Researchers Find Racial Bias in Hospital Algorithm
Healthier white patients were ranked the same as sicker black patients, according to study published in the journal Science
Black patients were less likely than white patients to get extra medical help, despite being sicker, when an algorithm used by a large hospital chose who got the additional attention, according to a new study underscoring the risks as technology gains a foothold in medicine.
Hospitals use the algorithm—from Optum, UnitedHealth Group Inc. ’s health-services arm—to find patients with diabetes, heart disease and other chronic ailments who could benefit from having health-care workers monitor their overall health, manage their prescriptions and juggle doctor visits, according to the study published Thursday in the journal Science.
Yet the algorithm gave healthier white patients the same ranking as black patients who had one more chronic illness as well as poorer laboratory results and vital signs.
The reason? The algorithm used cost to rank patients, and researchers found health-care spending for black patients was less than for white patients with similar medical conditions.
“What the algorithm is doing is letting healthier white patients cut in line ahead of sicker black patients,” said Dr. Ziad Obermeyer, the study’s lead author and an acting associate professor of health policy at the University of California, Berkeley.
Optum advises its customers that its predictive algorithms shouldn’t replace physician judgment, a company spokesman said. Efforts to use analytics in health care have only scratched the surface of their potential and should be continually reviewed and refined, he said.
Optum’s algorithm is used by more than 50 organizations, according the company’s website. Partners Healthcare in Boston is among those to have used it, according to published research. A Partners spokesman said the hospital system is vigilant about how well its algorithms perform. He added a Partners researcher co-authored the paper, which “is an important step in rooting out some of the flaws that exist.”
The Washington Post and Science News earlier reported Optum is the algorithm’s developer.
Algorithms, developed by computers crunching vast data sets, are increasingly shaping choices in medicine, from interpreting medical scans to predicting who might become addicted to opioids, suffer a dangerous fall or end up in the hospital.
The technology can speed up and improve some decisions, leading to better treatment for patients, supporters say. But doctors who get suggestions to tweak their patients’ care based on the findings of algorithms often don’t know the details of the technology that led to the recommendation.
Poorly designed algorithms risk reinforcing racial and gender biases, technology experts caution, as studies of algorithms in nonmedical settings like credit scoring, hiring and policing have found.
Algorithms “can give the gloss of being very data-driven, when in fact there are a lot of subjective decisions that go into setting up the problem in the first place,” said Solon Barocas, an assistant professor at Cornell University who is also a principal researcher at Microsoft Research.
Researchers behind the study said well-designed algorithms could help reduce bias that leads to wide disparities in health-care outcomes and access to care. They created an alternative algorithm that increased the percentage of those identified for extra help who were black to about 47%, up from 18%.
“It’s a tool that can do a great deal of good and a great deal of bad, it merely depends on how we use the tool,” said Sendhil Mullainathan, a University of Chicago computational science professor who was an author of the study.
Hospitals and health insurers across the U.S. use the Optum algorithm to spot patients who could benefit from extra help from nurses, pharmacists and case workers, the authors of the study said.
To identify those with the biggest medical needs, the algorithm looks at patients’ medical histories and how much was spent treating them, and then predicts who is likely to have the highest costs in the future.
For the study, data-science researchers looked at the assessments made by one hospital’s use of the algorithm. The study didn’t name the hospital. The researchers focused on the algorithm’s rankings of 6,079 patients who identified themselves as black in the hospital’s records, and 43,539 who identified as white and didn’t identify themselves as any other race or ethnicity.
Then the researchers assessed the health needs of the same set of patients using their medical records, laboratory results and vital signs, and developed a different algorithm.
Using that data, the researchers found that black patients were sicker than white patients who had a similar predicted cost. Among those rated the highest priority by the hospital’s algorithm, black patients had 4.8 chronic diseases compared with 3.8 of the conditions among white patients.
The researchers found the number of black patients eligible for fast-track enrollment in the program more than doubled by prioritizing patients based on their number of chronic conditions, rather than ranking them based on cost.
The findings show “how a seemingly benign choice of label (that is, health cost) initiates a process with potentially life-threatening results,” Ruha Benjamin, author of “Race After Technology” and an associate African-American studies professor at Princeton University, said in an accompanying commentary in Science.
