In any case, I was playing around with the application, and tossed in a few arbitrary pieces of information (65 years old, suspicious digital rectal exam, and prostate specific antigen of 1.7) and was rather surprised to find that, had I actually been that 65 year old man with these data, I would have been told I had a 41.9% chance of having prostate cancer. Not about 2 in 5, 4 in 10, 40 in 100, or 40%. Not even 42%, but precisely 41.9%. It surprised me so much that I took a screenshot:

I have since used this a couple of times in talks to illustrate the point that a lot of people design applications like this, but there is very little science upon which to base decisions about how to present results to users. Even if the developers manage to design for good usability (which, happily, more and more people are doing all the time), there doesn’t appear to be a lot of attention to the science of how subtle details can influence how users will interpret the data or information presented.

I know that the number 41.9% is based on mountains of carefully-collected data, and so the precision is actually defensible from a scientific perspective, but what does that level of precision mean to a man using the application? Does 41.9% convey more or better information than 42%? If he clicks around, and finds the screen that explains that the data upon which this estimate is based come from a series of nomograms in the Journal of Urology, and that the overall accuracy is 80%, is that meaningful? How is he supposed to use the 80% accuracy rating to interpret the 41.9% estimate? Does he understand what the estimate means? Does he even really want to know? And how does all of this depend on individual factors such as numeracy and decision-making preferences?

I have been thinking about these questions for a while, and was finally able to run a study looking at a piece of this issue. I submitted the manuscript recently, so stay tuned for some answers.

I took a really excellent short course on Sunday afternoon about the psychology of decision-making, led by Alan Schwartz. At one point, he was talking about the gist paradox. There is an emerging body of research demonstrating that when people are given the gist of the information vs. the full information picture, they will make better decisions. (Better = more rational and/or more in line with their own stated values. This is an admittedly problematic definition, but I think it is a reasonable one in this context.) This has major implications for informed consent procedures, decision aids, and so on.

He outlined this issue briefly, and then made a statement along the lines of, “Intuitively, this seems wrong. Why wouldn’t more information lead to better decisions?” My hand shot up as if I were in elementary school and I questioned his premise. I thought that those findings were absolutely intuitive. We discussed it briefly, but I didn’t really have a moment to reflect on why I might have had that reaction until later, when, upon reflection, I arrived at the idea that my intuition is probably heavily influenced by my longstanding alignment with the artificial intelligence/information studies view of information, which divides it into data, information and knowledge. (E.g., see Aamodt and Nygard.)

Loosely put, data are just the ones and zeroes, information is data processed into understandable puzzle pieces, and knowledge is the puzzle pieces put together in relation to each other. The transition from data to information can be done fairly easily by both humans and machines. (I’d even say that in a good proportion of cases now, machines can do it better.) The transition from information to knowledge is much less straightforward, and humans still outperform machines here by a reasonably wide margin. (For example, see the semantic web.)

It occurred to me that although it is sometimes there implicitly, I don’t recall ever seeing any sort of explicit hierarchy like this discussed in the literature about health communication, knowledge translation, medical decision-making, and the like. I’m going to ask around to see if it’s there and I have just missed it, but if it isn’t, I wonder if it might help to better clarify some of the issues with which the fields grapple. If the goal is to communicate knowledge (and then, hopefully, generate particular actions, another problematic process) but what’s often discussed is not really knowledge, but information, there is a missing element. To finish the story, you need to take into account the process of gathering or receiving individual information pieces, understanding each piece and its relationship to other pieces, and putting it all together accordingly into knowledge. I think that when you think of it in those terms, it completely makes sense that you can have too few pieces, and you can also have too many.

I came to the team as a very strong swimmer compared to the average person. These were not average people. I was nowhere near the level of these guys. (They were almost all men, though every so often there would be one other woman at practice.) So I started in the D lane and got lots of remedial stroke correction. Everyone around me was very kind to me, I slowly improved, and finally made it into the C lane. The people whom I had swam next to for months welcomed me warmly.

I noticed that when I swam next to the B lane swimmers, they were not nearly as kind and friendly as the C lane swimmers had been when they were my next-lane neighbours. The A lane swimmers were extremely nice, and were generous with encouragement, praise and tips. This wasn’t a hard and fast rule, but I started to notice a pattern: A, C, and D lane swimmers tended to be nice, friendly, and helpful to pretty much everyone; B lane swimmers tended to be nice to A lane and other B lane swimmers but not so much to C and D.

