Malcolm Gladwell & Mad Men

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Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-14 16:25

最近我不是在看 What the Dog Saw 么?里面有一篇很好玩的东西,实际上书里收集的文章大部分都很好玩,但这一篇跟 Mad Men 有直接关系。

这篇文章叫 True Colors,在里面他描述染发市场的历史,比较五六十年代 Clairol 染发产品的广告与七十年代 L'Oreal 的染发产品广告,反应出女性在社会中形象和位置的变迁。很眼熟吧?文章里还特地 profile 两个广告写手,都是女的,一个五十年代,一个是七十年代,让我立刻想起了 Peggy Olson。除此之外,Gladwell 还详细地讨论了染发以及广告在大众和社会的心理 context 中的作用和深层关系,也是 Mad Men 里面反复出现和阐述的主题。

最好笑的是,文章里提到一个叫做 Jack Tinker 的广告达人,是当时 Madison Avenue 上最大的广告公司之一 McCann Erickson 的头头(McCann Erickson 公司名字在 Mad Men 里多次出现)。他觉得公司太大,太被动,于是拉了几个最有才智的员工出来,把他们放在 Dorset Hotel 里租了个 penthouse 做事,结果大获成功,业绩卓著:
The Tinker Group rented the penthouse, complete with a huge terrace, Venetian-tiled floors, a double-height living room, an antique French polished-pewter bar, a marble fireplace, spectacular skyline views, and a rotating exhibit of modern art (hung by the partners for motivational purposes), with everything-walls, carpets, ceilings, furnishings-a bright, dazzling white. It was supposed to be a think tank, but Tinker was so successful so fast that clients were soon lined up outside the door. When Buick wanted a name for its new luxury coup?, the Tinker Group came up with Riviera. When Bulova wanted a name for its new quartz watch, Tinker suggested Accutron. Tinker also worked with Coca-Cola and Exxon and Westinghouse and countless others, whose names-according to the strict standards of secrecy observed by the group-they would not divulge. Tinker started with four partners and a single phone. But by the end of the sixties it had taken over eight floors of the Dorset.
四个合伙人,六十年代,在饭店里开广告公司。我简直要笑出声来,哈哈哈。 :wicked:

这两个事情绝不是巧合,那么是谁抄袭了谁的灵感呢?Gladwell 这篇文章写于 1999 年,可见是他先发现的题目。不知道 Matt Weiner 是否每月请他吃一顿豪华大餐,绝对应该,绝对!

Malcolm Gladwell 的文章 True Colors 可以在此处读到全文:
http://www.gladwell.com/1999/1999_03_22_a_colors.html
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putaopi
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Re: Malcolm Gladwell & Mad Men

Post by putaopi » 2010-03-14 16:43

也许不是谁抄袭了谁, 而是个当年广告业现在hi-tech的普遍现象?当然Hi-tech的人不在酒店里开公司,都在车库里开。:-)

很期待第四季的Mad Men,有工作激情的Don最有魅力了。他在家里或在情人的怀里都是一付忧郁的样子,好像是白博说过,他怎么总是有灵魂地婚外情,真让我受不了。

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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-14 17:06

我不这么认为,主要是因为 Mad Men 里面经常提到 McCann Erickson 而且观点完全一样,觉得公司太大,就是一个无创意的工厂。太多近似呼应的细节了。
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becks
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Re: Malcolm Gladwell & Mad Men

Post by becks » 2010-03-16 16:03

如果Gladwell真地被抄, 那也不是第一次了. What the dog saw里面有一篇something borrowed讲概念抄袭的界限, 歌舞剧Frozen的剧作家被指控抄袭精神科医生Dorothy Lewis写的关于连环杀人犯的书和Gladwell于1997年在纽约客上发表的关于这位教授的profile. 看的出来Gladwell是有点pissed off, 用的字很有意思,lifted materials from...

还有
Lavery wasn’t indifferent to other people’s intellectual property, then; she was just indifferent to my intellectual property. That’s because, in her eyes, what she took from me was different. It was, as she put it, “news.”
http://www.newyorker.com/archive/2004/1 ... ntPage=all

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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-16 16:24

还没看到 Something Borrowed 这一篇。

很搞的是,我发现 Gladwell 跟 Johah Lehrer 的文章有很多重叠的话题,例如 panic 和 choking 的差别。两个人常常引用同一心理学试验和研究,例如爱荷华赌牌试验。不过他们的角度有挺大的差别就是了,Lehrer 直接讲很多脑神经的研究,dopamine之类,Gladwell 就从来不提技术细节。对照一下"How We Decide" 和 "Blink" 和 "The Emotional Brain" 这三本书,里面很多都是引用同样的 source。
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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-17 7:47

Interesting. Gladwell is very forgiving about the "plagiarism" incident.

