Today has been a particularly good day. One of the days where I had a bit of freedom--meaning I didn't have a face-to-face meeting scheduled either in person or remotely. I like keeping my camera closed all day. There are books to be read and more than a few presentations to finalize. Just like makeup over 50--less is more. I prefer to seed the ideas and then switch over to conversations. ​I feel the same way about exploring categorical variables in spaces where we reflexively rely on numerics. What can they tell us about a population, community, or individual?

data & donuts

"As digital technologies have enabled a broadening of economic and social incorporation, the possibilities for classifying, sorting, slotting and scaling people have also grown and diversified. New ways of measuring and demonstrating merit have sprung up, some better accepted than others. Institutions, both market and state, find themselves compelled to build up and exploit this efficient, proliferating, fine-grained knowledge in order to manage individual claims on resources and opportunities.

This process, she argues, creates new social demands for self-care and individual fitness that possibly erode the universal and solidaristic basis upon which the expansion of citizenship historically thrived."Professor Marion Fourcade--London School of Economics (LSE) Public Lectures & Events.

Big Data on a Less Big Budget

"...deprivation comes in many forms and use a new multi-dimensional measure that not
only considers income but also education, electricity, water and sanitation"--New ways of looking at poverty

If you see me talking to myself, do not disturb, I'm having a staff meeting.

Some days are harder to show up for than others. Aren't we all on edge? If we truly are stardust--whipping up elements from the dawn of the universe on a cellular level--where does the sorrow, angst, or fear live? I would argue it is filtered through our brains.  Perhaps our creative selves can manifest these signals into meaningful or at the very least soothing tropes or missives. But today. I got nothing. I walked slowly to the gym hoping that my routine of "outsideness" would help to shake the funk. I listened to an uplifting conversation between Austin Kleon and Debbie Millman, Design Matters. And started to unclench a wee bit. Stories from the edges of how people define creativity or their work--Austin claims, a writer who draws. Also how to navigate the doubts and insecurities.

I am an ultra-runner so I have learned patience at the hand of "embracing the suck" but today I only checked the box of "showing up". Nothing slid into the groove but hey--I went through the motions.

While I am writing this I have a teenager losing his mind in the background. He is x-country captain and a rising senior in high school. He has spent 3 weeks at an academic program in Chicago and is heading for the beach for a week. He is mad because I won't let him miss practice for an overnight thing with his friends. I explain how when able--he needs to be there for his team. His argument? It sounds like that Charlie Brown teacher although less warm, fuzzy, and endearing. I just felt like checking in. I start most days running and writing. Those are the best days. Often we have to trust the ritual. Even if we feel like there is nothing to say. On a positive note I am left with more time to finish up the latest workshop classes for you, prepare for my month on an island, and work with large datasets. Not everything in our working lives is an instagramy perfect filter vibe. Case in point--drinking my tea on the run. The real deal.

You wanna fly, you got to give up the shit that weighs you down -- Toni Morrison

August brings into sharp focus and a furious boil everything I've been listening to in the late spring and summer--Henry Rollins 

This summer, faced with my youngest spending 3 weeks participating in an academic program at University of Chicago, Steve (husband) and I decided to take advantage of a long weekend in the lovely blue ridge mountains. The pace of summers vacillate between frenetic and this new normal--kids with new found independence and opportunities beyond the familiar. Fewer ferry rides to the beach and more sojourns with friends--pausing only to grab a set of keys and hoping for a little cash (just in case). I have observed an increased efficiency in my work as I evolved from a hired gun to simply write what I was asked to now being responsible for the data that informs the narrative. ​Don't get me wrong. I always did my due diligence with research and probing evidence-based medical articles but let me be frank. I only looked where the client was pointing.

Although my toolbox has expanded over the years to include Python, SQL, and R--I use them with intense focus and deliberation. When you evolve skills into exploring large data sets you innately comprehend why certain types of questions are higher value than others. For example, I sat through a Tableau session on how to analyze Likert data--data gathered from those ubiquitous uni- (one attribute) or multi (contrasting opposites)-polar scales. You are asked how likely you might be to exhibit a certain behavior.

We build too many walls and not enough bridges--Isaac Newton

...Since that time he has had no relationships with industry. Moreover, he now “sees” industry influence in almost all facets of patient care, medical education, clinical research, and even certification exams (in which the correct answers are based on pharmaceutical funded guidelines).--From the $80 hamburger to managing conflicts of interest with the pharmaceutical industry

In summary, we have found that modern RCTs in breast cancer, NSCLC, and CRC are substantially larger and more international in scope than those of earlier decades. Although methodology and quality of reporting seems to be improving over time, serious deficiencies persist, particularly in the identification of the primary end point and by not including all randomly assigned patients in ITT analyses. There has been a substantial shift toward industry sponsorship of oncology RCTs. Over the past 30 years, authors’ endorsement of novel therapies has increased while relative effect size has remained stable.

​A significant P value for the primary end point and industry sponsorship are independently associated with strong endorsement of the experimental therapy. Investigators and medical journals should continue to strive toward publication of high-quality studies and recognize the importance of adequate and unbiased reporting of study methodology and results. Finally, clinicians, investigators, and policy makers should maintain and refine perspective on what constitutes a meaningful benefit to patients beyond the P value associated with the result. Further research is needed to determine whether newly adopted therapies are truly worthwhile to patients.-- Evolution of the Randomized Controlled Trial in Oncology Over Three Decades

• Discrete choice experiments allow estimation of the relative importance of different aspects of care, the trade offs between these aspects, and the total satisfaction or benefit respondents derive from health care services. Monetary values of attributes may be indirectly estimated by including time-based attributes such as "waiting time"...Ryan et al. Use of discrete choice experiments to elicit preferences

Using discrete choice experiments to inform the design of complex interventions

Marketing books are awful. I have had an aversion to the self-help business genre since somebody stole someone's cheese and the Pharma company where I was working spun off a series of nauseating workshops with the same title. But as you likely know--Seth is different. I read his books and have been lucky enough to catch him on stage at a conference or two. I handed him a gift once and he stared at me momentarily with disbelief and teared up slightly. Oh. And he hugged me.  Full disclosure it was the On Being Gathering and we were all feeling about as good as you can possibly feel underneath beautiful redwoods being fed impossibly delicious food, drinking wine, and listening to some of the most influential purveyors of intention and goodness ever imagined. ​I needed to read this book. I think there is much you might enjoy as well.

People don't want what you make

If you can bring someone belonging, connection, peace of mind, status, or one of the other most desired emotions, you've done something worthwhile. The things you sell is simply a road to achieve those emotions, and we let everyone down when we focus on the tactics, not the outcomes. Who's it for and what's it for are the two questions that guide all of our decisions.--Seth Godin This is Marketing

“The sense of having walked from far inside yourself / out into the revelation, to have risked yourself / for something that seemed to stand both inside you / and far beyond you, that called you back”--David Whyte