Tag Archives: twitter

twitter content

Just a note regarding my two twitter accounts (personal and work).

My personal account was clearly fairly full of followers who were:

  • No longer active on Twitter
  • Probably muting me as they weren’t interested in what I had to say on  that forum (but may well be friends/colleagues who otherwise got on with me and didn’t like to block me)
  • Clearly just there to get ideas from me with no intention of having any meaningful interaction
  • Any combination of the above

Thus I have:

  • Made my personal account private, leaving my work account public
  • Started a process of “soft-blocking” a large number of followers from my personal account that seem to fit one of more of the criteria above. FYI a soft-block on twitter simply removes that person from your follower list. If your account is public, they can (if they notice they are no longer following you) instantly re-follow you. If your account is private they must submit a new request to follow you and see your postings, thus giving you complete control over your follower list.

I haven’t done this to spite anyone – it is simply a way to move people who I believe would only consider engaging with me in a professional capacity, including collaboration or contracting me for work, to my work account – they can follow me there if they wish. Those that I am keeping as followers on my personal account can see my non-work related stuff, together with some work-related stuff that I think is important but which I feel uneasy about sharing “for free” with just anyone.

Anyone on my personal account who doesn’t like the tone/content should feel free to unfollow me there and follow my work account instead. I’ll continue to keep a close eye on the postings from followers of my personal account – particularly those from people I have not met in person or had an online working relationship with – to spot anyone I think should really be following my work account and I feel uncomfortable having access to my personal one. (You are more likely to fall into this category if you tweet or retweet nothing.)

I do find it ironic that I started this process shortly before “peak social media” seemed to become a media story – see this.

Anyway just as a reminder: tflynnhealth is my personal account and tfchoices is my work account.

 

Twitter cull

In case you have come here having noticed I have culled you from Twitter (i.e. I am no longer following you), there’s a very simple set of reasons:

(1) I am increasingly persuaded by the journalists who feel that social media is actually a parasite on their life;

(2) You don’t engage with me. Why bother to link in some way if you show no demonstrable interest in my work or interest in engaging with me?

If you were to say “OK I really don’t care about patient preferences, I wanna sell phones to people, can we work together?” ironically I’d probably listen. That’s honest, at least. Not my favourite use of choice experiments but hey, it pays the bills.

Top tip – if you are working in health and are really interested in what I do, please do two things:

(1) Read the book – a good friend who is very renowned in the field used to hate it that everyone quoted McFadden for Random Utility Theory yet their referencing showed clearly, and beyond any doubt, that they had NEVER ever read the key chapter. (Mea culpa here – I speed-read it and my page-referencing is a page off in some places. Sorry, But at least I know what he endorsed and didn’t. Plus quite a few of you don’t seem to know even that.)

(2) Present something actionable to me.

As Jay from the Inbetweeners would say “Simples!” (Though of course I don’t intentionally tell complete porkies all the rest of the time like his character does!)

So, just to round off – I have ideas….I have ideas that work and which made me money  already….interested?

BWS neither friend nor foe

This post replies to some requests I have had asking me to respond to a paper concluding that DCEs are better than BWS for health state valuation. To be honest I am loathe to respond, for reasons that will become apparent.

First of all, let me clarify one thing that people might not appreciate – I most definitely do not want to “evangelise” for BWS and it is not the solution in quite a few circumstances. (See the papers coming out from the CHU-9D child health valuation study I was involved with for starters – BWS was effectively a waste of resources in the end….”best” choices were all we could use for the tariff.)

I only really pushed BWS strongly in my early days as a postdoc when I wanted to make a name for myself. If you read my papers since 2007 (*all* of them) you’ll see the numerous caveats appear with increasing frequency. And that’s before we even get to the BWS book, where we devote an entire chapter discussing unresolved issues including the REAL weaknesses and research areas for BWS (as opposed to straw men I have been seeing in recent literature).

