In Wisconsin, a Backlash Against Using Data to Foretell Defendants’ Futures

By Mitch Smith
The New York Times
Originally published June 23, 2016

Here is an excerpt:

Compas is an algorithm developed by a private company, Northpointe Inc., that calculates the likelihood of someone committing another crime and suggests what kind of supervision a defendant should receive in prison. The results come from a survey of the defendant and information about his or her past conduct. Compas assessments are a data-driven complement to the written presentencing reports long compiled by law enforcement agencies.

Company officials say the algorithm’s results are backed by research, but they are tight-lipped about its details. They do acknowledge that men and women receive different assessments, as do juveniles, but the factors considered and the weight given to each are kept secret.

“The key to our product is the algorithms, and they’re proprietary,” said Jeffrey Harmon, Northpointe’s general manager. “We’ve created them, and we don’t release them because it’s certainly a core piece of our business. It’s not about looking at the algorithms. It’s about looking at the outcomes.”

The article is here.

The experts' step-by-step guide to cyber security

By Kitty Dann
The Guardian
Originally published April 2 2015

Where does cyber security fall on your to-do list? If it’s not a priority, it should be because 60% of small businesses suffered a breach in the year leading up to October 2014. The worst of these breaches disrupted operations for an average of seven to 10 days.

We recently held a live Q&A on the topic, with a panel of experts on hand to answer your questions. From risk assessment to keeping your business safe on a budget, here are some of their suggestions:

The entire article is here.

An analysis of electronic health record-related patient safety concerns

By D. W. Meeks, M. W. Smith, L. Taylor and others
J Am Med Inform Assoc doi:10.1136/amiajnl-2013-002578

Here is a portion of the Discussion Section

Our findings underscore the importance of continuing the process of detecting and addressing safety concerns long after EHR implementation and ‘go-live’ has occurred. Having a mature EHR system clearly does not eliminate EHR-related safety concerns, and a majority of reported incidents were phase 1 or unsafe technology. However, few healthcare systems have robust reporting and analytic infrastructure similar to the VA's IPS. In light of increasing use of EHRs, activities to achieve a resilient EHR-enabled healthcare system should include a reporting and analysis infrastructure for EHR-related safety concerns. Proactive risk assessments to identify safety concerns, such as through the use of SAFER guides released recently by The Office of the National Coordinator for Health Information Technology, can be used by healthcare organizations or EHR users to facilitate meaningful conversations and collaborative efforts with vendors to improve patient safety, including developing better and safer EHR designs.

The entire article is here.

The potential benefit of the placebo effect in sham-controlled trials: implications for risk-benefit assessments and informed consent

By Remy L Brim and Franklin G Miller
J Med Ethics 2013; 39:703-707 doi:10.1136/medethics-2012-101045

Abstract

There has been considerable debate surrounding the ethics of sham-controlled trials of procedures and interventions. Critics argue that these trials are unethical because participants assigned to the control group have no prospect of benefit from the trial, yet they are exposed to all the risks of the sham intervention. However, the placebo effect associated with sham procedures can often be substantial and has been well documented in the scientific literature. We argue that, in light of the scientific evidence supporting the benefits of sham interventions for pain and Parkinson's disease that stem from the placebo effect, these sham-controlled trials should be considered as offering potential direct benefit to participants. If scientific evidence demonstrates the positive effect of placebo from sham interventions on other conditions, sham-controlled trials of interventions for the treatment of these conditions should be considered to have prospects of benefit as well. This potential benefit should be taken into account by research ethics committees in risk-benefit analyses, and be included in informed consent documents.

The article is here.

Clinical Psychologists’ Firearm Risk Management Perceptions and Practices

Andrea Traylor, James H. Price, Susan K. Telljohann, Keith King, and Amy Thompson

J Community Health. 2010 February; 35(1): 60–67.
Published online 2010 January 22.
doi:  10.1007/s10900-009-9200-6

Abstract

The purpose of this study was to investigate the current perceptions and practices of discussing firearm risk management with patients diagnosed with selected mental health problems. A three-wave survey was mailed to a national random sample of clinical psychologists and 339 responded (62%). The majority (78.5%) believed firearm safety issues were greater among those with mental health problems. However, the majority of clinical psychologists did not have a routine system for identifying patients with access to firearms (78.2%). Additionally, the majority (78.8%) reported they did not routinely chart or keep a record of whether patients owned or had access to firearms. About one-half (51.6%) of the clinical psychologists reported they would initiate firearm safety counseling if the patients were assessed as at risk for self-harm or harm to others. Almost half (46%) of clinical psychologists reported not receiving any information on firearm safety issues. Thus, the findings of this study suggest that a more formal role regarding anticipatory guidance on firearms is needed in the professional training of clinical psychologists.

