Internet search rankings have a significant impact on consumer choices, mainly because users trust and choose higher-ranked results more than lower-ranked results. Given the apparent power of search ...rankings, we asked whether they could be manipulated to alter the preferences of undecided voters in democratic elections. Here we report the results of five relevant double-blind, randomized controlled experiments, using a total of 4,556 undecided voters representing diverse demographic characteristics of the voting populations of the United States and India. The fifth experiment is especially notable in that it was conducted with eligible voters throughout India in the midst of India’s 2014 Lok Sabha elections just before the final votes were cast. The results of these experiments demonstrate that (i) biased search rankings can shift the voting preferences of undecided voters by 20% or more, (ii) the shift can be much higher in some demographic groups, and (iii) search ranking bias can be masked so that people show no awareness of the manipulation. We call this type of influence, which might be applicable to a variety of attitudes and beliefs, the search engine manipulation effect. Given that many elections are won by small margins, our results suggest that a search engine company has the power to influence the results of a substantial number of elections with impunity. The impact of such manipulations would be especially large in countries dominated by a single search engine company.
In previous experiments we have conducted on the Search Engine Manipulation Effect (SEME), we have focused on the ability of biased search results to shift voting preferences. In three new ...experiments with a total of 1,137 US residents (mean age = 33.2), we sought to determine whether biased search rankings could shift people's opinions on topics that do not involve candidates or elections. Each of the new experiments looked at a different topic, and participants were pre-screened to make sure they didn't have strong opinions about these topics. The topics were: Is artificial intelligence useful or dangerous? Is fracking helpful or dangerous? And: Are people born gay or do they choose to be gay? All participants were first asked various demographic questions, then shown brief summaries of the "pro" and "anti" views on each topic, and then asked their opinions about each topic. Next, participants were allowed to conduct an online search using our mock search engine (Kadoodle) lasting up to 15 minutes. In each experiment, one-third of the participants saw biased search results favoring one perspective; one-third saw biased search results favoring the opposing perspective; and one-third (the control group) saw mixed search results. After completing their search, participants were again asked for their opinions about the topic. Our primary dependent variable was Manipulation Power (MP), the percentage increase in the number of participants favoring one viewpoint after having viewed search rankings favoring that viewpoint. The MPs in the three experiments were 25.0%, 30.9%, and 17.8%, respectively. Corresponding shifts were also found for how persuasive participants found each viewpoint to be and for how much they trusted each viewpoint. We conclude that search rankings favoring one viewpoint on a wide range of topics might be able to cause people who have not yet formulated a strong opinion on such topics to adopt the favored perspective. If our findings prove to be robust, we are exposing what might be considered an unforeseen consequence of the creation of search engines, namely that even without human interference, search algorithms will inevitably alter the thinking and behavior of billions of people worldwide on perhaps any topic for which they have not yet formed strong opinions.
Generative social science Epstein, Joshua M; Epstein, Joshua M
2011., 20120102, 2012, 2007, 2007-01-01, 20060101, Letnik:
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eBook
Agent-based computational modeling is changing the face of social science. In Generative Social Science, Joshua Epstein argues that this powerful, novel technique permits the social sciences to meet ...a fundamentally new standard of explanation, in which one "grows" the phenomenon of interest in an artificial society of interacting agents: heterogeneous, boundedly rational actors, represented as mathematical or software objects. After elaborating this notion of generative explanation in a pair of overarching foundational chapters, Epstein illustrates it with examples chosen from such far-flung fields as archaeology, civil conflict, the evolution of norms, epidemiology, retirement economics, spatial games, and organizational adaptation. In elegant chapter preludes, he explains how these widely diverse modeling studies support his sweeping case for generative explanation.
Parsing the Turing Test is a landmark exploration of both the philosophical and methodological issues surrounding the search for true artificial intelligence. Will computers and robots ever think and ...communicate the way humans do? When a computer crosses the threshold into self-consciousness, will it immediately jump into the Internet and create a World Mind? Will intelligent computers someday recognize the rather doubtful intelligence of human beings? Distinguished psychologists, computer scientists, philosophers, and programmers from around the world debate these weighty issues – and, in effect, the future of the human race – in this important volume. Foreword by Daniel C. Dennett.
Subcutaneous (SC) administration of rituximab provides an opportunity for reduced patient treatment burden and increased healthcare efficiencies as an alternative to intravenous (IV) rituximab. There ...is minimal evidence comparing costs associated with SC and IV rituximab in a US setting. This research assessed the impact of transitioning patients from IV to SC rituximab for treatment of non-Hodgkin's lymphoma (NHL) from the US payer, provider, and patient perspective. We developed a model to estimate cost differences for transitioning 20% of a patient cohort from IV to SC rituximab. We included patients with incident diffuse large B-cell lymphoma, incident and recurrent follicular lymphoma, and incident and recurrent chronic lymphocytic leukemia. In the model, each patient received the same number of doses and that there was no difference in discontinuation between cohorts due to non-inferior efficacy and a similar safety profile. Model inputs were collected from published literature and publicly available data. Scenario analyses tested the impact of availability of low-cost biosimilars. In the base case (1,000,000 covered lives), we estimated a total of 157 patients, with 769 total drug administrations. A transition of 20% of patients from IV to SC was projected to generate $153,000 in payer savings, increase provider capacity by 270 hours, and free 470 hours of patient time. Scenario analyses suggest SC administration will be cost saving for payers even with a market where biosimilars approach 50% market share. A 20% transition to SC rituximab in a single cohort of patients has the potential to generate significant US health system value in the form of payer savings, increased practice capacity, and patient time.
