Archive for December, 2009

On the Failed Airplane Bombing Attempt

December 31, 2009

When geese “attacked” US Air Flight 1549, and Captain Sully Sullenberger landed the plane in the Hudson river, Americans were overjoyed that disaster had been averted.   When Abdul Mudallah ignited an explosive device on Northwest Flight 253, and no one was injured, Americans spent the next week afraid, with countless criticisms of our government (many of which were justified).  In reality, we should all be very thankful.

First of all, we should be thankful that disaster was averted.  This was great news.  We should also be thankful because we have learned a great deal of what went wrong, and security will improve in the future. Al Qaeda is not likely to succeed if they use the same technique again.  And it takes lots of time to develop new techniques.

I understand why people were so upset.  This event revealed that we were not nearly as safe as we hoped we were, and it revealed that the government is still not sharing information about terrorism well enough.  In other words, the event was the messenger of “bad news.”  Since we couldn’t “shoot the messenger”, Americans sought out others to shoot.

But we really have much to be thankful for.  And the Department of Homeland Security has their work cut out for them.  We all hope that this department has learned a lot of how to prevent the next incident.

Side note to Janet Napolitano:  it really is OK to be honest the first time around.  But other than your first statement about how our security system works, you are doing a heck of a job.

Side note to Dick Cheney:  we are getting very tired of seeing the Mr. Hyde part of your personality. (Perhaps Obama likes this side, since you constantly remind Americans of why voting for Obama was a good idea.)  When will we see the Dr. Jekyll side again?  Please let this side out more frequently.  It seems that we only see it when you talk about your daughter.

Side note to Senate Republicans:  Thanks to you, we still don’t have a head of the Transportation Security Administration (TSA).  “Advise and consent” should not mean “prevent the President from running the Executive branch.”

Traveling Incognito

December 18, 2009

Sarah Palin, in a recent vacation trip to Hawaii, wore a “McCain for President” visor, but crossed out the words.  Her explanation was:  “I Sharpied the logo out on my sun visor so photographers would be less likely to recognize me”.  So, if I understand correctly, she thinks that photographers recognize her by her logo instead of the way she looks.  Or perhaps she thought that crossing out the logo would make her invisible.  In any case, despite all these strenuous efforts at traveling incognito, she was recognized.  Who could have guessed that photographers would see through her clever ploy?  (Perhaps they relied on mathematical modeling approaches.)

How to make mammogram testing cheaper and more effective.

December 16, 2009

New recommendations concerning mammogram testing have upset a lot of people.   Previously, doctors recommended that women be tested yearly starting at age 40. The new recommendations say that most women should start mammogram testing at age 50, and only do it every other year.  The analysis relied on the following empirical result: one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 59, and one death for every 377 women age 60 to 69.  (These recommendation make sense, as pointed out by Mike Trick.)   However, if the ratio of cancer deaths prevented per mammogram could be improved for women aged 40, then mammograms would be recommended.

What this highlights is the importance of a cheap preliminary test with reliability that is pretty good.   For example, suppose that there was a test for which no women with breast cancer had false negatives, and where 1 out of 10 women with no breast cancer had a false positive.  With such a test, approximately 90% of women would be screened out as negative, with all of them having no cancer.  The remaining 10% would test as positive, with the vast majority of them being false positives.  These women would be given mammograms.  (Women would need to be reassured that the preliminary test is not a test for cancer but a test on who should be screened using mammograms.)    Since only 1/10th as many women would be given mammograms, this would result in cancer death prevented for every 190 women being tested, a huge improvement over the current system, with huge savings in terms of health outcomes and dollars.

Even if the test had a false negative rate of 10%, the prevention of cancer deaths would be almost as high.  There would be 1 cancer death prevented for approximately 210 mammograms.  Unfortunately, the false negative could lead to 1 cancer death for every 17,000 women not given mammograms (because of a negative test.)   At the same time, it would eliminate the health risks of mammogram testing for 17,000 women who didn’t have cancer.

The conclusion is that a cheap test with pretty good reliability (say around 90%) can dramatically improve the health outcome of mammogram testing,  while dramatically decreasing the cost of health care.   The NIH should dedicate research funding to find such tests.

To the Secret Service: count your blessings.

December 6, 2009

The Salahis crashed the state dinner in honor of the Indian Prime Minister.  I’m not normally a pollyanna (in fact, I’m rarely a pollyanna), but I view this as good news.  Here is why:  the secret service had a serious flaw in its operations, one that exposed the President to danger.  The Salahis, who were of no danger to the President, exposed the flaw and permitted it to be fixed.

Admittedly, it would be better if there were no flaw to begin with.  But conditioned on there being a flaw, it was very good news that it was revealed and fixed.  Incidentally, no one in the media seems to have observed that the nation owes some gratitude to the Salahis since their actions have improved the protection of the President.

Having said that, I also think that the Salahis should be put in jail for lying to the Secret Service.  They may claim that they think they were invited; however, unless they are totally delusional, they knew better.   And while I feel gratitude that the President will be better protected, I also think it is appropriate to punish those who violate federal crimes, especially ones designed to protect the President.