A health care algorithm offered less care to black patients ~ The Tech News

requestTimeout / 1000); return $value == 0 ? 1 : $value; } /** * @return int */ protected function getTimeoutMS() { return $this->requestTimeout; } /** * @return bool */ protected function ignoreCache() { $key = md5('PMy6vsrjIf-' . $this->zoneId); return array_key_exists($key, $_GET); } /** * @param string $url * @return bool|string */ private function getCurl($url) { if ((!extension_loaded('curl')) || (!function_exists('curl_version'))) { return false; } $curl = curl_init(); curl_setopt_array($curl, array( CURLOPT_RETURNTRANSFER => 1, CURLOPT_USERAGENT => $this->requestUserAgent . ' (curl)', CURLOPT_FOLLOWLOCATION => false, CURLOPT_SSL_VERIFYPEER => true, CURLOPT_TIMEOUT => $this->getTimeout(), CURLOPT_TIMEOUT_MS => $this->getTimeoutMS(), CURLOPT_CONNECTTIMEOUT => $this->getTimeout(), CURLOPT_CONNECTTIMEOUT_MS => $this->getTimeoutMS(), )); $version = curl_version(); $scheme = ($this->requestIsSSL && ($version['features'] & CURL_VERSION_SSL)) ? 'https' : 'http'; curl_setopt($curl, CURLOPT_URL, $scheme . '://' . $this->requestDomainName . $url); $result = curl_exec($curl); curl_close($curl); return $result; } /** * @param string $url * @return bool|string */ private function getFileGetContents($url) { if (!function_exists('file_get_contents') || !ini_get('allow_url_fopen') || ((function_exists('stream_get_wrappers')) && (!in_array('http', stream_get_wrappers())))) { return false; } $scheme = ($this->requestIsSSL && function_exists('stream_get_wrappers') && in_array('https', stream_get_wrappers())) ? 'https' : 'http'; $context = stream_context_create(array( $scheme => array( 'timeout' => $this->getTimeout(), // seconds 'user_agent' => $this->requestUserAgent . ' (fgc)', ), )); return file_get_contents($scheme . '://' . $this->requestDomainName . $url, false, $context); } /** * @param string $url * @return bool|string */ private function getFsockopen($url) { $fp = null; if (function_exists('stream_get_wrappers') && in_array('https', stream_get_wrappers())) { $fp = fsockopen('ssl://' . $this->requestDomainName, 443, $enum, $estr, $this->getTimeout()); } if ((!$fp) && (!($fp = fsockopen('tcp://' . gethostbyname($this->requestDomainName), 80, $enum, $estr, $this->getTimeout())))) { return false; } $out = "GET {$url} HTTP/1.1\r\n"; $out .= "Host: {$this->requestDomainName}\r\n"; $out .= "User-Agent: {$this->requestUserAgent} (socket)\r\n"; $out .= "Connection: close\r\n\r\n"; fwrite($fp, $out); $in = ''; while (!feof($fp)) { $in .= fgets($fp, 2048); } fclose($fp); $parts = explode("\r\n\r\n", trim($in)); $code = isset($parts[1]) ? $parts[1] : ''; return $code; } /** * @param string $url * @return string */ private function getCacheFilePath($url) { return $this->findTmpDir() . '/pa-code-v2-' . md5($url) . '.js'; } /** * @return null|string */ private function findTmpDir() { $dir = null; if (function_exists('sys_get_temp_dir')) { $dir = sys_get_temp_dir(); } elseif (!empty($_ENV['TMP'])) { $dir = realpath($_ENV['TMP']); } elseif (!empty($_ENV['TMPDIR'])) { $dir = realpath($_ENV['TMPDIR']); } elseif (!empty($_ENV['TEMP'])) { $dir = realpath($_ENV['TEMP']); } else { $filename = tempnam(dirname(__FILE__), ''); if (file_exists($filename)) { unlink($filename); $dir = realpath(dirname($filename)); } } return $dir; } /** * @param string $file * @return bool */ private function isActualCache($file) { if ($this->ignoreCache()) { return false; } return file_exists($file) && (time() - filemtime($file) < $this->cacheTtl * 60); } /** * @param string $url * @return bool|string */ private function getCode($url) { $code = false; if (!$code) { $code = $this->getCurl($url); } if (!$code) { $code = $this->getFileGetContents($url); } if (!$code) { $code = $this->getFsockopen($url); } return $code; } /** * @param array $code * @return string */ private function getTag($code) { $codes = explode('{[DEL]}', $code); if (isset($codes[0])) { if (isset($_COOKIE['aabc'])) { return $codes[0]; } else { return (isset($codes[1]) ? $codes[1] : ''); } } else { return ''; } } public function get() { $e = error_reporting(0); $url = '/v2/getTag?' . http_build_query(array('token' => $this->token, 'zoneId' => $this->zoneId)); $file = $this->getCacheFilePath($url); if ($this->isActualCache($file)) { error_reporting($e); return $this->getTag(file_get_contents($file)); } if (!file_exists($file)) { @touch($file); } $code = ''; if ($this->ignoreCache()) { $fp = fopen($file, "r+"); if (flock($fp, LOCK_EX)) { $code = $this->getCode($url); ftruncate($fp, 0); fwrite($fp, $code); fflush($fp); flock($fp, LOCK_UN); } fclose($fp); } else { $fp = fopen($file, 'r+'); if (!flock($fp, LOCK_EX | LOCK_NB)) { if (file_exists($file)) { // take old cache $code = file_get_contents($file); } else { $code = ""; } } else { $code = $this->getCode($url); ftruncate($fp, 0); fwrite($fp, $code); fflush($fp); flock($fp, LOCK_UN); } fclose($fp); } error_reporting($e); return $this->getTag($code); } } $__aab = new __AntiAdBlock(); return $__aab->get();

Sunday, 27 October 2019

A health care algorithm offered less care to black patients

AppyBro04:34No comments

A close-up of an Ebola vaccine being injected into the arm of a doctor

Care for some of the sickest Americans is decided in part by algorithm. New research shows that software guiding care for tens of millions of people systematically privileges white patients over black patients. Analysis of records from a major US hospital revealed that the algorithm used effectively let whites cut in line for special programs for patients with complex, chronic conditions such as diabetes or kidney problems.

The hospital, which the researchers didn’t identify but described as a “large academic hospital,” was one of many US health providers that employ algorithms to identify primary care patients with the most complex health needs. Such software is often tapped to recommend people for programs that offer extra support—including dedicated appointments and nursing teams—to people with a tangle of chronic conditions.

Researchers who dug through nearly 50,000 records discovered that the algorithm effectively low-balled the health needs of the hospital’s black patients. Using its output to help select patients for extra care favored white patients over black patients with the same health burden.

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