-government lawfare for public health. They are just better resourced, often, than individuals. They need groups to advocate on their behalf. Perhaps that's a direction the Open Philanthropy Project could take. 

I want to finish by soliciting an answer on the following question that is posed to smokers in a recurring survey by a tobacco control body:

Do you support or oppose the government suing tobacco companies to recover health care costs caused by tobacco use?

Now, there may be some 'reverse causation' at play here for why Tobacco Control has been so politically effect. BECAUSE it's such a good cause, it's a low hanging fruit that's already being picked. 

What's the case for or against this?

The case for it's cause selection: Tobacco control

Importance: high

tobacco is the leading preventable cause of death and disease in both the world (see: http://www.who.int/nmh/publications/fact_sheet_tobacco_en.pdf) and Australia (see: http://www.cancer.org.au/policy-and-advocacy/position-statements/smoking-and-tobacco-control/)

‘Tobacco smoking causes 20% of cancer deaths in Australia, making it the highest individual cancer risk factor. Smoking is a known cause of 16 different cancer types and is the main cause of Australia’s deadliest cancer, lung cancer. Smoking is responsible for 88% of lung cancer deaths in men and 75% of lung cancer cases in women in Australia.’

Tractable: high

The World Health Organization’s Framework Convention on Tobacco Control (FCTC) was the first public health treaty ever negotiate.

Based on private information, the balance of healthcare costs against tax revenues according to health advocates compared to treasury estimates in Australia may have been relevant to Australia’s leadership in tobacco regulation. That submission may or may not be adequate in complexity (ie. taking into account reduced lifespans impact on reduced pension payouts for instance). There is a good article about the behavioural economics of tobacco regulation here (http://baselinescenario.com/2011/03/22/incentives-dont-work/)

Room for advocacy: low

There are many hundreds of consumer support and advocacy groups, and cancer charities across Australia.

Room for employment: low?

Room for consulting: high

The rigour of analysis and achievements themselves in the Cancer Council of Australia annual review is underwhelming, as is the Cancer Council of Victoria’s annual report. There is a better organised body of evidence relating to their impact on their Wiki pages about effective interventions and policy priorities. At a glance, there appears to be room for more quantitative, methodologically rigorous and independent evaluation. I will be looking at GiveWell to see what I recommendations can be translated. I will keep records of my findings to formulate draft guidelines for advising organisations in the Cancer Councils’ positions which I estimate by vague memory of GiveWell’s claims are in the majority in the philanthropic space.

**Thought experiment 1 – arbitrage opportunities in prediction market**

You’re Mitt Romney, biding your time before riding in on your white horse to win the US republican presidential preselection (bear with me, I’m Australian and don’t know US politics). Anyway, you’ve had your run and you’re not too fussed, but some of the old guard want you back in the fight.

Playing out like a XKCD comic strip ‘Okay’, you scheme. ‘Maybe I can trump Trump at his own game and make a bit of dosh on the election’.

A data-scientist you keep on retainer sometimes talks about LessWrong and other dry things. One day she mentions that decentralised prediction markets are being developed, one of which is Augur. She says one can bet on the outcome of events such as elections.

You’ve made a fair few bucks in your day. You read the odd Investopedia page and a couple of random forum blog posts. And there’s that financial institute you run. Arbitrage opportunity, you think.

You don’t fancy your chance of winning the election. 40% chance, you reckon. So, you bet against yourself. Win the election, lose the bet. Lose the bet, win the election. Losing the election doesn’t mean much to you, losing the bet doesn’t mean much to you, winning the election means a lot of to you and winning the bet doesn’t mean much to you. There ya go. Perhaps if you put

Let’s turn this into a probability weighted decision table (game theory):

Not participating in prediction market:

Cumulative probability weighted value: (0.4*2) + (0.6*-1)=+0.2 value

participating in prediction market::

Cumulative probability weighted value: (0.4*2) + (0.6*-1)=+0.2 value

They’re the same outcome!
Looks like my intuitions were wrong. Unless you value winning more than losing, then placing an additional bet, even in a different form of capital (cash v.s. political capital for instance), then taking on additional risks isn’t an arbitrage opportunity.

For the record, Mitt Romney probably wouldn’t make this mistake, but what does post suggest I know about prediction?

**Thought experiment 2 – insider trading**

Say you’re a C level executive in a publicly listed enterprise. However, for this example you don’t need to be part of a publicly listed organisatiion, but it serves to illustrate my intuitions. Say you have just been briefed by your auditors of massive fraud by a mid level manager that will devastate your company. Ordinarily, you may not know how to safely dump your stocks on the stock exchange because of several reasons, one of which is insider trading.

Now, on a prediction market, the executive could retain their stocks, thus not signalling distrust of the company themselves (which itself is information the company may be legally obliged to disclose since it materially influences share price) but make a bet on a prediction market of impending stock losses, thus hedging (not arbitraging, as demonstrated above) their bets.