Then again Gladwell and Lehrer repeatedly cite exactly the same incident or research studies with somewhat different angles and come up with somewhat different (but not contradictory) interpretations. :worthy:

Fascinating (<Spock's head-tilt>). :mrgreen:
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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-18 7:29

What the Dog Saw 快看完了。后面一篇很有意思,Dangerous Minds: Criminal Profiling Made Easy http://www.gladwell.com/2007/2007_11_12_a_profile.html。当然我的意思不是文章本身很有意思,因为书里大部分的文章都很有意思,而是让我联想到一件跟自己有关的事。

这篇文章的内容和主题是,激发无数畅销小说、非小说书籍、电影、电视剧等等的大名鼎鼎的 FBI criminal profilers 跟摆摊算命的人卖的是同一葫芦里的药,说得天花乱坠实际上毫无用处。我一看到这个说法脑子里立刻叮地一声,deja vu! 这个说法我早见过,但是完全不记得在哪里见过,给我留下了很深的印象。 相当可靠而合理的说法: psychological profiling 是一件非常不靠谱的事情,在现实的侦探工作里毫无用处,警察之所以能抓到凶手罪犯,根本原因很简单,1) 大部分的罪犯都很笨,无条理,惊慌和混乱,留下大量线索,2) 朴素、沉闷、labor-intensive的侦查手段是唯一有实际用处的工具,例如在附近一家一家地询问有无听见看见异常现象,分析现场留下的各种物理线索,调查受害者的社会关系,如此等等。加上一些运气的因素。这就是侦探工作的全部,什么天花乱坠的神奇东西都是 bullshit。

这个解释非常合乎逻辑,虽然我根本没有第一手经验,也立刻相信了,并且从那时候开始逐渐迷上了 police procedural 类型的 mystery 小说(Martin Beck 和 Wallander 是典型的例子,梅格雷也差不多),而不再被沉默羔羊这种惊险小说吸引。但是我从来没想过去收集这方面的资料来源,这个说法的证据基础。Malcolm Gladwell 并没有发明这个理论,也没有亲手收集过数据,他只是收集和编织起行业内早已流传甚广的专业研究,用通俗易懂而且引人入胜的笔法叙述出来,而一手的数据资料都是从别人那里引用来的,实际上我怀疑在 criminology 里面 FBI profiling 那套早已过时,否则不会连我都听说过对它的批判。但是行业之外的大众是不知道这些数据和研究的: 例如英国有criminologist曾回头审查过上百个罪犯尚未抓到之前开出的profiles,发现只有百分之二点几是准确的,其他都不准,这个概率大概连 random hits 都不如。

我跟 Gladwell 的差别就在于,虽然我们的脑子里都塞满了各种乱七八糟毫无规律的碎片,但是他遇到 curious nuggets 会继续刨根问底,把一大堆的 primary research 都给挖出来,组织成一篇完整有逻辑有条理的文章或者一本书;而我呢,把碎片塞在脑子里的某个角落而已。
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猫咪头
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Re: Malcolm Gladwell & Mad Men

Post by 猫咪头 » 2010-03-18 19:56

Jun wrote:这篇文章的内容和主题是,大名鼎鼎的 FBI criminal profilers 跟摆摊算命的人卖的是同一葫芦里的药,说得天花乱坠实际上毫无用处。
:shock: :crying: 我的粉红玻璃心碎了一地。 讲讲细节。当初立这个学说难道没有破案证据? 现在呢,都错了?有黑幕么?
警察之所以能抓到凶手罪犯,根本原因很简单,1) 大部分的...
这个逻辑...
大部分的儿科工作无非是中耳炎/消化不良。所以关于儿童白血病的研究就是voodoo。
而且研究了这么久左一种右一种的新药新疗法只是增加希望没有包好,跟走江湖吉普赛人卖的是同一葫芦里的药。
MMT

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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-18 20:24

抱歉,我看不出犯罪profiling跟儿科医学有什么可比性。显然是我的逻辑太差的结果。

不过要砸砖也请把原文看了再批判,原文里类比 profiling 和算命技巧有直接从 profiles 摘录的话来对照,更不必说,Gladwell 自己都是二道贩子,质疑 profiling 并且拿出研究数据的另有其人,他只是引用人家的研究。看我这个三道贩子不顺眼就直接往我的脑门上扔砖头呗,要砸他们的说法恐怕还得拿出反面的事实和数据。

文章里引用的 criminal profiles (真实的profiles,不是小说里编出来的),倒让我觉得可以类比一个笑话:某人买了一瓶杀蟑螂药,在家里放了而蟑螂不见少,回去找卖药的问,”你说保证有效怎么没用呢?” 卖药的说,你得抓了蟑螂,直接往它嘴里倒,才保证有效。
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Jun
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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-19 6:03

