Tag Archives: U.S

Health technology and the Canadian Broadcasting Corporation’s (CBC) two-tier health system ‘Viewpoint’

Final comments

While I have some issues with Hirsh’s presentation, I agree that we should be discussing the issues around increased automation of our health care system. A friend of mine’s husband is a doctor and according to him those prescriptions and orders you get when leaving the hospital? They are not made up by a doctor so much as they are spit up by a computer based on the data that the doctors and nurses have supplied.

GIGO, bias, and de-skilling

Leaving aside the wonders that Hirsh describes, there’s an oldish saying in the computer business, garbage in/garbage out (gigo). At its simplest, who’s going to catch a mistake? (There are lots of mistakes made in hospitals and other health care settings.)

There are also issues around the quality of research. Are all the research papers included in the data used by the algorithms going to be considered equal? There’s more than one case where a piece of problematic research has been accepted uncritically, even if it get through peer review, and subsequently cited many times over. One of the ways to measure impact, i.e., importance, is to track the number of citations. There’s also the matter of where the research is published. A ‘high impact’ journal, such as Nature, Science, or Cell, automatically gives a piece of research a boost.

There are other kinds of bias as well. Increasingly, there’s discussion about algorithms being biased and about how machine learning (AI) can become biased. (See my May 24, 2017 posting: Machine learning programs learn bias, which highlights the issues and cites other FrogHeart posts on that and other related topics.)

These problems are to a large extent already present. Doctors have biases and research can be wrong and it can take a long time before there are corrections. However, the advent of an automated health diagnosis and treatment system is likely to exacerbate the problems. For example, if you don’t agree with your doctor’s diagnosis or treatment, you can search other opinions. What happens when your diagnosis and treatment have become data? Will the system give you another opinion? Who will you talk to? The doctor who got an answer from ‘Watson”? Is she or he going to debate Watson? Are you?

This leads to another issue and that’s automated systems getting more credit than they deserve. Futurists such as Hirsh tend to underestimate people and overestimate the positive impact that automation will have. A computer, data analystics, or an AI system are tools not gods. You’ll have as much luck petitioning one of those tools as you would Zeus.

The unasked question is how will your doctor or other health professional gain experience and skills if they never have to practice the basic, boring aspects of health care (asking questions for a history, reading medical journals to keep up with the research, etc.) and leave them to the computers? There had to be a reason for calling it a medical ‘practice’.

There are definitely going to be advantages to these technological innovations but thoughtful adoption of these practices (pun intended) should be our goal.

Who owns your data?

Another issue which is increasingly making itself felt is ownership of data. Jacob Brogan has written a provocative May 23, 2017 piece for slate.com asking that question about the data Ancestry.com gathers for DNA testing (Note: Links have been removed),

AncestryDNA’s pitch to consumers is simple enough. For $99 (US), the company will analyze a sample of your saliva and then send back information about your “ethnic mix.” While that promise may be scientifically dubious, it’s a relatively clear-cut proposal. Some, however, worry that the service might raise significant privacy concerns.

After surveying AncestryDNA’s terms and conditions, consumer protection attorney Joel Winston found a few issues that troubled him. As he noted in a Medium post last week, the agreement asserts that it grants the company “a perpetual, royalty-free, world-wide, transferable license to use your DNA.” (The actual clause is considerably longer.) According to Winston, “With this single contractual provision, customers are granting Ancestry.com the broadest possible rights to own and exploit their genetic information.”

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Winston also noted a handful of other issues that further complicate the question of ownership. Since we share much of our DNA with our relatives, he warned, “Even if you’ve never used Ancestry.com, but one of your genetic relatives has, the company may already own identifiable portions of your DNA.” [emphasis mine] Theoretically, that means information about your genetic makeup could make its way into the hands of insurers or other interested parties, whether or not you’ve sent the company your spit. (Maryam Zaringhalam explored some related risks in a recent Slate article.) Further, Winston notes that Ancestry’s customers waive their legal rights, meaning that they cannot sue the company if their information gets used against them in some way.