Algorithms are playing an increasing role in medicine, though largely invisible to patients.
Doctors are using algorithms to read scans for lung cancer, for instance. Hospitals are deploying the technology to spot which critically ill patients are likely to worsen dramatically. Meantime, health insurers are using algorithms for reasons including to detect patients who are at risk of opioid addiction or who appear headed toward costly lower-back surgery.
Alan Muney, a former executive at health insurer Cigna Corp., said it is common for insurers to use the projected cost of care as a focus in selecting who might get extra outreach or support.
“It’s troubling there was such a big difference” in the effects for black and white patients based on an algorithm focused on cost, he said.
Insurers are developing algorithms that include variables beyond medical costs, including issues that might signal barriers to accessing care, such as financial stress and food insecurity, he said.
Article via Wall Street Journal
“Harriet” Star Cynthia Erivo Responds to Backlash Over Her Casting | Oprah At Home
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New Jersey Sephora customer gets cocaine inside makeup delivery
HOBOKEN, N.J. — Like many professional makeup artists, Christina Milano is a regular customer at Sephora.
In the past year alone, she has spent more than $5,000 on the beauty retailer’s website.
A recent order, however, left her stunned.
In addition to foundation, Milano received a chalky surprise — and it wasn’t bronzer.
“So I end up looking through it and I find a dollar bill and its folded really really well,” she explained. “And there is a straw inside as well, and inside was cocaine.”
While no actual test was done on the substance, Milano says she’s certain that it was cocaine based on its texture and appearance.
“To receive drugs in the mail that’s highly illegal, I could’ve gotten in trouble for that,” she told PIX11.
What appeared to be a company ID for a Sephora worker was also stuffed inside the package, which originated from the company’s distribution center in Maryland.
After she contacted Sephora, a customer service rep issued an apology, $100 in online credit and even served up advice.
“Flush the foreign objects down the toilet,” the customer service representative told Milano over an email, she said.
“I felt like they should’ve called me over the phone — something a little bit more personal than just an email.”
Milano who has kept the evidence, is still trying to make sense of the makeup mixup. She believes it was a prank that went too far.
In a statement to PIX11, a Sephora spokesperson said the company “investigated the matter and taken appropriate actions. Sephora prides itself on our delivery and supply chain experiences and have a zero-tolerance policy around illegal substances in the workplace.”
Despite the circumstances, Milano is not bitter.
“I would still love a more personal apology from them but truly I still will shop at Sephora — I love them.”
via: https://pix11.com/2019/10/25/new-jersey-sephora-customer-gets-cocaine-inside-makeup-delivery/
Photo Credit: pix11.com
Man urinates next to couple fishing in Washington, shoots woman after he’s asked to leave
AUBURN, Wash. (KCPQ) – Police are searching for a man accused of shooting a woman as she fished with her husband in Washington state Thursday night.
Auburn Police Commander Steve Stocker said officers responded to reports of a shooting just before 11 p.m.
The couple were fishing along the Green River near 31500 104th Ave. SE when a truck approached, they told police. A man got out of the truck and started urinating next to the couple, prompting the man who was fishing to confront the man who was urinating.
“Do you mind, my wife is right here,” he reportedly told the man.
The suspect in the truck allegedly fired several shots at the couple, striking the wife.
Her husband drove to a nearby 7-Eleven and called 911. She was taken to Harborview Medical Center and is listed in stable, but serious condition.
No arrests had been made as of Friday evening.
Photo Credit: Getty Images
Florida mom punched 10-year-old son, dislocated his jaw after he wouldn’t stop playing Fortnite
(Meredith) – A mother punched her 10-year-old son in the face after he would not stop playing Fortnite and take a shower, according to Florida authorities.
Police arrested Ann Perugia, 35, at her home in South Daytona following the Wednesday night incident.
The mom had told her son to stop playing the popular video game at around 7 p.m. so he could take a shower, WFTV reported, citing an incident report from the South Daytona Police Department.
About ten minutes after Perugia told her son to get off the game, he still had not moved. She asked him if he had taken a shower, and the boy replied “no.” That’s when Perugia sternly told him to get in the shower, according to the Miami Herald.
Police said as the boy started walking toward the bathroom, his mother became “irate” and followed him.