猫咪头你看我不顺眼已经不是一天两天了,拜托你有什么意见敞开来说,何苦拉了儿童白血病和 Malcolm Gladwell 来垫背,我记性很差,不知道什么地方得罪了你,惹你隔几个月半年地上来不论话题地上来砸我几砖头,都有两三年了吧?我自己还摸不着头脑。不如你直接给我个了断,当众历数我的罪状,省得我老惦记老回忆到底三五年前什么地方冒犯了你。
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Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 6:30

huh? 这么紧张?
我想说一下两个事情。一是我听过project innocence 的成立人讲话,他对police work 里的'科学'非常看不起,说在DNA技术以前,根本没有真正的科学,尤其是什么弹道痕迹分析和指纹分析,所谓专家张口就抛出一个95%吻合的数字,追问他们的数据是如何得出,其实是他们根据经验讲的。总之不是hard science. 他是律师出身,看问题角度跟侦探不一样。
另一个是前一阵一个概率学教授David Spiegelhalter 来做了个谈话,说起profliling 的问题。我个人认为profiling 的准确度当然跟模型参数好坏有关,但常常跟直觉相差非常远,即使是简单的问题,不把概率推算走一遍,一般想不到每个因素的影响力有多大。
举个例子,

某个机器可以颇准确的认出恐怖分子。一百个无辜的人里,它能认准95个无辜。一百个恐怖分子里,它能鉴定95个为恐怖分子。
现在飞机上有一百个人,肯定有一个恐怖分子,该机器被拿出来,鉴定到你身边乘客,这个陌生人身上,突然警笛大响,说这个是恐怖分子。
你直觉上认为该陌生人是恐怖分子么?如果一定要你直觉的判断,可能性多高?



















事实是17%。
对于各种criminal profile,因为实际上的positive rate非常低,false positive rate 基本控制了准确程度。5% false positive 被放大成实用中的87%. 不信的算一算就知道。不想做算数的,这里有动画 http://understandinguncertainty.org/node/238


说到癌症的新药,问题不就在于对一组同样的病人,只有很低比例,百分之十五二十的人有用吗?如果真的对谁都没用也就算了,对每个人都起作用就牛了。我听过human genome project 的一个负责人讲话(怎么我尽听人讲话?),新的重要研究方向之一就是datamining 对某药发生好反应的病人基因,分析预测有什么基因的人可能对此药反应好。因为很多癌症病人身体和时间都不允许一个个的试过来了。
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tiffany
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Re: Malcolm Gladwell & Mad Men

Post by tiffany » 2010-03-19 7:31

false positive只有5%?这个数字已经很不错了啊。
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Jun
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Re: Malcolm Gladwell & Mad Men

Post by Jun » 2010-03-19 7:45

If you are really interested in Gladwell's argument and the research he cited, just read

http://www.gladwell.com/2007/2007_11_12_a_profile.html
In the mid-nineties, the British Home Office analyzed a hundred and eighty-four crimes, to see how many times profiles led to the arrest of a criminal. The profile worked in five of those cases. That's just 2.7 per cent, which makes sense if you consider the position of the detective on the receiving end of a profiler's list of conjectures. Do you believe the stuttering part? Or do you believe the thirty-year-old part? Or do you throw up your hands in frustration?
Not long ago, a group of psychologists at the University of Liverpool decided to test the F.B.I.'s assumptions. First, they made a list of crime-scene characteristics generally considered to show organization: perhaps the victim was alive during the sex acts, or the body was posed in a certain way, or the murder weapon was missing, or the body was concealed, or torture and restraints were involved. Then they made a list of characteristics showing disorganization: perhaps the victim was beaten, the body was left in an isolated spot, the victim's belongings were scattered, or the murder weapon was improvised.

If the F.B.I. was right, they reasoned, the crime-scene details on each of those two lists should "co-occur"—that is, if you see one or more organized traits in a crime, there should be a reasonably high probability of seeing other organized traits. When they looked at a sample of a hundred serial crimes, however, they couldn't find any support for the F.B.I.'s distinction. Crimes don't fall into one camp or the other. It turns out that they're almost always a mixture of a few key organized traits and a random array of disorganized traits. Laurence Alison, one of the leaders of the Liverpool group and the author of "The Forensic Psychologist's Casebook," told me, "The whole business is a lot more complicated than the F.B.I. imagines."

Alison and another of his colleagues also looked at homology. If Douglas was right, then a certain kind of crime should correspond to a certain kind of criminal. So the Liverpool group selected a hundred stranger rapes in the United Kingdom, classifying them according to twenty-eight variables, such as whether a disguise was worn, whether compliments were given, whether there was binding, gagging, or blindfolding, whether there was apologizing or the theft of personal property, and so on. They then looked at whether the patterns in the crimes corresponded to attributes of the criminals—like age, type of employment, ethnicity, level of education, marital status, number of prior convictions, type of prior convictions, and drug use. Were rapists who bind, gag, and blindfold more like one another than they were like rapists who, say, compliment and apologize? The answer is no—not even slightly.
"Here's where I'm at with this guy," Douglas said, kicking off the profiling session with which "Inside the Mind of BTK" begins. It was 1984. The killer was still at large. Douglas, Hazelwood, and Walker and the two detectives from Wichita were all seated around the oak table. Douglas took off his suit jacket and draped it over his chair. "Back when he started in 1974, he was in his mid-to-late twenties," Douglas began. "It's now ten years later, so that would put him in his mid-to-late thirties."