Over the weekend, Eric Heath, Ancestry’s chief privacy officer, responded to these concerns on the company’s own site. He claims that the transferable license is necessary for the company to provide its customers with the service that they’re paying for: “We need that license in order to move your data through our systems, render it around the globe, and to provide you with the results of our analysis work.” In other words, it allows them to send genetic samples to labs (Ancestry uses outside vendors), store the resulting data on servers, and furnish the company’s customers with the results of the study they’ve requested.

Speaking to me over the phone, Heath suggested that this license was akin to the ones that companies such as YouTube employ when users upload original content. It grants them the right to shift that data around and manipulate it in various ways, but isn’t an assertion of ownership. “We have committed to our users that their DNA data is theirs. They own their DNA,” he said.

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I’m glad to see the company’s representatives are open to discussion and, later in the article, you’ll see there’ve already been some changes made. Still, there is no guarantee that the situation won’t again change, for ill this time.

What data do they have and what can they do with it?

It’s not everybody who thinks data collection and data analytics constitute problems. While some people might balk at the thought of their genetic data being traded around and possibly used against them, e.g., while hunting for a job, or turned into a source of revenue, there tends to be a more laissez-faire attitude to other types of data. Andrew MacLeod’s May 24, 2017 article for thetyee.ca highlights political implications and privacy issues (Note: Links have been removed),

After a small Victoria [British Columbia, Canada] company played an outsized role in the Brexit vote, government information and privacy watchdogs in British Columbia and Britain have been consulting each other about the use of social media to target voters based on their personal data.

The U.K.’s information commissioner, Elizabeth Denham [Note: Denham was formerly B.C.’s Office of the Information and Privacy Commissioner], announced last week [May 17, 2017] that she is launching an investigation into “the use of data analytics for political purposes.”

The investigation will look at whether political parties or advocacy groups are gathering personal information from Facebook and other social media and using it to target individuals with messages, Denham said.

B.C.’s Office of the Information and Privacy Commissioner confirmed it has been contacted by Denham.

Macleod’s March 6, 2017 article for thetyee.ca provides more details about the company’s role (note: Links have been removed),

The “tiny” and “secretive” British Columbia technology company [AggregateIQ; AIQ] that played a key role in the Brexit referendum was until recently listed as the Canadian office of a much larger firm that has 25 years of experience using behavioural research to shape public opinion around the world.

The larger firm, SCL Group, says it has worked to influence election outcomes in 19 countries. Its associated company in the U.S., Cambridge Analytica, has worked on a wide range of campaigns, including Donald Trump’s presidential bid.

In late February [2017], the Telegraph reported that campaign disclosures showed that Vote Leave campaigners had spent £3.5 million — about C$5.75 million [emphasis mine] — with a company called AggregateIQ, run by CEO Zack Massingham in downtown Victoria.

That was more than the Leave side paid any other company or individual during the campaign and about 40 per cent of its spending ahead of the June referendum that saw Britons narrowly vote to exit the European Union.

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According to media reports, Aggregate develops advertising to be used on sites including Facebook, Twitter and YouTube, then targets messages to audiences who are likely to be receptive.

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The Telegraph story described Victoria as “provincial” and “picturesque” and AggregateIQ as “secretive” and “low-profile.”

Canadian media also expressed surprise at AggregateIQ’s outsized role in the Brexit vote.

The Globe and Mail’s Paul Waldie wrote “It’s quite a coup for Mr. Massingham, who has only been involved in politics for six years and started AggregateIQ in 2013.”

Victoria Times Colonist columnist Jack Knox wrote “If you have never heard of AIQ, join the club.”

The Victoria company, however, appears to be connected to the much larger SCL Group, which describes itself on its website as “the global leader in data-driven communications.”

In the United States it works through related company Cambridge Analytica and has been involved in elections since 2012. Politico reported in 2015 that the firm was working on Ted Cruz’s presidential primary campaign.

And NBC and other media outlets reported that the Trump campaign paid Cambridge Analytica millions to crunch data on 230 million U.S. adults, using information from loyalty cards, club and gym memberships and charity donations [emphasis mine] to predict how an individual might vote and to shape targeted political messages.

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That’s quite a chunk of change and I don’t believe that gym memberships, charity donations, etc. were the only sources of information (in the US, there’s voter registration, credit card information, and more) but the list did raise my eyebrows. It would seem we are under surveillance at all times, even in the gym.

