TUESDAY, DECEMBER 22, 2020
Step One looked like this: Where do unfortunate howlers come from? Let's consider this unfortunate race-involved groaner recently put in print by the Washington Post's Michele Norris:
NORRIS (12/10/20): We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain [than white patients] and were more likely to prescribe inadequate medical treatment as a result.
These White People Today! In fact, the recent study to which Norris linked includes no such finding. It includes no finding anything like the one which Norris described.
Almost none of the (white) medical students involved in the study said that black patients had a higher tolerance for pain. By our reckoning, it isn't entirely clear that any of the (white) medical students did.
What was the source of Norris' howler? Let's start with two aspects of the original study.
In the study in question, medical students—all of them "white"—were shown a list of 15 statements. They were asked if the various statements were true or false.
Well—that isn't exactly what they were asked. In fact, they were asked to rank each statement based on "a six-point scale:" Here were the six assessments from which they were asked to choose:
1) The statement is definitely true.
2) The statement is probably true.
3) The statement is possibly true.
4) The statement is possibly false.
5) The statement is probably false.
6) The statement is definitely false.
Is this a normal way to conduct a survey of this type? We ask for an obvious reason—it's hard to say what the difference is between assessments 3 and 4.
If a statement is "possibly true," it follows that the statement is also "possibly false!" Would it possibly make more sense to ask respondents to choose from these five assessments?
1) The statement is definitely true.
2) The statement is probably true.
3) I don't know whether the statement is true or false.
4) The statement is probably false.
5) The statement is definitely false.
There's a problem with survey design of that type. When respondents are given the chance to say that they don't know (or have no opinion), respondents often take it. In the design of this study, respondents were required to state an assessment, with possible answers 3 and 4 in a curious state of overlap / equivalence.
"Black people’s nerve-endings are less sensitive than White people’s nerve-endings."
In the study to which Norris refers, 87 third- and fourth-year medical students were asked to evaluate that particular statement. In fact, only one (1) of the 87 was recorded calling it "true."
As you know, one out of 87 is well less than half! And in that one case, the medical student may have said only that the statement was "possibly true!"
That's the way responses were scored in this particular study. To us, this seems like a slightly peculiar way to run a survey like this.
A somewhat larger number of first- and second-year medical students were asked to assess that same statement. In that group, 15 out of 135 students (11 percent) were recorded as rating the statement true.
Overall, that means that 16 out of 222 students were recorded as rating the statement true. That's 7.2% of all the students, and there's no way to know how many of those hapless white people merely said that the statement was "possibly" true.
At any rate, seven percent of the medical students were recorded as having rated the statement true. The percentage drops to roughly one percent (one out of 87) if we restrict ourselves to the various white boys and Karens who had completed two years of medical training.
Somehow, Norris ended up saying that half of These White Medical Students Today held the noxious racial belief in question. Tomorrow, we'll continue with our study of where her howler came from.
For today, one final note about the structure of this study. We note that zero (0) black medical students were asked to evaluate the 15 statements.
How many black medical students, especially those in their first year of study, might have offered the wrong assessments of the fifteen statements? There's no way to know; the lofty folk who conducted the study were careful not to ask any such students.
On occasion, we come away from studies like this with a certain suspicion. Because our suspicion is less than charitable, we won't state it here.
Tomorrow: How did Norris (and her editor) get fooled?
"...the noxious racial belief in question"
ReplyDeleteHmm. And what's so noxious about it, dear Bob? Skin color is a genetic trait, and it seems quite possible that it could statistically correlate with other characteristics.
Bone density, for example. So, why not the sensitivity of nerve-endings? Could be false, could be true, and we don't see anything noxious about it at all.
Racial differences tend not to transcend individual differences. That's what makes the belief in racial differences "noxious."
DeleteSo then, does it make your belief that "racial differences tend not to transcend individual differences" noxious?
DeleteMao is the common denominator...he is probably making everything noxious.
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"Is this a normal way to conduct a survey of this type?"
ReplyDeleteYes, and Somerby should read Fechner to understand the mathematical foundation for use of rating scales to measure subjective experience in psychology. S.S. Stevens is a good follow-on to that. And yes, there is a difference between 3 and 4 in a person's mind. Kahneman & Tversky nailed down the details of how people make judgments using rating scales. Just from the standpoint of common sense, there is a clear difference between something being possibly true as opposed to possibly false. Somerby is talking out of his ass about something he knows nothing about.
anon 3:29, yes, just like there is a major difference between a glass being half full or half empty. It seems undeniable logic that if something is "possibly true" it is also "possibly false." Maybe you know better that answering "possibly true" somehow is more indicative that the responder believes the proposition's potential truth to some degree greater than an answer that it is "possibly false," using a standard other than simple logic. I don't think the difference is as clear as you suggest, especially when the result here is to demonstrate that white medical students at Brown of all people harbor racist stereotypes.
