Instead of setting a Yearly Theme ⊕ A CGP Gray video is where I first heard it used as a replacement for New Year’s resolutions, but I’m not entirely sure if he’s the originator. right at the outset, I let it crystalize on its own in the first few months of the year. The theme of 2022 was shelter-building — guess where that came from — and as a result we now have a whistle-clean basement ready to serve as a home gym until a nuclear strike anhilates us all.

Odds are that this year’s theme will end up being statistical shenanigans. First a brief letter to JAMA Internal Medicine we wrote received a confused commentary from a giant of cancer care that showed that even oncology giants are not immune to errors ⊕ Finding the error I will leave as an excercise for the reader; I do, however, plan to address it in a follow-up letter. Never pass an opportunity to increase your publication count! of statistical reasoning. Soon after that, working on a different — still top-secret — paper got me down a rabbit hole of the many ways we use to present clinical data. I thought these were lacking in oncology; other fields of medicine showed me that there was room for further deterioration. ⊕ Not to be so secretive about everything, but clinical data representation in this particular field will also be the subject of a commentary. And yet, the US FDA still thinks statistically illeterate doctors — present company included — are important gatekeepers of diagnostic tests, essentially banning home test kits available in other parts of the world because they are worried people are too innumerate to correctly interpret their own results.

Humans being pattern-recognition machines, I don’t doubt I will continue seeing matemathical malpractice, malfeasance, and just plain stupidity everywhere I look. It is pretty much guaranteed I will inadvertently comit some myself! I hope this yearly theme results in a few papers, at least.

Adam Mastroianni’s Experimental History newsletter has enabled paid subscriptions today, and if there is one science-oriented Substack worth paying for, it’s Adam’s. I’m sold.

I have seen many people sharing links to Maciej Cegłowski’s (excellent!) case against colonizing Mars.

Of course, Werner Herzog said it first, and more succinctly. Good luck with that, indeed.

🍿 A Trip to Infinity started off strong: I can never get enough Steve Strogatz, and between him, Eugenia Cheng, and Moon Duchin the first third of the documentary focusing on mathematics was stellar. Then came the muddled physics and incomprehensible philosophy. Too bad.

• Fractional use of vials/pills to decrease per-patient cost, because the main driver of high cost of drugs is not manufacturing (i.e. a ten times more efficient manufacturing process would not result in 10 times, or even 2 times lower prices). If you don’t believe me just look at what Sanofi did with alemtuzumab.
• Using real-world data instead of randomized controlled trials, because while retrospective, non-randomized, uncontrolled studies Now rebranded as “real-world data”. are good for generating hypotheses and maybe, maybe, detecting enormous effect sizes Think: smoking causing cancer, but not: who-knows-what new material causing lymphoma. we have learned through much trial and error that RCTs are critical for evaluating whether a medical intervention works or not. Back when personal computers were too big and expensive for mass use, the answer wasn’t to invent a story of why calculators were better — it was to make PCs so cheap and small that not having one in your pocket was a matter of personal choice, not cost. Same for RCTs.
• The Choosing Wisely initiative, which was all the rage back when I was a resident and still seems to have legs. ⊕ Not to mention that the program unintentionally promoted a dangerous frame of mind in which some doctors thought extensive testing was never indicated, thus missing some rare but life-theratening diagnoses. Money spent on producing more content for doctors to read, listen, and watch — thus taking up their time — and encouraging patients to talk to their doctors at length about questionable data behind many of the procedures — thus, again, taking up their time — may have been better spent designing and running pragmatic RCTs that would answer these questions and save both the doctors' and patients' time by reducing ambiguity. Oh well.
• Yet another health care delivery reform — this may be just my healthcare policy naiveté, but these all had the whiff of rearranging deck chairs on the Titanic. ⊕ See also: the Homer Simpson car Mandating the desired outcome instead of thinking about the right incentives is bound to increase cost through second-order effects.

Anything else?

Speaking of Quanta Magazine, their own series of year-in-review articles is out. If you have no other plans this weekend (heh), you may learn what was new in 2022 in:

• Biology
• Computer Science
• Physics
• Math(s)
• Comments

Enjoy!

Fascinating how people least deserving of sitting at the table are so often the ones making the most noise.

To all trainees who are smart and lazy: no, you are not getting away with it. Sure, you can creatively avoid responsibilities on your way to graduation, but it will burn many more bridges than you realize. Your teachers aren’t stupid.

Samuel G Rodriques ⊕ If you were looking for his blog’s RSS feed, you won’t find one listed. Thankfully, NetNewsWire was able to dig up the url. is an inventor, entrepreneur, and author of my favorite blog post so far this year:

Serious drug developers have long since learned not to trust animal models when it comes to predicting the efficacy of a treatment for most diseases.

And also:

There is a phenomenon that all biologists will be aware of, where after working on a new idea for 2 years, you one day come across a paper from 2008 and say, “oh my god, if only I had known this two years ago.” If we want biology to move fast, we need to figure out how to eliminate this phenomenon.

And:

In biology, until recently, it seemed like everyone wanted to be a professor or start a company, i.e., that the only high status thing you could do after your PhD was to become a manager.

Not sure I agree with his prescriptions, but the diagnosis is right!

Fad of the day: Longtermism.

Longtermism is an ethical stance which gives priority to improving the long-term future. It is an important concept in effective altruism and serves as a primary motivation for efforts to reduce existential risks to humanity.

This is how you reduce existenal risks to humanity: avoid ruin. The rest is gobbledygook meant to dazzle venture capitalists and other sources of funding.