It was Walker's turn: BTK had never engaged in any sexual penetration. That suggested to him someone with an "inadequate, immature sexual history." He would have a "lone-wolf type of personality. But he's not alone because he's shunned by others—it's because he chooses to be alone. . . . He can function in social settings, but only on the surface. He may have women friends he can talk to, but he'd feel very inadequate with a peer-group female." Hazelwood was next. BTK would be "heavily into masturbation." He went on, "Women who have had sex with this guy would describe him as aloof, uninvolved, the type who is more interested in her servicing him than the other way around."

Douglas followed his lead. "The women he's been with are either many years younger, very naïve, or much older and depend on him as their meal ticket," he ventured. What's more, the profilers determined, BTK would drive a "decent" automobile, but it would be "nondescript."

At this point, the insights began piling on. Douglas said he'd been thinking that BTK was married. But now maybe he was thinking he was divorced. He speculated that BTK was lower middle class, probably living in a rental. Walker felt BTK was in a "lower-paying white collar job, as opposed to blue collar." Hazelwood saw him as "middle class" and "articulate." The consensus was that his I.Q. was somewhere between 105 and 145. Douglas wondered whether he was connected with the military. Hazelwood called him a "now" person, who needed "instant gratification."

Walker said that those who knew him "might say they remember him, but didn't really know much about him." Douglas then had a flash—"It was a sense, almost a knowing"—and said, "I wouldn't be surprised if, in the job he's in today, that he's wearing some sort of uniform. . . . This guy isn't mental. But he is crazy like a fox."

They had been at it for almost six hours. The best minds in the F.B.I. had given the Wichita detectives a blueprint for their investigation. Look for an American male with a possible connection to the military. His I.Q. will be above 105. He will like to masturbate, and will be aloof and selfish in bed. He will drive a decent car. He will be a "now" person. He won't be comfortable with women. But he may have women friends. He will be a lone wolf. But he will be able to function in social settings. He won't be unmemorable. But he will be unknowable. He will be either never married, divorced, or married, and if he was or is married his wife will be younger or older. He may or may not live in a rental, and might be lower class, upper lower class, lower middle class or middle class. And he will be crazy like a fox, as opposed to being mental. If you're keeping score, that's a Jacques Statement, two Barnum Statements, four Rainbow Ruses, a Good Chance Guess, two predictions that aren't really predictions because they could never be verified—and nothing even close to the salient fact that BTK was a pillar of his community, the president of his church and the married father of two.

"This thing is solvable," Douglas told the detectives, as he stood up and put on his jacket. "Feel free to pick up the phone and call us if we can be of any further assistance." You can imagine him taking the time for an encouraging smile and a slap on the back. "You're gonna nail this guy."
But I suspect all this has nothing to do with the article.

我这个人迟钝得很,从小没读过红楼梦,冷嘲热讽,弦外之音,只听得见,但听不懂。如果需要我改正错误,赔礼道歉,且痛改前非,只能把罪状摆出来说清楚。
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silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 7:52

Knowing wrote:因为很多癌症病人身体和时间都不允许一个个的试过来了。
死马当成活马医,只要给医就还好啊。
我妈有个朋友的先生在加州开中医加针灸诊所,他们总结说,第一广告贴到有机食品店的布告栏,看得人才多,这些人容易相信alternative medicines;第二常常是西医看了半天看不出名堂的人,来看他们就特相信,然后就特有效,这些人跟亲朋好友、病友们口口相传,特别有效。
我觉得serial killers什么的,都杀了好多回了,还抓不着,也差不多是死马活马这个心理,与其毫无头绪、无处下手,不如让profiling的人试试,给点线索能先查着也好啊。

关于警察抓坏人,我年轻时听我哥说过一个反动观点,当时让我特震惊,后来慢慢觉得有一定道理(声明:毫无科学根据)。他说,警察抓住坏人,常常不是警察牛,而是坏人笨,或者坏人做了坏事,不是一锤子买卖,早晚还要再出来做坏事,一回生二回熟,怎么也能撞上个把;而医生治病,真能碰上神医名医,上来就手到病除,那是可遇不可求的福气,大部分医生只能治着看,其实去看医生,重要的不是立马诊断出什么毛病,而是当场排除是其它什么更严重的病。

Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 8:11

到desperate 的时候就容易上当嘛。正如皮肤科医生对我说"啥啥,啥啥,都没有用,就是个昂贵的安慰剂。"我虚弱的回答:"我需要安慰。"医生哈哈的笑说:"安慰剂也有更便宜的。"我抗议:"但是贵的安慰剂更有效!"
讲完笑话讲正经的。理论上没有任何有效选择的时候,当然什么都愿意尝试,别说美国进口新药,中医针灸草药,巫医,求神祷告,都可以试试。事实上每一步都有trade off,上这个药就不能上那个药,信法轮功就不能去医院,费用和病人的生活质量,所以没有选择里也得选,信息还是重要的,安慰剂也有坏效果。
Last edited by Knowing on 2010-03-19 8:17, edited 1 time in total.
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silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 8:16

