Not only that, do you tax AI that doesn’t replace humans? How can you tell? Do you tax differently depending on how many workers it replaces? How do you measure that? Do you create exemptions for non-profit or humanitarian use? How do you measure that?
I can only image the Kafkaesque tax code the government would come up with. Then it would create all sorts of weird incentives as companies attempt to minimize tax paid.
First off it ignore the fact that if you include frail patients you’ll confound the results of the trial. So there is a good reason for it.
Second, saying “rate of SAE is higher than rate of treatment effect” is a bit silly considering these are cancer trial - without treatment there is a risk of death so most people are willing to accept SAE in order to achieve treatment effect.
Third, saying “the sickest patients saw the highest increase in SAE” seems obvious? It’s exactly what you’d expect.
First, ignoring frail patients means your trial isn't representative of the wider population, so it shouldn't be accepted for general use - only on people who were well-represented in the trial.
Second, you're ignoring the possibility of other treatment options. It isn't always the binary life-or-death you're making it, so SAEs do matter.
Third, a big part of trials is to discover and develop prevention methods for SAEs. Explicitly ignoring the people most likely to provide data valuable for the general population sounds like a pretty silly approach.
> Second, you're ignoring the possibility of other treatment options. It isn't always the binary life-or-death you're making it, so SAEs do matter.
A common reason for a drug (especially a cancer drug) going to trial is because other options have already failed. For example CAR-T therapies are commonly trialed on patients with R/R (relapsed/refractory) cohorts.
> "In subjects who have early-stage disease and available therapies, the unknown benefits of first-in-human (FIH) CAR T cells may not justify the risks associated with the therapy."
> First, ignoring frail patients means your trial isn't representative of the wider population, so it shouldn't be accepted for general use - only on people who were well-represented in the trial.
Sure, but including frail outliers does not automatically mean you can generalize to the whole population. People can be frail for a wide variety of reasons. Only some of those reasons will matter for a given trial. That means the predictive power varies widely depending on which subpopulation you're looking at, and you'll never be able to enroll enough of some of the subgroups without specifically targeting them.
The results in the posted paper seem valid to me, but the conclusion seems incorrect. This seems like a paper that is restating some pretty universal statistical facts and then trying to use that to impose onerous regulations that can't and won't solve the problem. It will improve generalizability for a small fraction of the population, at a high cost.
> Second, you're ignoring the possibility of other treatment options. It isn't always the binary life-or-death you're making it, so SAEs do matter.
Of course they do. It's a good thing we have informed consent.
> Third, a big part of trials is to discover and develop prevention methods for SAEs. Explicitly ignoring the people most likely to provide data valuable for the general population sounds like a pretty silly approach.
If your primary claim is that data from non-frail people is not generalizable to frail people, then how can you claim that data from frail people is generalizable to non-frail people? If the trials for aspirin found that hemophiliacs should get blood clot promoting medications along with it, then should non-hemophiliacs also be taking those medications?
I'm thankful we can extract some amount of useful data from these trials without undue risk. It's always going to be a balancing act, and this article proposes putting a thumb on the scale that reduces the data without even solving the problem it's aiming at addressing.
But you’re stating the obvious? It’s not like physicians don’t know trials are designed this way, and for good reasons.
Frail patients confound results. A drug may work great, but you’d never know because your frail patients die for reasons unrelated to the drug.
Second is obvious as well. Doctors know there are treatment alternatives (with the same drawback to trial design).
And I already touched on your third point. The alternative to excluding frail patients is not being able to tell if the drug does anything. In many cases that means the drug isn’t approved.
Excluding frail patients has its drawbacks, but it has benefits as well. This paper acts like the benefits don’t exist.
87% of the overall population, yet only 13% of the child. That’s a stark difference.
But the comment reminds me of an observation in SE Asia - go to Singapore and very few kids and tons of senior citizens.
Then go to Vietnam and its most people in their 20’s and younger. It’s a difference you can’t help but notice.
And since Singapore is extremely selective about who they give citizenship too, they’re really struggling with the age pyramid. I believe the estimate is it will be 2 workers for every retired person by 2030.
Yup, it’s funny seeing people say how bad the past was without realizing people 100 years from now will say the exact same thing about today.
Not to mention the opinions and beliefs that people hold “as the right side of history” without realizing these things change and no doubt some view they hold will be seen as “barbaric” in the future.
No, I really don't think so. You used to have to build your own house and stable. Dig up your own well and carry water from it. Shower maybe twice a week (usually just once). Remember, you're doing hard physical labor in the sun all day long. Someday you can finally afford a tractor, but develop hearing damage thanks to it. No electricity. Wash clothes by hand for hours. Cook all the time. Your babies might die, your husband or wife might die, and then good luck. This is literally within living memory in most developed countries. Many here have grandparents who lived like this for a big chunk of their lives (not just growing up).
No matter what the future looks like, the present won't look like that, relative to it, than the past does to the present. The average developed country inhabitant objectively lives in decent material conditions.
Your best bet is to plan a year or so ahead and get sponsorship in the queue so the spouse can enter with a green card. Timelines are about 8-14 months.
But as PRoberts said, a non-citizen spouse can't enter on a tourist visa with the intention to change status. A spouse can visit, but then change their mind while in the US.
But CBP is well aware of people trying to shortcut the process this way, so it can be very challenging convincing CBP your non-citizen spouse intends to leave. But it can be done showing a job, property or other elements that would require someone to go back.
You'd be surprised at the number of people who willingly give up their social media accounts, only for immigration officials to find comments in support of terror attacks in the Middle East.
It's pretty easy to think it's harmless if you live in a country where that viewpoint is not uncommon.
That's not surprising at all, but I think the people who could get caught by the justpaste.it thing are not the same people casually praising Hamas on Instagram.
If you're putting terrorism related content on justpaste.it, you're probably pretty deep into the whole thing.
Sounds like a great way to throw the economy into a depression.
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