OK now that’s out of the way, I will lay some other cards on the table, many of which are well-known since I’ve not exactly been quiet about them. I had mental health issues associated with my exit from academia. I’m back on my feet now doing private sector work for very appreciative clients, but that doesn’t mean I want to go back and fight old battles….battles which I erroneously thought us three book authors had “won” by passing muster with the top mathematical psychologists, economists and others in the world during peer review. When you publish a paper in the Journal of Mathematical Psychology (the JHE of that field) illustrating a key feature/potential weakness of a DCE (or specifically Case 2 BWS) back in 2008 you tend to expect that papers published in 2016 would not ignore this and would not do research that showed zero awareness of this issue and as a result made fundamental errors – after all, whilst we know clinical trials take a while to go from proposal to main publication, preference studies do NOT take 8+ years to go through this process. I co-ran a BWS study from conceptualisation to results presentation in 6 days when in Sydney. Go figure.

So that’s an example of my biggest frustration – the standards of literature review have often been appalling. Two or three of my papers (ironically including the JHE one, which includes a whopping error which I myself have repeatedly flagged up and which I corrected in my 2008 BMC paper) seem to get inserted as “the obligatory BWS reference to satisfy referees/editors” and in many cases bear no relation to the point being made by authors. Alarm bells immediately flash when I read an abstract via a citation alert and see those were my references. But it keeps happening. Not good practice, folks.

In fact (and at a recent meeting someone with no connection to me said the same thing) in certain areas of patient outcomes research the industry reviews are considered far better than academic ones – they have to be or get laughed out of court.

Anyway, I have been told that good practice eventually drives out bad. Sorry, if that’s true, the timescale was simply too long for me, which didn’t help my career in academia and raised my blood pressure.

Returning to the issue at hand. I’m not going to go through the paper in question, nor the several others that have appeared in the last couple of years purporting to show limitations of BWS. I have a company to run, caring obligations and I’ve written more than enough for anyone to join the dots here if they do a proper literature review. My final attempt to help out was an SSRN paper. But that’s it – without some give and take from the wider community, my most imaginative BWS work will be for clients who put food on the table and who pay – sometimes quite handsomely – for a method that when properly applied shows amazing predictive ability together with insights into how humans make decisions.

Now, of course, health state valuation is another kettle of fish – no revealed preference data etc. However, Tony, Jordan and I discussed why “context” is key in 2008 (JMP); I expounded on this with reference to QALYs in my two 2010 single authored papers, and published a (underpowered) comparison in the 2013 JoCM paper (which I first presented at the 2011 ICMC conference in Leeds, getting constructive criticism from the top choice modellers on Earth). So this issue is not particularly new.

It’s rather poor that nobody has actually used the right design to compare Case 2 BWS with DCEs for health state valuation…I ended up deciding “if you want something done properly you have to do it yourself” and I am very grateful to the EuroQoL Foundation for funding such a study, which I am currently analysing with collaborators. I don’t really “have a dog in this fight” and if Case 2 proves useful then great, and if not then at least I will know exactly why not…and the reasons will have nothing to do with the “BWS is bad m’kayyyyy” papers published recently. (To be fair, I am sometimes limited in what I can access, with no longer having an academic affiliation so full texts are sometimes unavailable, but when there’s NO mention of attribute importance in the abstract, NOR why efficient designs for Case 2 are problematic my Bayesian estimate is 99.99% probability the paper is fundamentally flawed and couldn’t possibly rule BWS in or out as a viable competitor to a DCE.)

If you’d like to know more:

  • Read the book
  • Read all the articles – my google scholar profile is up to date
  • Get up to speed on the issues in discrete choice design theory – fast. Efficient designs are in many many instances extremely good (and I’ve used them) but you need to know exactly why in a Case 2 context they are inappropriate.

If you still don’t understand, get your institution to contract me to run an exec education course. When I’m not working, I’m not earning, full stop.

I’m now far more pragmatic about the pros and cons of academia and really didn’t want to be the archetypal “I’m leaving social media now” whinger. And I’m not leaving. But I am re-prioritising things. Sorry if this sounds harsh/unhelpful – I didn’t want to write this post and hoped to quietly slip beneath the radar, popping up when I thought something insightful based on one of BWS’s REAL disadvantages or Sen’s work etc was mentioned. But people I respect have asked for guidance. So I am giving what I can, given 10 minutes free time I have.