太对了太对了,安慰剂必得贵的才有安慰作用! :mrgreen:

mirrorflower
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Re: Malcolm Gladwell & Mad Men

Post by mirrorflower » 2010-03-19 10:13

我刚刚看完"how we decide",来赞叹小K一句:您真明事理!我才看到实验数据说了,这个同样的energy drink,原价拿出来的,和号称是打折买的,给人的效果就是有明显差别!原价的就是更有用!哪怕它们装的是一模一样的东西 :mrgreen:

还有比如给你手上涂点润滑油,跟你说可以减轻痛感,结果回头电击你,你真的觉得没有那么疼了!你没有自我欺骗——你聪明的前额叶预计了该止痛剂的效果,活动起来,结果就是抑制了你痛觉区的活动。。。
"A wealth of information creates a poverty of attention."

mirrorflower
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Re: Malcolm Gladwell & Mad Men

Post by mirrorflower » 2010-03-19 10:17

Knowing wrote:
讲完笑话讲正经的。理论上没有任何有效选择的时候,当然什么都愿意尝试,别说美国进口新药,中医针灸草药,巫医,求神祷告,都可以试试。事实上每一步都有trade off,上这个药就不能上那个药,信法轮功就不能去医院,费用和病人的生活质量,所以没有选择里也得选,信息还是重要的,安慰剂也有坏效果。
这句话令我沉思,比如说我发明一种安慰剂/xx功,告诉大家,我这个是众神之神,用了之后大方向就对了,然后下面具体事务各种(药效不特别互相冲突地)药都可以上,这样岂不是治愈率应该更高?我岂不是很有希望成亿万富翁+一代宗师? :smile-big:
"A wealth of information creates a poverty of attention."

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 10:45

说到统计学在医学上的意义, 正好专家在这里, 好奇地问一声Triple/Quad screening 对遗传病测试有意义么? 一方面到处都做, 一方面妈妈们都抱怨, 连医生甚至以前我遇到的一个生统专业的人都说是voodoo. 所谓的70-80%正确率指什么? False positive? False negative?
Last edited by 豪情 on 2010-03-19 15:03, edited 1 time in total.
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Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 10:54

mirrorflower wrote:
Knowing wrote:
讲完笑话讲正经的。理论上没有任何有效选择的时候,当然什么都愿意尝试,别说美国进口新药,中医针灸草药,巫医,求神祷告,都可以试试。事实上每一步都有trade off,上这个药就不能上那个药,信法轮功就不能去医院,费用和病人的生活质量,所以没有选择里也得选,信息还是重要的,安慰剂也有坏效果。
这句话令我沉思,比如说我发明一种安慰剂/xx功,告诉大家,我这个是众神之神,用了之后大方向就对了,然后下面具体事务各种(药效不特别互相冲突地)药都可以上,这样岂不是治愈率应该更高?我岂不是很有希望成亿万富翁+一代宗师? :smile-big:

It is already invented. It is call....RELIGION!
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Re: Malcolm Gladwell & Mad Men

Post by mirrorflower » 2010-03-19 10:56

Knowing wrote:
mirrorflower wrote:
Knowing wrote:
讲完笑话讲正经的。理论上没有任何有效选择的时候,当然什么都愿意尝试,别说美国进口新药,中医针灸草药,巫医,求神祷告,都可以试试。事实上每一步都有trade off,上这个药就不能上那个药,信法轮功就不能去医院,费用和病人的生活质量,所以没有选择里也得选,信息还是重要的,安慰剂也有坏效果。
这句话令我沉思,比如说我发明一种安慰剂/xx功,告诉大家,我这个是众神之神,用了之后大方向就对了,然后下面具体事务各种(药效不特别互相冲突地)药都可以上,这样岂不是治愈率应该更高?我岂不是很有希望成亿万富翁+一代宗师? :smile-big:

It is already invented. It is call....RELIGION!
:worthy: :worthy: :worthy: 还有没有什么新的religion有希望脱颖而出?我知道,竞争已经太激烈了。。。垄断已经形成。。。
"A wealth of information creates a poverty of attention."

silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 11:32

豪情 wrote:说到统计学在医学上的意义, 正好专家在这里, 好奇地问一声Triple/Quaduple screening 对遗传病测试有意义么? 一方面到处都做, 一方面妈妈们都抱怨, 连医生甚至以前我遇到的一个生统专业的人都说是voodoo. 所谓的70-80%正确率指什么? False positive? False negative?
这个测试给出的应该不是“正确率”,而是有问题的风险概率probability。
所以即使说1%的风险,远远低于此孕妇年龄段的cutoff rate,也不代表就肯定没事,还有百分之一的可能性是有问题的。

