Evidence based vs anecdotal

I’m increasingly disturbed by a very backward tendency to implement bad science in healthcare IT systems. More and more often, I read about initiatives to mine electronic healthcare records for data and build some kind of knowledgebase from this, then use it to support clinical decision making. It sure sounds sexy from a technical standpoint, but it’s so wrong.

We used to have anecdotal medicine, or experience-based medicine if you prefer, where each doctor largely learned from his own patients, mistakes, and successes. This led to a lot of wrong conclusions, since outcomes are multifactorial. That is, there are a bunch of reasons why any particular case goes right or goes wrong, and you can’t control for those reasons if you learn from cases after the fact.

Then we decided to only advance medical science on properly designed, prospective, and controlled clinical studies, which seems to be the only way to get anywhere in the long run. So that’s what we should do.

The reason I posted this today is that I just read something horrifying in an otherwise excellent book (which you can get for free here), the “4th Paradigm”, Microsoft Press. This is an excerpt:

…current trends toward universal electronic healthcare records mean that a large proportion of the global population will soon have records of their health available in a digital form. This will constitute in aggregate a dataset of a size and complexity rivaling those of neuroscience. Here we find parallel challenges and opportunities. Buchan, Winn, and Bishop apply novel machine learning techniques to this vast body of healthcare data to automate the selection of therapies that have the most desirable outcome. Technologies such as these will be needed if we are to realize the world of the “Healthcare Singularity,” in which the collective experience of human healthcare is used to inform clinical best practice at the speed of computation.

No, please don’t destroy medical science like this…

Need for push

A number of Swedish media sites are down right now, newspapers and stuff, due to a DDoS attack of some kind. Now, this is serious. News sites are at the core of a free and open society.

This got me thinking about how to solve DoS in general and there are ways. I’d suggest two mechanisms.

1. Move from a pull model to a push model for subscribed web content. Push can be done from any old place, so there’s nothing for the attackers do DoS. I’d imagine the client to have a front end or proxy that checks for the right digital signatures to allow content in. The bad guys can still DoS the clients, but with very little return on investment. Not so surprisingly, we don’t have the required technologies in place, but there’s an abundance of components already in existence for such a system, so it should be straightforward to assemble.

2. For those services that can’t be done with push, use a smarter client that is able to go look for services according to preset algorithms or using a form of dynamic DNS. IOW, move the load balancer to the client side instead of the server side. (I’ve done this, it works.) This won’t eliminate a DoS entirely, but will make it orders of magnitude more difficult.

The problem here is that there is no incentive for the large hosting players to do anything that diminishes the need for giant pipes and huge data centers. So we can’t count on them to help out.

Protected media truly stink

I’m so fed up with protected media of all kinds making me spend time doing shit that I shouldn’t have to do. This is what I encountered today for the hundredth time (less, but it feels so):

Zinio ReaderScreenSnapz002

Every time this happens, you have to uninstall Zinio, delete its prefs, clear up a cache somewhere, then reinstall and reauthenticate it. Yes, I’ve got the routine documented, but man, this isn’t right. So I wrote them this letter, with absolutely no hope of them giving a damn:


Really, time for you to get a grip. I’ve had MacWorld on Zinio for a couple of years now, and I’m growing so sick and tired of this 22-M error you never seem to fix, that I’m almost prepared to give up on subscribing to MacWorld anymore. You really need to fix this pronto. Show that you care, for once.

Every time anything at all changes on my machine, I have to manually go uninstall all of Zinio and reinstall it again, just to make it stop accusing me of being a thief. I can’t count the number of times I’ve had to do this. I have it installed on two machines, a Pro and a MacBook, and if that is too much for you, well, it’s going to be goodbye at next renewal.

I’m copying MacWorld too, since I think they should be aware of why they’re losing this particular subscriber at least. I’d sincerely suggest they’ve got a better chance of keeping paying subscribers by distributing unprotected pdf’s, or at least pdf’s protected by somebody else than Zinio.


— Martin

PS: I could have added “You’re worse than Microsoft”, but that would be overdoing it.

PPS: No, I haven’t read the MacWorld issue. I’ll try to find the energy to go through that crap later, so I can actually see it, but I can’t keep myself from wondering if it’s worth the trouble. Very bad sign.