Just trying to end on a positive note – I gave a great exec education course recently. It was a pleasure to engage with people who asked questions that were pertinent to the limitations of BWS and who just wanted to use the right tool for the right job. That’s what I try to do and what we should all aim for. I take my hat off to them all.

Happiness isn’t quality of life if you’re old

The subject of happiness, particularly among older people, has come up (again) in the media. I reckon they trot out the latest survey results whenever there’s a slow news day. I think it’s no coincidence the newest stories have appeared in the slow month of August.

Anyway I shall keep this short as I’ll rant otherwise. Once again, neither happiness nor life satisfaction is the same as quality of life and we can argue til the cows come home as to which of the three (if any) is truly well-being.

First of all, if I can find the time to write up a follow-up to the paper I published on the mid 2000s survey of Bristolians I will show this:

Five year age bands showing mean levels (after rescaling) of self-rated happiness versus scored quality of life in Bristol

Five year age bands showing mean levels (after rescaling) of self-rated happiness versus scored quality of life in Bristol

The two track reasonably closely until retirement age. Then whilst happiness continues to rise, quality of life certainly does not. The wealth of other evidence on health, money, friends, etc from the survey suggests our QoL, the ICECAP-O instrument, is the better measure of overall well-being.

We are not the only ones to find this. A large US study pretty much concluded they didn’t know WTF older people were doing when they answered life satisfaction/happiness questions but they sure don’t answer them the same way that younger adults do. Older people use a different part of the numerical scale (typically a higher portion, all other things being equal). That’s rating scale bias and there is a huge and growing literature on it.

Stop asking these dumb questions. There are good alternatives.

 

 

my top 5 dce papers update

Just to let readers know – I have decided not to go ahead with the “my top 5 DCE papers the health economists should be reading” paper after one round of review from the journal*.

A (currently not peer reviewed) paper by Richard Norman and a colleague analysing google scholar profiles for self-citation suggested the phenomenon is more common in Australasia. Apparently there is a perception out there that (current? former?) I4C members may be driving this – I know:

(1) My self-citations are primarily, like all members of the now defunct ICEPOP group, necessary ones to show the construction and development of the ICECAP outcome instruments. It is only now that there begins to be sufficient other groups using and developing the instruments for citations to be more spread.

(2) I don’t believe I’ve done so in my DCE papers, but again, for Best-Worst Scaling, as for ICECAP, since I was a primary developer, of course I had to do some self-citing!

(3) I don’t want, even as a former I4C member, even to be perceived to be engaging in this phenomenon unnecessarily – even when I know I am not. I have checked with the main journals’ preferred tools which can (unlike google scholar) strip out self-citations and my h-index only dropped by 2. I will have quite a wait before I get results from the similar online program constructed by Norman’s co-author to do so with google scholar.

So, I know I am not driving any unnecessary self-citing in Australasia, but my “5 papers” paper inevitably mentioned I4C member papers and might have contributed to bad perceptions of me/them – therefore I have decided not to take it further.

*EDIT I had a revise and resubmit decision with referee comments that I didn’t anticipate being difficult to address.

 

twitter lulz

It’s often more amusing to see who stops* following you on Twitter than who adds you.

Been a few in the light of the Institute launch announcement….

*There are lots of apps/programs to do this easily.

last day plus icecap

Last day at UTS! Please note that from Monday I will be an employee of the University of South Australia (UNISA). My email is up and running (see posting elsewhere) and I have an office etc – working in North Sydney will be fantastic and I nosed around the office yesterday. It’s gorgeous – the operations team and some of the directors are already in place.

Also, if you use twitter you might like to follow the official ICECAP measure profile or @ICECAPm – it already has news of the next user group meeting at which I will be presenting.

For newbies, the ICECAP instruments use Sen’s Capabilities Approach as a framework for measuring and valuing well-being in a way that isn’t limited to “just” health. Thus, they are good alternatives to existing well-being instruments. The valuation is/has been done using the methods of another winner of the Nobel prize in Economics – Dan McFadden – discrete choice modelling. In particular the best-worst scaling variety in which I have led development in health and am a recognised global expert. BWS is now taking the world by storm and the book – to be published by CUP – will be finished in the next few weeks.