In any event, I hope that Hirsh’s call for discussion is successful and that the discussion includes more critical thinking about the implications of Hirsh’s ‘Brave New World’.

The Canadian nano scene as seen by the OECD (Organization for Economic Cooperation and Development)

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I’ve grumbled more than once or twice about the seemingly secret society that is Canada’s nanotechnology effort (especially health, safety, and environment issues) and the fact that I get most my information from Organization for Economic Cooperation and Development (OECD) documents. That said, thank you to Lynne Bergeson’s April 8, 2016 post on Nanotechnology Now for directions to the latest OECD nano document,

The Organization for Economic Cooperation and Development recently posted a March 29, 2016, report entitled Developments in Delegations on the Safety of Manufactured Nanomaterials — Tour de Table. … The report compiles information, provided by Working Party on Manufactured Nanomaterials (WPMN) participating delegations, before and after the November 2015 WPMN meeting, on current developments on the safety of manufactured nanomaterials.

It’s an international roundup that includes: Australia, Austria, Belgium, Canada, Germany, Japan, Korea, the Netherlands, Switzerland, Turkey, United Kingdom, U.S., and the European Commission (EC), as well as the Business and Industry Advisory Committee to the OECD (BIAC) and International Council on Animal Protection in OECD Programs (ICAPO).

As usual, I’m focusing on Canada. From the DEVELOPMENTS IN DELEGATIONS ON THE SAFETY OF MANUFACTURED NANOMATERIALS – TOUR DE TABLE Series on the Safety of Manufactured Nanomaterials No. 67,

CANADA
National developments on human health and environmental safety including recommendations, definitions, or discussions related to adapting or applying existing regulatory systems or the drafting of new laws/ regulations/amendments/guidance materials A consultation document on a Proposed Approach to Address Nanoscale Forms of Substances on the Domestic Substances List was published with a public comment period ending on May 17, 2015. The proposed approach outlines the Government’s plan to address nanomaterials considered in commerce in Canada (on Canada’s public inventory). The proposal is a stepwise approach to acquire and evaluate information, followed by any necessary action. A follow-up stakeholder workshop is being planned to discuss next steps and possible approaches to prioritize future activities. The consultation document is available at: http://www.ec.gc.ca/lcpe-cepa/default.asp?lang=En&n=1D804F45-1

A mandatory information gathering survey was published on July 25, 2015. The purpose of the survey is to collect information to determine the commercialstatus of certain nanomaterials in Canada. The survey targets 206 substances considered to be potentially in commerce at the nanoscale. The list of 206 substances was developed using outcomes from the Canada-United States Regulatory Cooperation Council (RCC) Nanotechnology Initiative to identify nanomaterial types. These nanomaterial types were cross-referenced with the Domestic Substances List to develop a preliminary list of substances which are potentially intentionally manufactured at the nanoscale. The focus of the survey aligns with the Proposed Approach to Address Nanoscale Forms of Substances on the Domestic Substances List (see above) and certain types of nanomaterials were excluded during the development of the list of substances. The information being requested by the survey includes substance identification, volumes, and uses. This information will feed into the Government’s proposed approach to address nanomaterials on the Domestic Substances List. Available at: http://gazette.gc.ca/rp-pr/p1/2015/2015-07-25/html/notice-avis-eng.php

Information on:

a.risk assessment decisions, including the type of: (a) nanomaterials assessed; (b) testing recommended; and (c) outcomes of the assessment;

Four substances were notified to the program since the WPMN14 – three surface modified substances and one inorganic substance. No actions, including additional data requests, were taken due to low expected exposures in accordance with the New Substances Notifications Regulations (Chemicals and Polymers) (NSNR) for two of the substances. Two of the substances notified were subject to a Significant New Activity Notice. A Significant New Activity notice is an information gathering tool used to require submission of additional information if it is suspected that a significant new activity may result in the substance becoming toxic under the Canadian Environmental Protection Act, 1999.

b.Proposals, or modifications to previous regulatory decisions

As part of the Government’s Chemicals Management Plan, a review is being undertaken for all substances which have been controlled through Significant New Activity (SNAc) notices (see above). As part of this activity, the Government is reviewing past nanomaterials SNAc notices to see if new information is available to refine the scope and information requirements.    As a result of this review, 9 SNAc notices previously in place for nanomaterials have been rescinded.    This work is ongoing, and a complete review of all nanomaterial SNAcs is currently planned to be completed in 2016.