**Thought experiment 3 – market efficiency**

I’d expect that prediction opportunities will be most popular where individuals weighted by their capital believe they gave private, market relevant information. For instance, if a prediction opportunity is that Canada’s prime minister says ‘I’m silly’ on his next TV appearance, many people might believe they know him personally well enough that it’s a higher probability that the otherwise absurd sounding proposition sounds. They may give it a 0.2% chance rather than 0.1% chance. However, if you are the prime minister yourself, you may decide to bet on this opportunity and make a quick, easy profit…I’m not sure where I was going with this anymore. But it was something about incentives to misrepresent how much relevant market information one has, and the amount that competitor betters have (people who bet WITH you)

Inspired by the group rationality diary and open thread, this is the second goal setting journal (GSJ) thread.

If you have a goal worth setting then it goes here.

Notes for future GSJ posters:

1. Please add the 'gsj' tag.

2. Check if there is an active GSJ thread before posting a new one. (Immediately before; refresh the list-of-threads page before posting.)

3. GSJ Threads should be posted in Discussion, and not Main.

4. GSJ Threads should run for no longer than 1 week, but you may set goals, subgoals and tasks for as distant into the future as you please.

5. No one is in charge of posting these threads. If it's time for a new thread, and you want a new thread, just create it.

**What GiveDirectly says:**


>This study documented large, positive, and sustainable impacts across a wide range of outcomes including assets, earnings, food security, **    mental health**, and domestic violence. It found no evidence of impacts on alcohol or tobacco use, crime, or inflation. It also examined a number of design questions such as how to size transfers and whether to give them to men or women.

Source: [GiveDirectly](https://www.givedirectly.org/research-at-give-directly.html)

**What the evidence says:**

*GiveDirectly*

>Overall, GiveDirectly increased households’ assets, consumption, and food security. The program also improved psychological well-being, especially among households with female recipients and households that received the large transfer. GiveDirectly had no impact on health or education measures.

>Psychological impacts: GiveDirectly households reported a 0.2 standard deviation increase (0.35 sd for large transfer recipients) on an index measuring psychological well-being. This improvement was largely driven by increases in happiness and life satisfaction, and reductions in stress and depression. There were no differences in self-reported measures between monthly-transfer and lump-sum recipients, but cortisol levels were significantly higher for monthly-transfer recipients. A potential explanation being that the monthly-transfer recipients seemed to have difficulty saving or investing the transfer, which may have led to increased stress.

Source: [Innovations for Poverty Action](http://www.poverty-action.org/project/0522)

*SCI*

>There is a very strong case that mass deworming is effective in reducing infections. The evidence on the connection to positive quality-of-life impacts is less clear, but there is a fairly strong possibility that deworming is highly beneficial.

>There is strong evidence that administration of the drugs reduces worm loads, but weaker evidence on the causal relationship between reducing worm loads and improved life outcomes.

>Evidence for the impact of deworming on short-term general health is thin, especially for soil-transmitted helminth (STH)-only deworming. Most of the potential effects are relatively small, the evidence is mixed, and different approaches have varied effects. We would guess that deworming populations with schistosomiasis and STH (combination deworming) does have some small impacts on general health, but do not believe it has a large impact on health in most cases. We are uncertain that STH-only deworming affects general health.

>In our view, the most compelling case for deworming as a cost-effective intervention comes not from its subtle impacts on general health (which appear relatively minor and uncertain) nor from its potential reduction in severe symptoms of disease effects (which we believe to be rare), but from the possibility that deworming children has a subtle, lasting impact on their development, and thus on their ability to be productive and successful throughout life.

>Community deworming before a child’s first birthday brings about a 0.2-standard-deviation improvement in performance on Raven’s Matrices, a decade after the intervention. Estimated effects on vocabulary measures are similar in magnitude, but not always as significant; effects on memory are not statistically distinguishable from zero. A summary measure, the first principal component of all six cognitive measurements, also shows a roughly 0.2-standard-deviation effect. These effects are equivalent to between 0.5 and 0.8 additional grades in school … The effect of community deworming spillovers on height, height-for-age, and stunting all appear statistically

Source: [GiveWell](http://www.givewell.org/international/top-charities/schistosomiasis-control-initiative).

GiveWell goes on to argue that this leads to improvements in income. In turn, I would expect that this leads to increases in income, assets and consumption with consequences similar to direct cash transfers as in the case of GiveDirectly.

source: AIHW

According to the AIHW, the procedure with the lowest median waiting time in 2005 06 was coronary artery bypass graft (15 days); the procedure with the longest wait time was total knee replacement (178 days). There were also variations in waiting times for these procedures across jurisdictions; Queensland patients waited a median time of 41 days for cataract surgery, while those in Tasmania waited a median time of 389 days.

Source: Australian Parliamentary Library

How can hospital emergency department and surgery waiting times be cut?

Cut doctors pay and hire more?

Create specialised sub-professions without the comprehensive training costs?

Something else?