Objective: The objective of this study was to evaluate the impact of medication adherence on healthcare utilization and cost for 4 chronic conditions that are major drivers of drug spending: ...diabetes, hypertension, hypercholesterolemia, and congestive heart failure. Research Design: The authors conducted a retrospective cohort observation of patients who were continuously enrolled in medical and prescription benefit plans from June 1997 through May 1999. Patients were identified for disease-specific analysis based on claims for outpatient, emergency room, or inpatient services during the first 12 months of the study. Using an integrated analysis of administrative claims data, medical and drug utilization were measured during the 12-month period after patient identification. Medication adherence was defined by days' supply of maintenance medications for each condition. Patients: The study consisted of a population-based sample of 137,277 patients under age 65. Measures: Disease-related and all-cause medical costs, drug costs, and hospitalization risk were measured. Using regression analysis, these measures were modeled at varying levels of medication adherence. Results: For diabetes and hypercholesterolemia, a high level of medication adherence was associated with lower disease-related medical costs. For these conditions, higher medication costs were more than offset by medical cost reductions, producing a net reduction in overall healthcare costs. For diabetes, hypercholesterolemia, and hypertension, cost offsets were observed for all-cause medical costs at high levels of medication adherence. For all 4 conditions, hospitalization rates were significantly lower for patients with high medication adherence. Conclusions: For some chronic conditions, increased drug utilization can provide a net economic return when it is driven by improved adherence with guidelines-based therapy.
Myelodysplastic syndromes are hematological malignancies characterized by ineffective hematopoiesis and a high risk of progression to acute myeloid leukemia. Hypomethylating agents (HMAs), ...azacitidine and decitabine, are standard of care therapy for higher-risk myelodysplastic syndromes. However, outcomes reported for real-world studies fall short of those achieved in clinical trials. We conducted a targeted literature review exploring real-world utilization, persistence and outcomes with intravenous and subcutaneous HMA therapies to better understand barriers to achieving optimal outcomes in clinical practice. The potential benefits of oral HMA therapy were also explored. Underutilization and poor persistence with HMA therapy are associated with suboptimal outcomes, highlighting the need for approaches to improve utilization and persistence, so that patients achieve the optimum benefit from HMA therapy.
FGFR2
fusions or rearrangements occur in up to 14% of patients with intrahepatic cholangiocarcinoma. In a study, futibatinib, an FGFR inhibitor, induced responses (median, 9.7 months) in 42% of ...patients.
What kinds of information and alerts might cause internet users to be more cautious about what they reveal online? We used a 25-item survey to determine whether the strength of Terms of Service (TOS) ...warnings and the inclusion of a click requirement affect people's willingness to admit to engaging in inappropriate behaviors. A racially and ethnically diverse group of 1,500 people participated in the study; 98.3% were from the US and India and the remainder from 18 other countries. Participants were randomly assigned to five different groups in which warnings and click requirements varied. In the control condition, no warning was provided. In the four experimental groups, two factors were varied in a 2 × 2 factorial design: strength of warning and click requirement. We found that strong warnings were more effective than weak warnings in decreasing personal disclosures and that click requirements added to the deterrent power of both strong and weak warnings. We also found that a commonly used TOS warning has no impact on disclosures. Participants in the control group provided 32.8% more information than participants in the two click requirement groups combined and 24.3% more information than participants in the four experimental groups combined. The pattern according to which people dropped out of the five different groups sheds further light on the surprising power of the click requirement, as well as on the importance of tracking attrition in online studies.
The coronavirus disease 2019 (COVID-19) pandemic has brought increased attention to vulnerable populations such as older or immunocompromised patients and heightened the focus on alternatives to ...intravenous (IV) formulations, particularly those that may be administered in a non-clinical setting. Among these alternative formulations are subcutaneous (SC) injections, which comprise an increasing share of commercialized and pipeline therapies. While much has been published about the benefits and limitations of IV versus SC administration to patients and health systems, less attention has been given to payer considerations regarding these routes of administration. Accordingly, this article provides payer perspectives on some of the key differences between IV and SC administration as they relate to management and billing, cost, treatment adherence and safety, and patient preference and quality of life. The benefits and limitations of these drug administration routes to key healthcare stakeholders--namely patients, physicians, and payers--are also discussed. Considerations of relevance are highlighted, including the potential for misalignment of stakeholder interests and countervailing factors that may impact decision-making about IV and SC formulations. Keywords: drug utilization management, formularies, pharmacy benefits management
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