The entire article is here.

Thanks to Dan Warner for this article.

The Relationship Between Level of Training and Accuracy of Violence Risk Assessment

by A. R. Teo, S. R. Holley, M. Leary, and D. E. McNeile
Psychiatric Services
Psychiatric Services 2012; doi: 10.1176/appi.ps.201200019

Objective  Although clinical training programs aspire to develop competency in violence risk assessment, little research has examined whether level of training is associated with the accuracy of clinicians’ evaluations of violence potential. This is the first study to compare the accuracy of risk assessments by experienced psychiatrists with those performed by psychiatric residents. It also examined the potential of a structured decision support tool to improve residents’ risk assessments.

Methods  The study used a retrospective case-control design. Medical records were reviewed for 151 patients who assaulted staff at a county hospital and 150 comparison patients. At admission, violence risk assessments had been completed by psychiatric residents (N=38) for 52 patients and by attending psychiatrists (N=41) for 249 patients. Trained research clinicians, who were blind to whether patients later became violent, coded information available at hospital admission by using a structured risk assessment tool—the Historical, Clinical, Risk Management–20 clinical subscale (HCR-20-C).

Results  Receiver operating characteristic analyses showed that clinical estimates of violence risk by attending psychiatrists had significantly higher predictive validity than those of psychiatric residents. Risk assessments by attending psychiatrists were moderately accurate (area under the curve [AUC]=.70), whereas assessments by residents were no better than chance (AUC=.52). Incremental validity analyses showed that addition of information from the HCR-20-C had the potential to improve the accuracy of risk assessments by residents to a level (AUC=.67) close to that of attending psychiatrists.

Conclusions  Having less training and experience was associated with inaccurate violence risk assessment. Structured methods hold promise for improving training in risk assessment for violence.

The full article is here.

Violence risk instruments overpredicting danger

By Karen Franklin
forensic psychologistblogspot.com
Originally posted August 2, 2012

Here is an excerpt:

Bottom line: Risk assessment instruments are fairly good at identifying low risk individuals, but their high rates of false positives -- people falsely flagged as recidivists -- make them inappropriate “as sole determinants of detention, sentencing, and release.”

In all, about four out of ten of those individuals judged to be at moderate to high risk of future violence went on to violently offend. Prediction of sexual reoffense was even poorer, with less than one out of four of those judged to be at moderate to high risk going on to sexually offend. In samples with lower base rates, the researchers pointed out, predictive accuracy will be even poorer.

The entire story is here.

Thanks to Gary Schoener for this information.

8 Breach Prevention Tips: Action Items Based on Lessons Learned

By Howard Anderson

Govinfosecurity.com

Originally published February 8, 2012

What can be learned from the more than 390 major breaches affecting more than 19 million individuals that have been reported as a result of the federal HIPAA breach notification rule? Plenty, breach prevention experts say.

Here are eight key breach-prevention insights from information security thought-leaders:

1. Don't Forget Risk Assessments

The details of the biggest breaches last year "make it painfully clear that inadequate, if any, HIPAA security risk analysis took place prior to the breaches," says Dan Berger, CEO at Redspin.

2. Encrypt Mobile Devices, Media

"Even though encryption is what's referred to as an addressable standard in the HIPAA security rule - which means it's not actually mandated in all cases - I don't see any reason why information shouldn't be encrypted in all cases on portable media and devices," says Robert Belfort, partner at the law firm Manatt, Phelps & Phillips LLP. "That's one step that organizations can take that can address a very significant share of the types of breaches that are occurring."

3. Beef Up Training

"People have to be trained to understand the policies of the organization, and they have to be trained about common-sense safeguards that they can follow to avoid breaches or the misuse of information," Szabo stresses.

4. Conduct Internal Audits

In addition to training, an important step toward addressing internal breach threats is to conduct audits of records access, Belfort says.

5. Monitor Business Associates

About 22 percent of major breaches, including many of the largest incidents, have involved business associates. As a result, it's essential to work with vendor partners to ensure they're taking adequate breach prevention steps.

The rest of details are here.

In the Resources section of this blog, there is a White Paper on Preventing a Data Breach and Protecting Health Records – One Year Later: Are You Vulnerable to a Breach? by Kaufman, Rossin & Co. to augment these security issues.