When I stopped doing tris and moved back to field sports, I started to notice the same thing. The very top athletes were nice to everyone and so were the middle and bottom of the pack. The not quite top players, though, were less friendly. They played more political games, and acted out their threatened feelings of being not quite good enough by being snobbish to those below them. (In retrospect, I think I did some of this, too, especially when I was playing on a top team but was not a top player. I definitely felt a need to prove myself.)

I have since noted the same phenomenon in nearly every domain, including academia. The truly great researchers are generous and friendly; so are many of the middle of the roaders. Those who have something to prove, though, and who feel like they aren’t quite managing to do it, show definite aspects of being B lane swimmers.

I haven’t quite worked it out for myself, nor have I quite managed to integrate all the literature I’ve read thus far, but roughly speaking, I think that there is a cycle here that goes both ways: more power allows you to take more responsibility, and if you have more responsibility, you assume more power. It’s more difficult to take responsibility with little to no power, and when you have little responsibility, you have less power. Put into practice, I think this incorporates the tensions between legal and moral authority, but I haven’t quite worked it all out yet in a way that I can articulate clearly.

Recommended literature welcome!

Some very brief, off-the-cuff reviews:

Three Cups of Tea by Greg Mortenson

I really enjoyed this book. The writing was quite good — occasionally a little awkward, but I think that was a reflection of the occasionally disjointed nature of the story. My primary enjoyment of this book was rooted in how well it aligned with my own ideals and experiences of what really works in international development. Bottom line: 4/5 stars.

The Book of Negroes by Lawrence Hill

I finished this book in a day a half over the holidays. Thank goodness there were grandparents around so that my husband didn’t have to pick up ALL of the child care responsibilities I was neglecting. This was one of the most captivating, engaging, horrifying and illuminating books I have read in a long while. Hill set the story amid many extremely familiar historical events and details, and yet somehow managed to tell a story that felt raw and new. The only quibble I have with the book is that the ending is a little unrealistic. (Satisfying, but unrealistic.) As a woman and mother, this book made me bawl. I was pleased to see it win Canada Reads this year. Bottom line: 5/5 stars.

Things I Learned About My Dad in Therapy, edited by Heather Armstrong

I wanted to love this book. I didn’t. As previously mentioned, I love creative nonfiction and books of personal essays. Also, I have followed dooce.com (Armstrong’s blog) on and off since 2001, so I had high hopes. Unfortunately, this book of collected essays doesn’t live up to the standards for humour and perceptiveness she sets in her own writing. Some essays are good, some are significantly less than good. I gave up on reading a few of them. The overall result is mediocre, like when you mix together all sorts of brilliant and less brilliant paints to achieve a sort of odd, unnatural, muddy colour vaguely reminiscent of baby poop. On the plus side, I look forward to trying again when her solo book comes out. Bottom line: 3/5 stars.

Better late than never, I say. I’ve already had a writing-heavy month, and I had some loose goals for next month, so I’m firming them up. By Dec 20 (conveniently: one month from now, my birthday, AND my intended start of Christmas vacation) I will:

• finish and submit three papers that are currently in various stages of unfinished-ness*
• write 10,000 more words in my dissertation**

*One of these has dragged on so long that my husband refers to it as ‘The Zombie Paper’. (It is not actually about zombies.)

**A modest goal, I know. I am a success-breeds-success kind of person and have learned through experience that I do my best work when I feel fantastic about how I just raced past that goal and kept on going.

Progress reports to follow.

• the autofill on the metadata (I wish it worked better on some of my areas of interest — I rarely get more than half of the metadata with any mass import — but I will grant that it is improving over time)
• the smooth import when I am on campus (off campus is a different story: I cannot get the U of T proxy to work for me inside Papers and it is making me crazy — suggestions welcome!)
• the iPhoto/iTunes-esque star rating system, smart folders and ability to sort files into multiple folders without making unnecessary copies

One of the most frustrating things about Papers for me has always been the lack of functionality beyond basic filing and citing. There is a facility for adding notes, but it’s Very. Very. Slow. on my two year old bare bones laptop; it takes up a lot of screen real estate; it’s on the second tab, and, as far as I know, there is no export/report function. (I could be wrong here. I am far from a power user of this application.) For me, flipping through articles in Papers to assemble notes into a manuscript is a little laborious. It’s also annoying that Papers only runs on Mac operating systems, because it means that I can’t flip back and forth between my laptop (Mac), desktop (Windows), or, for that matter, any of my husband’s computers (Linux.)

