I am going to whisper a little secret, it won't work. What works is hard work. Really hard work. You must consume more than you create. Read, listen, and watch everything. Jerry Saltz described the ordinary brilliantly--"generic but ambitious". I follow Jerry for many reasons--most importantly are his lessons on observation. Yes, I could read the stacks of books falling like manna from the heavens about data visualization. But that is too narrow of a focus. I like edges from other perspectives. I subscribe to ARTFORUM to learn how to consume information. My reality will never be yours, what worked for me will never work the same way for you, but the hard work will.
I recommend listening to Jerry's interview on the Longform Podcast. He became an art critic in his 40s from a career as a truck driver...his humility and cleverness is and should be industry agnostic. Let me know what you think.
Metaphors of a Magnifico by Wallace Stevens (1879-1955)
Twenty men crossing a bridge,
Into a village,
Are twenty men crossing twenty bridges,
Into twenty villages...
In the case of the medical literature I don't know whom to blame first, the shoddy media coverage or the confusing study design. The wallpaper can be changed folks.
The article in the New York Times doesn't seem to like the wallpaper and can't see beyond the hype to actually look at the merits or opportunities to query the data in a way that might be meaningful.
I am not blaming the brilliant author because let's face it--he didn't create the headline. But I am blaming the metric--avoiding repeat hospitalization or hospital readmission rates. Maybe we should look earnestly into better measures for this highly edited study population.
at least one hospital admission at any of four Camden-area hospital systems in the 6 months before the index admission,
at least two chronic conditions;
and at least two of the following traits or conditions:
use of at least five active outpatient medications,
difficulty accessing services,
lack of social support,
coexisting mental health condition
active drug habit, and homelessness.
oncologic care or had been admitted for a surgical procedure for an acute health problem, for mental health care (with no coexisting physical health conditions), or for complications of a progressive chronic disease for which limited treatments were available.
CMS defines readmission rates within the 30 day time-frame in order to capture events most likely associated with the independent admission. I am assuming then that a 180 day time-frame is a bit noisier.
"Readmission and death rates are measured within 30 days, because readmissions and deaths after a longer time period may have less to do with the care gotten in the hospital and more to do with other complicating illnesses, patients’ own behavior, or care provided to patients after hospital discharge."--Medicare.gov
Hospital Compare datasets
Dissecting racial bias in an algorithm used to manage the health of populations
What does race have to do with it (link to discussion of bias)
Graphical presentation of confounding in directed acyclic graphs
Health Care Hotspotting--A Randomized, Controlled Trial
Supplement to: Finkelstein A, Zhou A, Taubman S, Doyle J. Health care hotspotting — a randomized, controlled trial. N Engl J Med 2020;382:152-62. DOI: 10.1056/NEJMsa1906848
Trouble accessing clinical research articles? Try Sci-Hub...
The bias introduced in an algorithm widely used in hospital systems revealed that black patients were considerably sicker when compared to white patients at the 97th percentile metric--a qualifier for being referred for additional supports. Although the use of healthcare costs appears to be an effective measure to indicate interventions successful in managing patient outcomes--the racial biases are evident.
The authors are planning additional analyses and I anticipate insights regarding improvements in a wider variety of patient populations. Often being ambitious is not the only goal--we need to be curious--not generic.