但是这个测试本来就不应该认为是诊断diagnosis,而只能定位在筛查screening。如果测出来是高风险,假如愿意,还可以进行更准确的测试,比如羊水穿刺。羊水穿刺,那就是诊断性的了。

不过就操作、费用来看,抽血做Triple/Quaduple screening还是可行性高于羊水穿刺,所以目前还是先做筛查,而不是上来就查羊水。

可是,再进一步说,羊水穿刺说是诊断性的,也只能看染色体数量对不对、大体宏观外形对不对。再微观的问题,甚至到基因水平、分子水平上更多的问题,羊水穿刺也瞧不出来。所以,诊断性测试,也只是个相对的概念。

那么就不做筛查了么?羊水穿刺也不做。那超声波还看不看?这端的看各人的选择了。我个人是只要可以做的,保险也cover,那我就做。如果很需要,自己掏钱,我也做。

笑嘻嘻
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Re: Malcolm Gladwell & Mad Men

Post by 笑嘻嘻 » 2010-03-19 11:39

我听说如果你创立了一个 religion ,然后因为这个 religion 而获利,比如信你的人给你钱,这个钱免税。。。
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Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 11:41

创立了一个 religion 哪里有这么容易。你们K偶K偶叫的那叫一个响啊,一宣布要收什一税全改回小K了。
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mirrorflower
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Re: Malcolm Gladwell & Mad Men

Post by mirrorflower » 2010-03-19 11:42

Knowing wrote:创立了一个 religion 哪里有这么容易。你们K偶K偶叫的那叫一个响啊,一宣布要收什一税全改回小K了。
:mrgreen: :mrgreen: :mrgreen:
"A wealth of information creates a poverty of attention."

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 12:04

silkworm wrote:
豪情 wrote:说到统计学在医学上的意义, 正好专家在这里, 好奇地问一声Triple/Quaduple screening 对遗传病测试有意义么? 一方面到处都做, 一方面妈妈们都抱怨, 连医生甚至以前我遇到的一个生统专业的人都说是voodoo. 所谓的70-80%正确率指什么? False positive? False negative?
这个测试给出的应该不是“正确率”,而是有问题的风险概率probability。
所以即使说1%的风险,远远低于此孕妇年龄段的cutoff rate,也不代表就肯定没事,还有百分之一的可能性是有问题的。

但是这个测试本来就不应该认为是诊断diagnosis,而只能定位在筛查screening。如果测出来是高风险,假如愿意,还可以进行更准确的测试,比如羊水穿刺。羊水穿刺,那就是诊断性的了。

不过就操作、费用来看,抽血做Triple/Quaduple screening还是可行性高于羊水穿刺,所以目前还是先做筛查,而不是上来就查羊水。

可是,再进一步说,羊水穿刺说是诊断性的,也只能看染色体数量对不对、大体宏观外形对不对。再微观的问题,甚至到基因水平、分子水平上更多的问题,羊水穿刺也瞧不出来。所以,诊断性测试,也只是个相对的概念。

那么就不做筛查了么?羊水穿刺也不做。那超声波还看不看?这端的看各人的选择了。我个人是只要可以做的,保险也cover,那我就做。如果很需要,自己掏钱,我也做。
我的问题就是, 如果筛查说1%的风险, 有多可靠? 真的是1%吗? 宣传上说70-80%可靠, 某筛查比某筛查更可靠, 是怎么定量的? 数字怎么来的? ultra-sound soft marker, 找到一个, 几率翻一倍, 又是怎么定量的? 这个定量对医疗操作又有多大帮助? 用年龄的概率来cut-off, 我觉得是个很奇怪的概念. 难道不该用羊穿的流产率来cutoff么?
我觉得这些筛查, 就是为保险公司省钱服务的. 保险公司才不管你的利益呢.
Last edited by 豪情 on 2010-03-19 12:18, edited 1 time in total.
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Re: Malcolm Gladwell & Mad Men

Post by saveas » 2010-03-19 12:13

在现实的侦探工作里毫无用处,警察之所以能抓到凶手罪犯,根本原因很简单,1) 大部分的罪犯都很笨,无条理,惊慌和混乱,留下大量线索,2) 朴素、沉闷、labor-intensive的侦查手段是唯一有实际用处的工具,例如在附近一家一家地询问有无听见看见异常现象,分析现场留下的各种物理线索,调查受害者的社会关系,如此等等。加上一些运气的因素。这就是侦探工作的全部,什么天花乱坠的神奇东西都是 bullshit。
我觉得这理论非常之对也,事实上有时候我会娱乐性的考虑下如果我要蓄谋杀某个人,要怎么下手,最后怎么能安全的逃脱,当然最困难的部分是杀人之后如何不留线索的逃脱,最好撇的清清爽爽完全不被警方调查,无匹多推理小说里面狡猾的凶手都功亏一篑在某不起眼的小疏漏上。