DeleteAC/MA, human psychology does not conform to formal logic. Think of true and false as the ends of a continuum. 3 and 4 along such a continuum are not in the same position. One is closer to the true end and the other is closer to the false end. That is how people think about rating scales, not your half-full half-empty analogy, nor Somerby's logic.
DeleteThis is an empirical matter. You use such a scale with a bunch of people and you see what they do. You don't reason it out using logic. There are many ideas in philosophy about mind and behavior that are unsupported by the empirical data collected by psychologists. What people actually do, is reality, not Somerby's suppositions.
Philosophy is not a science because it does not rely on observations, empirical evidence, or manipulations of hypothesized causal variables. Psychology does these things and that makes it a science. Science is a method for knowing more about reality, especially those aspects of reality that are not readily observable by other means. Science identifies patterns and relationships among measurable aspects of reality. Philosophy doesn't do any of that. Somerby's education in philosophy has handicapped him from participating in discussions about what is true for African Americans and pain treatment. He has done Michele Norris a wrong and he owes her an apology.
DeletePhilosophy means never having to say you're sorry...I think Ryan O'Neal said that.
DeleteThat's the dumbest thing I've ever heard...Barbra Streisand said that.
@AC, the study merely shows that the students held erroneous beliefs that led them to underprescribe pain medication to black patients. It doesn’t say anything about “racism” or “noxious racial beliefs.” Somerby has introduced that idea into the conversation, just to get you triggered. He is falsely characterizing the study in order to attack it. It is a form of propaganda.
Deletemh & anons -The thrust of TDH's post is that Norris asserted that 50% of the students surveyed said the statement was 'true" while in fact only 1 out of 87 said it was true, and then it wasn't clear what category (definitely, probably or possibly) that 1 person chose. No one seems to be taking issue with that point, though I'm not clear that is what actually was the case. If TDH is accurate on that, this is an example of abuse of objectivity engendered by the woke movement, that everyone here wants to defend. MH - it's not clear, especially if what I just said is the case, that these medical students actually underprescribed anybody anything. The survey tested their beliefs, not what they were prescribing, and since they are students, not doctors, I don't know that they have prescribed anything at all, especially opiates. As to the science of psychology, I don't dispute that it is a "science" though it isn't like physics. It is applied by advertisers, including political advertisers and political campaigns to influence, or manipulate peoples' choices, and it must work, but obviously not on everybody each time. There are 2 ways of looking at the possibly true / possibly false issue. Someone who is able to think critically, not a good target for manipulators, would consider each alternative to be equivalent. But choosing one or the other might indicate some rough type of stereotypic thinking on the part of the responders, but this seems a subtle difference. Skepticism about surveys like this is, and the conclusions that are drawn from them, I think, warranted.
DeleteHere is what the study reported:
Delete"Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations. "
Study 1 consisted of laypersons and Study 2 consisted of medical students and residents.
Table 1 breaks down the data question-by-question for laypersons and med students by year (1, 2, 3) and residents:
Blacks’ nerve endings are less sensitive than whites’ 20 8 14 0 4
These are percentages, so you multiply the percent (converted to a proportion) by the n size (number of subjects in each group) and round to the nearest whole person:
18 5 10 0 1
So, the number 1 is only among the residents (who have had considerable medical training) and it is one person among 28 total residents (the smallest of the samples recruited for this study). Note that this is NOT one person in the whole study as Somerby claimed.
First, there are no 4th year med students. Somerby is dishonestly collapsing data to include the 1 person among the medical residents with the 0 3rd year med students (who will have had recent practical medical experience under instruction by then) to arrive at the total of 87. He makes that seem like it is the entire sample, when it is half of the cohort, as Nicole Wallace stated.
Somerby worked very hard to produce this "damning" figure, entirely ignoring the results of the remainder of the study, the results of the composite scale, and the mitigating effect that advanced training has on these fallacious beliefs.
You should be suspicious when someone works this hard to discredit a study they don't want to acknowledge, using data in inadmissible ways and ignoring every result in the study that contradicts Somerby's preferred belief.
Somerby selective focus on one number for one item in a questionnaire that includes 9 measures and four samples, is your clue that Somerby is not trustworthy when it comes to this kind of analysis. He is deliberately misleading you and your skepticism should be directed at Somerby (who has no qualifications in this area of study), not the researchers who published these two studies after peer review in a recognized medical journal.
You are making yourself sound foolish by defending Somerby on this.
As for the possibly true matter, if a researcher wants to assess the degree of certainty of a subject who has been forced to make a judgment using a rating scale, the way to do it is to ask them to make a separate "confidence judgment." For each question with a 1-6 rating, you present a second scale asking them how confident (sure) they are about the rating they just gave. There is a large literature about how to administer and interpret such confidence judgments, just as there are books about how to create composite scales (such as a likert scale) and how to validate surveys, and how to use the resulting numbers.
One problem with Somerby's suggesting about including that midpoint on a 5-point scale is that it would make that question no longer comparable to the others, which would mean the resulting choices could not be averaged together with the rest of the items on the scale.