I am currently exploring Zotero as another tool that could complement or perhaps eventually replace my Papers obsession. So far, I am extremely impressed. I am not usually an early adopter (I rarely use a version 1.x of anything) so I am a little annoyed some of the ‘coming soon’ issues, but as I work on a long manuscript that involves taking notes on multiple articles and sorting and organizing them intelligently, I am really, really enjoying this tool.

Overall, the writing was clear. Sometimes it was very good. Yet, I had the sense as I was reading that each essay had been subjected to severe editing and/or each author had been given a set outline: (1) tell us how/why you chose a career in science, (2) describe your experience combining that career with motherhood, and (3) please share any words of wisdom for women coming up behind you. It felt like some strange adaptation of IMRAD, applied to themed biographies. I appreciate logical structure, but I’m looking for something a little less predictable and plodding in personal essays. Also, summing up a long career in just a few pages leaves very little space for the delicious contextual details that flesh out stories.

Perhaps I’m just disappointed. I liked Mama, PhD, but I wanted more stories from scientists. Here I had a feast of such stories, and my expectations may have been too high.

It’s also possible that I am just tired of reading about how difficult it is to raise a family while building an academic career. I am living some of the difficulties, especially right now. (It only took me a few years, but I am beginning to suspect that academic life never stops being frantically busy; you just learn to deal with the chaos more effectively as you ramp up the level of activity.) Maybe I should read things that take my mind off of this precarious balancing act.

Bottom line: I liked it, but I didn’t love it.

I love books of essays. I have always been an enormous fan of books of short stories, and over the years, I have gravitated more and more towards nonfiction and especially creative nonfiction. (I really do like bite-sized reading.)

The turning point for me was when I was living in Bolivia. When I left Canada, I got on the plane with one half-finished English book: In the Skin of a Lion, by Michael Oondatje, which I enjoyed even less than The English Patient. (I don’t know why I just can’t love his books — I recognize they are beautifully written, but there is something about them that leaves me cold.)

It was especially disappointing because that was the only English book I had, and although I had thought that having only Spanish reading materials would encourage me to read in Spanish, as it turned out, living and working in two foreign languages (Castellano and Quechua) was completely mentally exhausting. At the time, the city where I lived, Cochabamba, had no accessible English library, and no place to buy English books at a reasonable price. I desperately wanted to read and relax into my native tongue, but had little spending money.

I traded with other expats and travelers, but no one else ever seemed to burn through books quite as quickly as I did. In a wonderfully happy accident, I stumbled across a library sale and found a few books with crumbing spines. They were between half a Boliviano and two Bolivianos each (about 8-32 cents) and I bought every single English one I could find. I read all sorts of old, unknown authors, delirious with the freedom of reading without a dictionary by my side. (I especially liked How Green was my Valley by Richard Llewellyn.)

The feast lasted about two weeks, and then I was back to re-reading and begging. Finally, on a weekend trip to Paraguay, I sought out a used book store in Asuncion. Thinking the prices were in local currency, I gleefully gathered a stack of books. At the cash register, I learned that the numbers actually referred to US dollars, so I had some hard choices to make. I settled on two books, one that I can’t recall, and another that sits on my shelf of favourites to this day: High Tide in Tucson, a book of essays by Barbara Kingsolver, whom I hadn’t heard of yet. I meant to savour each essay; instead, I finished the whole book in less than twenty-four hours. (Later, back in Canada and with a little more spending money for such things, I bought everything she had ever written.)

I didn’t finish Mama, Ph.D. in less than a day, but that’s only because I am a mama finishing a Ph.D. It was a similarly refreshing book for me.

Not all of it resonated. Outside of articles like these, I have never heard anyone actually refer to, ‘The Academy.’ (I call it, ‘academia,’ and I wonder if that reflects thinking of it as a system rather than as an institution?) I also found some of the pieces spoke to issues far outside my experience, approaches that I don’t think I would take, or problems that I hope are less prevalent now in Canada than they might have been in the US at the time of the events recounted.

Still, it was a really wonderful collection of personal essays, and although much of it tended toward discussions of difficulties, it was also inspiring and hopeful to read about women who managed to find a balance that worked for them between their academic and family ambitions. I continue to strive and stumble my way towards that.

In that moment, I realized exactly how deeply the web has changed the way I think about communication.