不过警察们的破案率好像其实很低,国内没有啥统计,小道消息有个百分之十的数字,那么杀人之后逃脱的概率好像更高了,跑题的说

tiffany
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Re: Malcolm Gladwell & Mad Men

Post by tiffany » 2010-03-19 12:19

这个东西吧,我觉得跟高血压似的,有个平均值范围作为参考,在那个范围里面,有很大概率说该人健康,但是,该人是否确乎就健康呢?100%没有问题呢?谁都不敢说这话,只能说该人有这么大的概率没问题,21。
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豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 12:44

高血压不一样吧. 有定量吗? 超过什么数字就有一个概率数字吗?
我觉得这都属于profiling, 就象保险公司根据你的车的颜色决定保险费一样. 红色车和高车祸率没有因果关系, 只有相关, 而且受其他因素影响很大, 只对保险公司有意义, 对个人没有意义. 比如说如果你换了车的颜色, 难道出车祸的概率就改变了?
所以对破案和诊断用处都不大.
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Re: Malcolm Gladwell & Mad Men

Post by 笑嘻嘻 » 2010-03-19 12:56

我觉得我开座位高的大车或者开性能好的时候,好像就会性格上有所改变,然后更强行猛拐一些。我还真喜欢红车。。。,虽然从来没开过。
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silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 13:07

豪情 wrote:用年龄的概率来cut-off, 我觉得是个很奇怪的概念. 难道不该用羊穿的流产率来cutoff么?
我觉得这些筛查, 就是为保险公司省钱服务的. 保险公司才不管你的利益呢.
年龄这个参数一点都不奇怪啊,20多的孕妇和30多40多的孕妇,胎儿有问题的概率差好多呢。

那不给保险公司省钱,每个孕妇上来都给羊穿,我恐怕好多人不要做呢,到底是有点危险的。现在>35岁的产妇,可以做早期筛查,除了抽血,还照超声波看胎儿脖子鼻子什么的,就比单抽血强。
Last edited by silkworm on 2010-03-19 13:15, edited 1 time in total.

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 13:11

唐筛结果不是一个几率么, 我是说是正是负用年龄的几率来CUTOFF很奇怪. 为啥比本人年龄算出的几率高就该做进一步检查, 反之就不做? 难道不是只要比进一步检查的风险高就该做? 反之就不该做?
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Re: Malcolm Gladwell & Mad Men

Post by tiffany » 2010-03-19 13:16

小情要是说的唐氏症3筛4筛的话,那个据我所知,1,本地35岁以上直接打发去羊穿,2,35岁一下呢,有几个标记拿来筛,第一个标记是12周b超的时候测神经管的宽度,同时还测母体血液里某种蛋白的浓度,这两个都低于某标准,就认为娃儿正常,不建议羊穿;要是超过了,就建议。这种3筛4筛的检测假阳性可能性很大,是参考值而已,羊穿结果就属于诊断性的了。
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silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 13:21

白金,抽血测的不是某种蛋白,而是某三种或某四种--是为triple或quad screening。

我这儿是35岁以下15周左右做quad,35岁以上12周左右做quad+ultrasound。所得几率超过年龄风险概率,就要做羊穿。

豪情,风险几率跟年龄有关,如果年纪很轻,概率超过其年龄的风险几率,但没有羊穿流产风险大,还是应该去羊穿。

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 13:24

风险几率跟年龄有关,如果年纪很轻,概率超过其年龄的风险几率,但没有羊穿流产风险大,还是应该去羊穿
较真地说, 我就是认为这个例子里的做法不对.
就用小K给的恐怖分子的例子, 做一下算数就知道, 这种筛查, OVERALL POSITIVE RATE越低, 越不可靠.
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tiffany
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Re: Malcolm Gladwell & Mad Men

Post by tiffany » 2010-03-19 13:31

哦,就是说查3,4个蛋白哈。我当初还知道来着呢。 :mrgreen:

这个东西就是需要划一条人为线而已,一般认为过了35岁风险大,但是你说实际上34岁11个月跟35岁另一个月有啥具体区别?跟统计P>.05就不显著了一样没道理,不妨碍广大科学青年争取到了P=0.47就勉强交差了。
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silkworm
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Re: Malcolm Gladwell & Mad Men

Post by silkworm » 2010-03-19 13:34

豪情,我实在没明白你的主张是什么。
筛查不该做,应该直接羊穿?
还是说筛查该做,做完以后,不管孕妇是20/30/40岁,就比较风险几率和羊穿流产几率,来判断下一步做不做羊穿。

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 13:38

那我来做个算数吧.
假设20岁, 唐氏的几率是万分之一, 检查5%false positive, 5%false negative. 一个人查出来是positive. 有多大可能性真positve? 答案是0.2%.
假设40岁, 唐氏的几率是200分之一, 检查5%false positive, 5%false negative. 一个人查出来是positive. 有多大可能性真positve? 答案是9%.