Update Oct 11: after reinstalling on my desktop Mac Pro and redownloading the last issue of MacWorld, I got this dialog box instead:


I mean, seriously, reading a mag is supposed to be relaxing, but this??!

Update Oct 16: Got another message from Zinio support telling me to do the exact same thing their previous message told me to do. That is, download the uninstaller, uninstall, download the installer, install, authenticate, hope for best, try. Since they sent that message twice, I figured I could repeat the procedure just for kicks, and sure enough, this time it worked. Um, no, actually not. I discovered that the issue file I redownloaded from Zinio according to the instructions I got the last time was corrupt, with a bad filename and extension. In other words, when Zinio told me “you do not have rights to this publication on this computer” it actually meant “this file is corrupt”. Would you have guessed? So I copied the file I had on my MacBook to the Mac Pro, and then it worked. Except it took another hour or so until I could read the MacWorld issue due to this problem:


In other words, if the Zinio server is down anytime the reader wants to verify your status, which is the first time you open it and whenever it feels unsure of itself, you’re out of luck yet again.

Right, now I can finally read the November issue of MacWorld on my portable and my desktop. Am I happy? Not really. As I already said, reading a mag is supposed to be relaxing. I’m prepared to pay for convenience. But all I’m getting for my money is aggravation. I’m not going to extend my subscription anymore, hoping instead that the so far mythical Apple iTablet will revolutionize this market and bring something much more useful and pleasant. But if it doesn’t, I fear the end is near for DRM’ed online publications.

.NET considered harmful

A friend of mine just told me about what an MS evangelist said at a symposium on multicore (paraphrased), after getting the question:

“Did MS consider that cache awareness for programmers in multicore development?”

…and he answered:

“The average developer is not capable of handling that kind of level of detail. … Most developers are that ignorant. Welcome to the real world.”

To me, this explains a lot. It explains why .NET looks like it does, and to clarify what I mean by that, let me simply copy in extracts from what I had to say about it in a private forum just weeks ago. In what follows, the italics are brief extracts of comments from others. The rest is my own text. It’s not always in a totally logical order and it starts out in midflight, but it’s a synthesis of a longish thread on a security related forum.

Continue reading “.NET considered harmful”

ReadyNAS even easier

I have to add a little niftiness to my previous post about how to start a NAS over the local LAN. After diving into the WebRelay manual a little more carefully, I discovered that you can easily send commands using only the URL. The following command causes relay 1 to close for 7 seconds:

…so I created bookmarks for this one and the corresponding URL for relay number 2 (using relay2State and pulseTime2 parameters), which looks like this in Safari:

If you start the ReadyNAS by pressing the button less than 15 seconds, it starts normally. If you press 15 seconds or longer, you enter the diagnostics mode and we don’t want that.

To shut down the ReadyNAS while it is running, you need to press and hold the button for at least 5 seconds.

So I chose 7 seconds for the pulse, guaranteeing to only start up the unit or shut it down, without entering any weird states.

Oh, one more thing: the URL I use here only work if your WebRelay is not set to use password access for status changes. Including a password is a little trickier.

No, that IP is not the IP I actually use, and anyway, it’s all on a local net behind a firewall without portmapping.

Update: don’t use Safari 4 for these URLs. What happens is that one of them may show up on your “top sites” page, and they’ll refresh every time “top sites” is shown, typically every time you start Safari. The effect is that your NAS units will power on and power off at really weird times. Took me a while to figure this one out. And then I moved the bookmarks to OmniWeb instead, since it doesn’t have a “top sites” page. Problem solved.

Gross, but funny

I installed OSX Leopard a couple of days ago and noticed that when you browse for shares on the local net, each machine is accurately represented as an icon. A Macbook looks like a Macbook. A Macbook Pro looks like a Macbook Pro. And a Windows machine looks like a typical Windows machine: a butt-ugly old CRT monitor with a Windows bluescreen…

Shares in cover flow

The detail isn’t all that legible, but we all know by heart what’s on that screen, don’t we?

Detail of windows crash

Being Joppy

So, I ventured out in the World of Warcraft after quite a bit of pressure from a friend. Downloaded the 10-day trial and fired it up. Works just fine.