Information related to good practice documents

The Canada-led, ISO standards project, ISO/DTR 19716 Nanotechnologies — Characterization of cellulose nanocrystals, [emphasis mine] initiated in April 2014, is now at Committee Draft (CD) 3-month ISO ballot, closing    Aug 31, 2015. Ballot comments will be addressed during JWG2 Measurement and Characterization working group meetings at the 18th Plenary of ISO/TC229, Nanotechnologies, being held in Edmonton, Alberta, Sep. 28 – Oct. 2, 2015.

Research   programmes   or   strategies   designed   to address   human   health   and/   or environmental safety aspects of nanomaterials

Scientific research

Environment Canada continues to support various academic and departmental research projects. This research has to date included studying fate and effects of nanomaterials in the aquatic, sediment, soil, and air compartments. Funding in fiscal 2015-16 continues to support such projects, including sub-surface transportation, determining key physical-chemical parameters to predict ecotoxicity, and impacts of nano-silver [silver nanoparticles] addition to a whole lake ecosystem [Experimental Lakes Area?]. Environment Canada has also partnered with the National Research Council of Canada recently to initiate a project on the development of test methods to identify surfaces of nanomaterials for the purposes of regulatory identification and to support risk assessments. In addition, Environment Canada is working with academic laboratories in Canada and Germany to prepare guidance to support testing of nanoparticles using the OECD Test Guideline for soil column leaching.

Health Canada continues its research efforts to investigate the effects of surface-modified silica nanoparticles. The   aims   of   these   projects   are to:   (1) study the importance of size and surface functionalization; and (2) provide a genotoxic profile and to identify mechanistic relationships of particle properties to elicited toxic responses. A manuscript reporting the in vitro genotoxic, cytotoxic and transcriptomic responses following exposure to silica nanoparticles has recently been submitted to a peer reviewed journal and is currently undergoing review. Additional manuscripts reporting the toxicity results obtained to date are in preparation.

Information on public/stakeholder consultations;

A consultation document on a Proposed Approach to Address Nanoscale Forms of Substances on the Domestic Substances List was published with a public comment period ending on May 17, 2015 (see Question 1). Comments were received from approximately 20 stakeholders representing industry and industry associations, as well as non-governmental organizations. These comments will inform decision making to address nanomaterials in commerce in Canada.

Information on research or strategies on life cycle aspects of nanomaterials

Canada, along with Government agencies in the United States, Non-Governmental Organizations and Industry, is engaged in a project to look at releases of nanomaterials from industrial consumer matrices (e.g., coatings). The objectives of the NanoRelease Consumer Products project are to develop protocols or
methods (validated through interlaboratory testing) to measure releases of nanomaterials from solid matrices as a result of expected uses along the material life cycle for consumer products that contain the nanomaterials. The project is currently in the advanced stages of Phase 3 (Interlaboratory Studies). The objectives of Phase 3 of the project are to develop robust methods for producing and collecting samples of CNT-epoxy and CNT-rubber materials under abrasion and weathering scenarios, and to detect and quantify, to the extent possible, CNT release fractions. Selected laboratories in the US, Canada, Korea and the European Community are finalising the generation and analysis of sanding and weathering samples and the    results    are    being    collected    in    a   data    hub    for    further    interpretation    and    analysis.