所以结论是越年轻, 筛查越不可靠.

但是我这是最粗浅的计算, 难道漏了什么?
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Re: Malcolm Gladwell & Mad Men

Post by dropby » 2010-03-19 13:42

啊,我一直以为是正是负是按羊穿的危险几率来cut off的, 难道不是? 我印象中是算那个几率的时候不只要看血液检查的指标, 而是还要把年龄加进去算的. 35岁以上按概率已经比羊穿高了, 所以保险公司可以让直接做.

当然这也要看不同的妈妈接受程度. 我知道有高龄妈妈只做唐筛结果正就不做羊穿的, 还有高龄妈妈连唐筛都懒得做的, 因为那个负也只是个概率, 所以如果坚决不肯做羊穿的话唐筛也没有意义. 我相信有35岁以下妈妈自己出钱做羊穿.

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 13:44

我就是给这些筛查的信息搞糊涂了. 觉得肯定漏了什么我不知道的信息.
根据目前我知道的数据,我觉得筛查都不该做, 按年龄概率和羊穿风险比较, 以个人选择决定.
谁道闲情抛掷久?每到春来,惆怅还依旧。

tiffany
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Re: Malcolm Gladwell & Mad Men

Post by tiffany » 2010-03-19 13:47

哦,实际操作的话,上来就羊穿,不然没别的做好像也不是最好的选择?
乡音无改鬓毛衰

dropby
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Re: Malcolm Gladwell & Mad Men

Post by dropby » 2010-03-19 13:52

是啊, 我觉得概率是二百万之一和知道概率是二百分之一的情况下, 大家做的决定还是很不一样的. 最简单的例子,新妈妈做功课,二十几岁年轻的对唐筛和羊穿啥的估计看一眼就完了,像我这样的就找了一堆东西来看,整天担心,不等到羊穿结果都不让人知道我怀孕了。

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 14:18

Knowing wrote:到desperate 的时候就容易上当嘛。正如皮肤科医生对我说"啥啥,啥啥,都没有用,就是个昂贵的安慰剂。"我虚弱的回答:"我需要安慰。"医生哈哈的笑说:"安慰剂也有更便宜的。"我抗议:"但是贵的安慰剂更有效!"
郁闷地说, 同一个皮肤科的安慰剂, 对小K就有用,对我就没用. 都怪保险公司给我报销了.
谁道闲情抛掷久?每到春来,惆怅还依旧。

Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 15:39

去雀斑那个特别慢,要擦好几个月呢。我安慰剂的说。
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笑嘻嘻
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Re: Malcolm Gladwell & Mad Men

Post by 笑嘻嘻 » 2010-03-19 16:22

女人!这么科学的帖子都能讲到皮肤雀斑上。 :mrgreen: :mrgreen: :mrgreen:
云浆未饮结成冰

豪情
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Re: Malcolm Gladwell & Mad Men

Post by 豪情 » 2010-03-19 16:35

我不是很NERD地要算数么, 没人和我算. :mrgreen: 主要是我的算法太粗浅了.
谁道闲情抛掷久?每到春来,惆怅还依旧。

Knowing
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Re: Malcolm Gladwell & Mad Men

Post by Knowing » 2010-03-19 16:39

一看穿羊水啥的我就连算数的劲头都没有了。
今天仰慕ian mckellen 去看等待戈多,mmd 戏本来就不好看,还一台四个老头,还穿的那么差,老子看了一半闷的半死就出来了。
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笑嘻嘻
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Re: Malcolm Gladwell & Mad Men

Post by 笑嘻嘻 » 2010-03-19 17:45

Knowing wrote:创立了一个 religion 哪里有这么容易。你们K偶K偶叫的那叫一个响啊,一宣布要收什一税全改回小K了。
我搅着吧,你就一个k 偶就叫人交什一税,性价比太低了,你得打出“叫k偶,得永生”的旗子来,才会有人交什一税。永生!永生!你知道嘛!
云浆未饮结成冰

mirrorflower
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Re: Malcolm Gladwell & Mad Men

Post by mirrorflower » 2010-03-19 17:56

笑嘻嘻 wrote:
Knowing wrote:创立了一个 religion 哪里有这么容易。你们K偶K偶叫的那叫一个响啊,一宣布要收什一税全改回小K了。
我搅着吧,你就一个k 偶就叫人交什一税,性价比太低了,你得打出“叫k偶,得永生”的旗子来,才会有人交什一税。永生!永生!你知道嘛!
是的是的,你得让大家信这个:
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"A wealth of information creates a poverty of attention."

putaopi
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Re: Malcolm Gladwell & Mad Men

Post by putaopi » 2010-03-19 18:26

这题跑的,怎么没有人谈Mad Men啦?被Jun 忽悠得去看了,完全是个古装恐怖片儿么, 太dark了。不过,是甜蜜而痛的黑暗。

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