Treatment effect heterogeneity, self-selection into RCTs, and racial disparities

In drug development, clinical trials typically aim for a population that is representative of the patients who would be eligible for the treatment. While randomized controlled trials (RCTs) typically focus on measuring the average health impact of a drug across this population, a paper Basu and Gurjal (2020) argue that treatment effect heterogeneity and self-selection…

How good are you at ‘X’?

Where X can be basically any task. Likely your answer is that you are pretty good at X. In fact, you probably think you are above average. There is an explanation for this: the Dunning-Kruger effect. This is a bias where people generally believe they are better at a task than they are. This effect…

Is Uber a substitute for ambulances?

According to a paper by Moskatel and Slutsky (2019), the answer appears to be ‘yes’. In this paper, we ask whether UberX’s entry into a city caused substitution away from traditional ambulances for low‐risk patients, reducing overall volume. Using a city‐panel over‐time and leverage that UberX enter markets sporadically over multiple years, we find that…

Open-Source Publishing

An interesting new approach to academic article publishing as described by Josh Cohen from Tufts University: Open-peer review journals preserve scientific review by conducting reviews after the article’s initial release. Review takes place in the open, with comments and the peer reviewer’s name published online, along with the article authors’ responses and revised manuscript, and…

How to measure preferences in health

Which treatment is the best?  This is a seemingly simple question, but there are many answers.  Some people would say whatever the clinical evidence says.  Others would contend that patient preferences are paramount and patient preferences should rule the day.  In our current world of health care largely paid for by insurance, how should the preferences…

Average vs. Marginal Benefit of Medical Treatment

“The weak relationship between aggregate spending and health outcomes is in stark contrast to evidence showing pronounced medical benefits for use of specific medical devices, procedures, or pharmaceuticals. For example, advances in the treatment of heart attacks reduced the one-year mortality rate for these patients by 5 percentage points between 1984 and 1991 (Cutler et…

Does competition improve health care quality?

If economists decided to re-write the Ten Commandments, “Thou shalt love Competition” may make the list.  However, does competition always improve quality?  Even in the case of health care? A paper by Scanlon et al. (2008) “…found no evidence of a strong and consistent relationship between HMO competition (measured either by the HHI or the…