Additional details about the project can be found at the project website: http://www.ilsi.org/ResearchFoundation/RSIA/Pages/NanoRelease1.aspx

Under the OECD Working Party on Resource Productivity and Waste (WPRPW), the expert group on waste containing nanomaterials has developed four reflection papers on the fate of nanomaterials in waste treatment operations. Canada prepared the paper on the fate of nanomaterials in landfills; Switzerland on the recycling of waste containing nanomaterials; Germany on the incineration of waste containing nanomaterials; and France on nanomaterials in wastewater treatment. The purpose of these papers is to provide an overview of the existing knowledge on the behaviour of nanomaterials during disposal operations and identify the information gaps. At the fourth meeting of the WPRPW that took place on 12-14 November 2013, three of the four reflection papers were considered by members. Canada’s paper was presented and discussed at the fifth meeting of the WPRPRW that took place on 8-10 December 2014. The four papers were declassified by EPOC in June 2015, and an introductory chapter was prepared to draw these papers together. The introductory chapter and accompanying papers will be published in Fall 2015. At the sixth meeting of the WPRPW in June – July 2015, the Secretariat presented a proposal for an information-sharing platform that would allow delegates to share research and documents related to nanomaterials. During a trial phase, delegates will be asked to use the platform and provide feedback on its use at the next meeting of the WPRPW in December 2015. This information-sharing platform will also be accessible to delegates of the WPMN.

Information related to exposure measurement and exposure mitigation.

Canada and the Netherlands are co-leading a project on metal impurities in carbon nanotubes. A final version of the report is expected to be ready for WPMN16. All research has been completed (e.g. all components are published or in press and there was a presentation by Pat Rasmussen to SG-08 at the Face-to-Face Meeting in Seoul June 2015). The first draft will be submitted to the SG-08 secretariat in autumn 2015. Revisions will be based on early feedback from SG-08 participants. The next steps depend on this feedback and amount of revision required.

Information on past, current or future activities on nanotechnologies that are being done in co-operation with non-OECD countries.

A webinar between ECHA [European Chemicals Agency], the US EPA [Environmental Protection Agency] and Canada was hosted by Canada on April 16, 2015. These are regularly scheduled trilateral discussions to keep each other informed of activities in respective jurisdictions.

In March 2015, Health Canada hosted 3 nanotechnology knowledge transfer sessions targeting Canadian government research and regulatory communities working in nanotechnology. These sessions were an opportunity to share information and perspectives on the current state of science supporting the regulatory oversight of nanomaterials with Government. Presenters provided detailed outputs from the OECD WPMN including: updates on OECD test methods and guidance documents; overviews of physical-chemical properties, as well as their relevance to toxicological testing and risk assessment; ecotoxicity and fate   test   methods;   human   health   risk   assessment   and   alternative   testing   strategies;   and exposure measurement and mitigation. Guest speakers included Dr Richard C. Pleus Managing Director and Director of Intertox, Inc and Dr. Vladimir Murashov Special Assistant on Nanotechnology to the Director of National Institute for Occupational Safety and Health (NIOSH).

On   March   4-5, 2015, Industry   Canada   and   NanoCanada co-sponsored “Commercializing Nanotechnology in Canada”, a national workshop that brought together representatives from industry, academia and government to better align Canada’s efforts in nanotechnology. This workshop was the first of its kind in Canada. It also marked the official launch of NanoCanada (http://nanocanada.com/), a national initiative that is bringing together stakeholders from across Canada to bridge the innovation gap and stimulates emerging technology solutions.

It’s nice to get an update about what’s going on. Despite the fact this report was published in 2016 the future tense is used in many of the verbs depicting actions long since accomplished. Maybe this was a cut-and-paste job?

Moving on, I note the mention of the Canada-led, ISO standards project, ISO/DTR 19716 Nanotechnologies — Characterization of cellulose nanocrystals (CNC). For those not familiar with CNC, the Canadian government has invested hugely in this material derived mainly from trees, in Canada. Other countries and jurisdictions have researched nanocellulose derived from carrots, bananas, pineapples, etc.

Finally, it was interesting to find out about the existence of NanoCanada. In looking up the Contact Us page, I noticed Marie D’Iorio’s name. D’Iorio, as far as I’m aware, is still the Executive Director for Canada’s National Institute of Nanotechnology (NINT) or here (one of the National Research Council of Canada’s institutes). I have tried many times to interview someone from the NINT (Nils Petersen, the first NINT ED and Martha Piper, a member of the advisory board) and more recently D’Iorio herself only to be be met with a resounding silence. However, there’s a new government in place, so I will try again to find out more about the NINT, and, this time, NanoCanada.

Snow reveals the truth about crystalline growth