“When the two got into the bathroom, [he] stated that she punched him with a closed fist … which dislocated his jaw and caused great pain,” the incident report stated.
Perugia confirmed the argument started when her son disobeyed her orders, but she claimed there was more to the story. According to the Miami Herald, the mother said her son stomped his feet into the bathroom, so she followed him and asked about his attitude.
She said her son responded: “I hate you, and you don’t do anything for me!”
Perugia left the room and then overheard him speaking to his father on the phone while packing a bag. When the boy started to leave, Perugia said she grabbed him by his arm and brought him back inside. She claims the boy walked back outside and began throwing rocks at her car.
The father said when he arrived at the home to pick up the boy, Perugia came outside and told him to “take his child and leave.” After the boy told his father that Perugia punched him, the dad said he wanted to press charges.
Police arrested Perugia and charged her with infliction of mental and physical injury to a child.
The boy is staying with an aunt because his father does not have full custody, according to WFTV.
Photo Credit: South Daytona Police Department
A man was shot 16 times and walked into a hospital two miles away
(CNN) — Philadelphia police say it’s “miraculous” that a man shot 16 times was able to walk into the hospital two miles away.
Early Friday morning, the 27-year-old was wounded in Philadelphia’s Kensington neighborhood. Police say it’s unclear why he was shot so many times. They haven’t been able to interview him yet.
Investigators found large caliber shell casings at the scene.
Philadelphia Police Department spokesman Sgt. Eric Gripp told CNN the man was shot:
- five times on his right side;
- two times in his left hip;
- three times in his upper chest;
- once in his right shoulder;
- once in the right side of his neck;
- three times on his left forearm;
- and once on his right forearm.
Police are not identifying the man who somehow made it to Temple University Hospital and admitted himself.
“For him to be hit that many times throughout his body … even though he’s critical, he’s expected to survive,” Chief Inspector Scott Small said. “That’s pretty miraculous.”
Police told CNN that he was in critical but stable and was undergoing surgery.
Photo Credit: Getty Images
Video shows officer shoot an unarmed 16-year-old as he runs away. Police say it was justified
(CNN) — Newly released video of a fatal police shooting in April 2017 shows an officer firing a deadly shot at an unarmed 16-year-old who had jumped over a fence and was running away.
Police in Fresno, California, say that three different official departments have ruled the shooting justified.
The surveillance camera footage, provided by attorney Stuart Chandler, shows 16-year-old Isiah Murrietta Golding climb a fence and enter a small yard as he is being chased by two officers.
Murrietta Golding, wearing a gray sweater, lands on his feet and starts to run. One officer climbs the fence while the other gets into a crouching stance and fires through the fence, the video shows. Murrietta Golding then stumbles and falls to the ground.
In the police body camera footage, also provided by the attorney, someone off camera can be heard saying “good shot.”
Murrietta Golding’s parents filed separate wrongful death lawsuits against the city of Fresno and several of its officers in March 2018. Chandler, who represents Murrietta Golding’s father, said the suits were filed separately because the couple are divorced.
The bullet went through the back of the teen’s head, according to the father’s lawsuit, and he died three days later. The lawsuit claims the officer who fired had no “objective facts” to believe that Murrietta Golding was armed or reaching for a weapon. The teen was unarmed, the lawsuit states.
“The fact that the police department and the city of Fresno’s police auditor all agreed that this shooting was justified is troubling in light of the video that clearly shows that it’s not,” Chandler told CNN.
Lawsuit: Teen wanted for questioning
Citing police statements, the father’s lawsuit says that Murietta Golding was wanted for questioning in connection with a shooting one day earlier that had caused a fatal car crash. Fresno Police sought to question the teenager and pulled over a car in which he was a passenger, the lawsuit states.
The teenagers in the car initially complied with police. But Murietta Golding then took off running, the lawsuit states, leading to the fatal chase.
Fresno Police Chief Andrew Hall told CNN affiliate KSEE that the shooting was ruled justified by police’s Internal Affairs Bureau, the Fresno County District Attorney’s Office and the City of Fresno’s Office of Independent Review.
“The use of lethal force in this case occurred while officers were investigating a homicide. The 16-year-old in this case was involved in the homicide with his brother and the brother was later arrested and pled guilty,” Hall said.