Scaling is a specialization within mathematical psychology. Somerby knows nothing about it. That doesn't prevent him from calling reporters such as Michele Norris names they don't deserve. He owes her an apology.
Thank you anon 11:07. My comment allowed for the possibility that TDH was putting his fingers on the scale. Whether that means that the study proves anything significant is another matter. I also don't understand what you mean by the numbers "20 8 14 0 4" or "18 5 10 0 1" - you don't explain it. I'm a trial lawyer, and am familiar with what it takes to prove something in court. I'm not a social scientist. I assume that in the case of any two respondents, one who answered "possibly true" and the other who answered "possibly false", from a legal standard you couldn't conclude that person A had more anti-Black stereotypical views that person B - there could be myriad reasons why the divergent responses were given. Persons with expertise, such as social scientists or psychologists are often called as expert witnesses at trials. Usually, each side has its own expert, each of whom gives contrary views. I very much doubt that the survey in question provides a legitimate basis for advancing the 'systemic racism' narrative that is going on now, as Norris seemed to be doing. If TDH was putting his finger on the scale - could it be the case that she was doing the same?
DeleteWas Norris correct? Did a recent study of white medical students find that half believed that black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result??
ReplyDeleteIs that a true statement by Norris? Is her logic solid?
"Would it possibly make more sense to ask respondents to choose from these five assessments?
ReplyDelete1) The statement is definitely true.
2) The statement is probably true.
3) I don't know whether the statement is true or false.
4) The statement is probably false.
5) The statement is definitely false."
If you use this scale, you have introduced a zero point (item 3) and that point is not on the same scale as all of the other choices. For one thing, item 3 applies to all of the other choices as well because a person may feel that they don't know the truth of any of the choices. So you are now talking about uncertainty with item 3 but truth with the other 4 items (which are also uncertain to one degree or another). So this is not as good a scale as the one with 6 values that Somerby is trying to improve upon.
The problem of respondents taking the choice of saying I don't know, is exactly why you would not give them that option. All scales are forced choice and there are books written about how people guess under uncertainty. The biases involved in making forced choices are part of Signal Detection Theory. I would bet Somerby has never encountered that. Somerby assumes 3 and 4 "overlap" but has no data supporting his assertion. He is making shit up with that one.
Somerby claims that only 1 person said the statement about nerve endings was true, but items 1-3 all assert the possibility of truth to a greater or lesser degree. Is Somerby claiming that only 1 person answered on that end of the scale (1-3) as opposed to choosing 4-6? Saying that only 1 person considered it true makes no sense given the data, which apparently consists of choices 1-3.
But there is a bigger problem here. Somerby links to the study and it does not report data for individual items (questions). It reports a composite measure that consists of a subset of the 15 questions (9 of them) averaged across subjects in the groups compared. The point of the questions was to give a consistent measure that would show change resulting from their manipulation of the attitudes of the two groups. It is a measure of the extent to which the subjects consider black and white people different in their biology. Somerby clearly has no idea what a composite measure is or how a scale is created and validated or what it's use was in the two studies reported.
Hubris, thy name is Somerby. His ignorance doesn't prevent him from saying a bunch of ridiculous stuff.
"For today, one final note about the structure of this study. We note that zero (0) black medical students were asked to evaluate the 15 statements."
ReplyDeleteMy daughter was a med student in a highly prestigious medical school. There were 0 black medical students in her class, and none in any of the classes at her school. Hard to create a comparative sample of med students when there aren't enough African Americans enrolled. That's a difficulty Somerby should appreciate, given that he uses it to excuse the lack of integrated schools all the time.
How many African American med students would you need? If you add race as another IV, you will need to double your sample size. So, the researchers would need to have as many African American med students as there were white students included in the original two studies.
DeleteI can imagine that if these researchers were to reduce the white sample size in order to have roughly equal numbers in each of their conditions, Somerby would complain that the samples are too small (utterly ignoring the effect size and significance of the results). Because that's how he rolls.
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ReplyDelete“Norris ended up saying that half of These White Medical Students Today held the noxious racial belief in question”
ReplyDeleteSomerby: what a card!
He makes you think that the researchers concluded (and indeed he insinuates that they deliberately rigged the study to show it) that those white medical students were essentially racist, or that they “held noxious racial beliefs.”
But that isn’t what the researchers said. They simply said that the white medical students held false beliefs which led to underprescribing pain medication to black patients. They do not charge the medical students with racism. The beliefs are being examined in order to correct them, with the ultimate goal being to improve the quality of medical care for black patients, hardly a bad thing.
It is revealing that Somerby reacts by caterwauling about those Liberal Researchers and insinuating that they rigged the test to show that whites are a bunch of racists. My, what a hysterical and very conservative-like reaction.
This comment has been removed by the author.
DeleteAnd Norris is simply re-iterating what the researchers are saying.
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