this week i

wrote my second wikipedia article, outlining the cdc's national health interview survey.

stood by the train tracks.

crossed a few canals.
gave way to cyclists..

..and other commuters.

headed to amsterdam's cafes for a few final days of working from europe.

figured out that i am anti-principles. in this complex world, if you're unflinching in your decisions based on a few pithy sentences, you have mush for brains.  related: patrick henry is my least favorite of the founding fathers.

bade farewell to the omnipresent smell of pot and the scandalous airport signage.

made it home to dad's for some steak.

watched all three: life in a day trumps tree of life, but true grit wins.

read some of a sure-to-be-seminal lancet article on physical activity.  here's the crux:

love the speech our current director of cms gave twelve years ago.  reminds me not why to fight but what to fight for.  best line: "the only memories in the system were ours."

started my first two courses toward a phd in biostatistics.  night school, just like stringer bell.

learned some poker odds:  out of 52 cards, each five card hand has a 1 in 2,598,960 chance of being selected.  that's 1 over (52 choose 5).  since a hand with four aces has all four aces and then any of the other 48 cards, being dealt a four-ace hand has exactly a 48 / 2,598,960 probability.  the goal of probability theory is to find a mathematical equation that reflects your beliefs about the world.

enjoyed atul gawande's collection of essays, better.  he discusses successes in medicine and tempers expectations..

mortality from gun assaults has fallen from 16 percent in 1964 to 5 percent today

smallpox, with its distinctive blisters and vesicles, could be readily and quickly identified; the moment a case appeared, a team could be dispatched to immunize everyone the victim might have come into contact with.  that strategy, known as 'ring immunization,' eradicated the disease by 1979.  polio infections are far harder to identify.  for every person who is paralyzed, between two hundred and a thousand infected people come down with little more than a stomach flu-and they remain silently contagious for several weeks after the symptoms abate..the area targeted for polio immunization must be far larger than that for smallpox.  and whereas people needed to be vaccinated against smallpox only once for immediate protection, a single dose of polio vaccine does not always take-children with diarrheal illnesses tend to pass the oral vaccine straight through.

..doctors' finances..

doctors quickly learn that how much they make has little to do with how good they are.  it largely depends on how they handle the business side of their practice.

the average doctor in a high-risk practice like surgery or obstetrics is sued about once every six years.  seventy percent of the time, the suit is either dropped by the plaintiff or won by the doctor in court.  but the cost of defense is high, and when doctor's lose, the average jury verdict is half a million dollars.  general surgeons pay anywhere from thirty thousand to three hundred thousand dollars a year in malpractice-insurance premiums, depending on the litigation climate of the state they work in

..the flaws of quality assessment..

death among the elderly or disabled mostly has to do with how old or sick they are to begin with, and the statisticians could never quite work out how to apportion blame between nature and doctors.

..and the way forward.

always look for what more you could do.  i am sympathetic to this rule.  it gives us our best chance of avoiding the worst error of all-giving up on someone we could have helped.

don berwick argued that openness would drive improvement, if simply through embarrassment

do what is right and do it now

new laboratory science is not the key to saving lives.  the infant science of improving performance--of implementing our existing know-how--is


this week i

published this description and analysis of the regulatory definition of affordability in the health reform law.

consider movement as addictive as any other drug: the more i travel, the more i want to travel.

left the land of sodas and seatbelts on buses.

followed the clouds across gibraltar.

landed with rainbows encircling our wings.. time for another african sunset.

walked both from and to the airport.

saw ramadan in full bloom..

which means nobody eats till sunset

..but when they do, they make it count.

weaved through every alleyway in the old city.

found an oasis.. by a friendly french innkeeper with razor-sharp cartography skills.

tried a gritty local hammam, half ymca sauna room, half tuberculosis incubation chamber.

rank marrakech high on the list of great cities of the world.

motorcyclists whip through crowds like there's no tomorrow

satellite dishes observe unidirectional positioning reminiscent of prayer toward mecca

cats congregate around butcher shops hoping to enjoy some intestine a la sidewalk

traditional wares make life feel both simple and rich

shoulders to lean on are never far away

spice merchants compete in the open air, and everybody's nose wins

tourists who have a hard time saying no, well, they look a little silly

..and traffic snarls are usually melon-based.

left morocco.

re-read aesop's fables, the hare and the hound and the wolf and the lamb definitely the best.

stole away to stratford-upon-avon..

..where local artists continue to embody shakespeare's sophistication.

took the tudor walking tour.

shakespeare wuz born here

shakespeare wuz educated here

shakespeare iz here

suppose it's beautiful, but i can do this later in life.

don't do it for the money, do it for the funny.

can still sniff a dollar store a kilometer away.

don't get it.  it's clearly not.

spent a few more days in london.

worked from the standing desk overlooking the water..

 ..and, when that got tiring, a ramshackle coffee shop.


this week i

proudly work for the butt of the most recent onion joke, and await angry calls from idiots like these.

got picked up by the health business section of the new york times, the u.s. news and world report health page, and hey why not the l.a. times for good measure.

took off.  saw the mediterranean.  heard over the loudspeaker, "we're headed back to london, there's a problem with the electronics."  the most talkative flight i have ever been on.  the captain came back into the cabin to let us take his pulse and pinky-swear that we wouldn't crash.

waited for them to apply duct tape to the check engine light.

flew to post-revolutionary tunisia.

found the typo that makes life complete.  what's a saharan tunisian's favorite halloween costume? a sandwitch.

sat by the sea.

consider islamic architecture the world's best, though cambodians deserve honorable mention.

have apparently done a good job at preventing google from collecting too much data about me.

toured the roman ruins of carthage, second in size only to rome..

..though after two thousand years, you'd expect more professional upkeep.

dropped by the refurbished roman amphitheater..

..complete with caves for hungry lions.

took tunisian light rail.. the villages.
found an idyllic hotel room.

flew back to the u.k.

slept three hours at huseyin's, seen here displaying his lightning-quick vanity reflex, which removes his glasses when there's a camera around.

left london before the crack of dawn.

caught the northbound.. the 2011 r conference in coventry.

presented our poster on big survey data and limited computing resources in r.

fit right in.  'a mathematician would rather build a firehouse than put out a fire.'

learned how to mine data for factors associated with a particular dependent variable.  valuable methods to quickly find associations within categorical data.  a long-term dream of ours is to use regression trees to describe the primary drivers of health care costs.

took a tutorial on emacs and the r version - emacs speaks statistics - which convinced me that i will be programming in notepad++ forever.  this programming graphical user interface most perfectly aligns with my principle of keeping hands off the mouse, but the library of shortcuts appears to require as much brain re-wiring as switching to a dvorak keyboard, which i found impossible.

decided that the most useful talk was by ulrike gromping about her work on the design of experimentsfractional factorial designs are a tremendous tool for saving money when you want to do something better.  take an automobile assembly line: if there are ten uncertain factors (like whether to use titanium or steel for the car seats' bolts), and you want to know how much each of those ten factors cushion the collision impact on a crash test dummy, what's the best way to maximize your information from a finite number of crash tests?  even if each factor had only two options (titanium versus steel bolts), testing every possible combination of ten factors would require 1,024 experiments (two to the tenth).  instead, fractional factorial designs allow exponentially-fewer experiments while maximizing what you can learn about the effect and relative importance of each of your factors.

appreciate that this is a living, breathing programming language.  we're all working on our own r code, then sharing and updating via the r package system.  a community perpetually in beta.

uploaded the code from our poster, as well.