“The (surveillance) video represents a different vantage point and was not what the pursuing officers could see. The 16-year-old was also known to carry firearms and had jumped a fence into a child daycare center.”
CNN has reached out to the Fresno Police Department and the Office of Independent Review for comment.
Photo Credit: thedailybeast.com
Man sends video of himself strangling cat to fiancée’s ex
An Indiana man was reportedly arrested for sending a video of himself strangling a cat to his fiancée’s ex because he suspected the two were still romantically involved.
“You think I am f—ing around,” Zackary Nichols, 29, allegedly said in a video that he sent Sunday to his fiancee’s ex, which showed his hand wrapped around the neck of the feline, according to arrest records obtained by The Evansville Courier Press.
“You really think I am f—ing around. I’ll f—ing murder this godamn cat. F–k you, you little b–ch,” he continued in he recording, which was sent via text.
The video then shows the cat being slammed onto a couch, the report said.
Nichols’ outburst was allegedly precipitated by his suspicion that his fiancée had cheated on him with her ex.
“Because she cheated on me with you the cats are no longer alive,” Nichols’ texted the man before sending the footage.
The man admitted to cops that he has kids with Nichols’ fiancée, but denied they’re still seeing each other.
Nichols allegedly copped to abusing the cat to cops, but told them he assumed he couldn’t be arrested since the cat was unharmed.
Animal Control took the cat, but it’s unclear what condition the animal is in, the report said.
There were six other cats in the house that were handed over to Nichols’ fiancée.
Nichols was charged with animal cruelty and released on $100 bond.
via: https://nypost.com/2019/10/23/man-sends-video-of-himself-strangling-cat-to-fiancees-ex/
Photo Credit: Vanderburgh County Sheriff’s Office
Woman strangled new boyfriend ‘to know what it felt like’ — after he had asked her to kill him because of his crippling depression
A woman sentenced to 60 years behind bars for strangling her new boyfriend in a Walmart parking lot in Montana said she “wanted to know what it felt like” — after he had asked her to kill him because of his crippling depression, according to a report.
Lindsay Haugen, 32, and Robert Mast, 25, were traveling from Olympia, Washington, to North Dakota in 2015 when they stopped in Billings, Montana, where she got behind him in their car and choked him as she held his mouth and nose shut.
She told investigators that she killed him “because he asked me to” as he struggled to battle his depression — but added that she wanted to “know what it felt like to kill someone with my bare hands,” according to the UK’s Mirror.
“My last fiance broke my hand, then he got behind me, just like I did to Robby, and choked me,” she said. “I woke up on the floor and it was like I was underwater and I just wanted to do that back — but he wanted it to happen.”
Police also learned that Mast had been talking about his ex-girlfriend to Hauger before his murder, something she admitted she was jealous about.
In 2016, Haugen pleaded guilty to the crime, which is featured in a new episode of the Netflix series “I Am A Killer” to be shown on the UK’s Crime+Investigation on Tuesday.
“I remember, one morning he woke up and just said, ‘Have you ever been disappointed that you woke up and you’re still alive?’” said Haugen, now 36. “I just remember how upset he looked.”
She claims she is “heartbroken” over her boyfriend’s death.
“He was only 25 and he had his whole life ahead of him but I made a choice and I took his life. Nothing I can do can undo that,” said Haugen, who ran away from home when she was 15, was addicted to heroin by age 16 and was pregnant by 17.
She later left her baby boy with her mother and joined the National Guard, where she met an abusive man who would regularly beat her, rape her and even tried to kill her.
In 2015, she met Mast at a house party.
“He had just come out of rehab but I didn’t see that, I just saw a beautiful face among a pile of beer cans,” she said.
“He held my hand and said, ‘I wish I could be happy with you but I’m not and it’s not you,’” she said. “He kept telling me he wanted to see what the next life was like. I took it personally, that I wasn’t enough for him to live for.
“He said he just wanted to die,” she added.
Mast’s mother and stepfather have forgiven the killer and regularly visit her in prison, saying they “lost a son but have gained a daughter.”
“The only way I can show how sorry I am is to live the best life I can,” Haugen said. “If I can do something good with my life, then his life will mean something.”
via: https://nypost.com/2019/10/23/woman-strangled-new-boyfriend-to-know-what-it-felt-like/
Photo Credit: nypost.com