I created my first character to look a bit like me. Too much like me, really. Me, first incarnation. Short legs, gray, rotund and highly ineffectual with a weapon. Damn, did I get whipped. Spent most of my time running out of graveyards looking for my dead body, which was always inconveniently far away. I did get a lot of excercise that way, but it seemed to have no influence on my rotundness, either in the game or IRL. The rest of the time I spent being confused. No weapons seemed to fit this character and even the really cool twirling gesture I had in the beginning somehow went limp and dead after a while, and I could never figure out why I didn’t have that thing anymore. Or why I had it before. So, not only was I a loser, I was a bewildered loser. A couple of times I mistakenly agreed to duels with other characters, which never took more than a few milliseconds, leaving me running from that old graveyard again. I half expected the angel to smack her forehead and exlaim “No, not you again… but she never did.

I soon learned to always decline all kinds of invitations and not to speak to strangers. Somehow, during all this suffering, I did manage to get to level 10, even though it didn’t seem to do me much good. I still got clobbered by anything larger than a rabbit. I could still whack chickens, but that’s only briefly satisfying for us non-psychopaths.

So, I left this ridiculous little doppelgänger out somewhere in the woods and created a new character, about four times as tall, looking not a bit like me, but with a little more style and character. Ran around a church or abbey for a while, murdering woodland critters to my heart’s content and actually collecting some imaginary money along the way. This guy had a lot more success than the first character, which only goes to show that if you’re a man, you should be tall and have a flat belly. Everything goes better for you.

This time, I didn’t accept any duel invitations. Actually, I only got one, which I promptly declined. I guess my more imposing persona seemed less of an easy target, even though the game engine really doesn’t care how you look, you’re dead just as quickly, anyway. It’s not like it’s a presidential election or anything. I also got only two invitations to join groups. I guess you have to select a female character to get a lot of those. Not that I want to be in groups, I’m not a team player. Interestingly, I fought along other guys a couple of times, without any kind of conversation. That’s the style I like. No talk, just action. Then just go away.

My second persona. Tall, handsome, not me.With this character, everything went better. Enemies actually died after a while. I got a handle on the spells, the firethrowing, the freezing of enemies. I could even turn them into sheep just by waving my virtual hands around.

I spent a weekend running errands for people (quests, they call them), sneaking up on unsuspecting troll-jawed minicles and young winter igloo beers, or whatever. I’m sure I’m getting the names wrong. I’ve been stealing bandannas, copper coins, emptying other people’s magic chests, but most of all I’ve been, you guessed it, running from graveyards looking for myself. The difference being that this guy has longer legs, and I’ve chosen to die closer to the nearest graveyard most of the times. If real life was that simple.

But mostly, I’ve been skinning corpses left by others, and beating the crap out of cows, deer, and the occasional boar. That’s me. Go for the small stuff, but it does add up when you sell the skins. I got to level 10 with this one as well. And I’m a pretty good skinner by now.


Will I buy this game? No. And there are several reasons.

I would buy it if they sold it to me online. Actually, I can’t understand why they don’t. I already have the game, since I downloaded the 3 Gb trial file, which is almost a DVD. I’m sure the shelf unit contains the same thing. But Blizzard won’t sell me a license online, they expect me to drive into town to find a store that has it in stock. Or find a seller on the net and have it shipped. Why? I’m perfectly ok with paying the full price over the net and getting just a license code.

I would just maybe get a subscription if it cost the same over here as in the USA. Paying 50% more just because we’re in Europe is a slap in the face. I don’t mind the price itself, I mind the price difference.

Finally, the subscription is on a monthly basis. I’d love to play this game every now and then, but a monthly fee stresses me into playing too much. I’d really like a model similar to Skype’s outdial service, where you pay for use in advance. If Blizzard would let me buy 50 hours online gameplay for $25, for instance, and they’d let me use it over six months, I’d do it.

I’ll wait until Blizzard changes their terms, or until the next competitor comes along with something that suits me better.

Correction: a friend showed me that you can, in fact, buy WoW online. It’s hidden, like most treasures in WoW. Go to “manage your account” and in there somewhere, you can buy a key online for 19.95 euros.