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1.
N Engl J Med ; 385(1): 78-86, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34192436

RESUMEN

Companies have recently begun to sell a new service to patients considering in vitro fertilization: embryo selection based on polygenic scores (ESPS). These scores represent individualized predictions of health and other outcomes derived from genomewide association studies in adults to partially predict these outcomes. This article includes a discussion of many factors that lower the predictive power of polygenic scores in the context of embryo selection and quantifies these effects for a variety of clinical and nonclinical traits. Also discussed are potential unintended consequences of ESPS (including selecting for adverse traits, altering population demographics, exacerbating inequalities in society, and devaluing certain traits). Recommendations for the responsible communication about ESPS by practitioners are provided, and a call for a society-wide conversation about this technology is made. (Funded by the National Institute on Aging and others.).


Asunto(s)
Embrión de Mamíferos , Fertilización In Vitro , Pruebas Genéticas , Variación Genética , Herencia Multifactorial/genética , Fenotipo , Diagnóstico Preimplantación , Escolaridad , Interacción Gen-Ambiente , Estudio de Asociación del Genoma Completo , Humanos , Valor Predictivo de las Pruebas
2.
Proc Natl Acad Sci U S A ; 118(20)2021 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-33926993

RESUMEN

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor's appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19/prevención & control , Vacunas contra la Influenza , Gripe Humana/prevención & control , Visita a Consultorio Médico/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Médicos de Atención Primaria , Sistemas Recordatorios , Envío de Mensajes de Texto , Vacunación/psicología
3.
J Econ Lit ; 58(2): 299-347, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37691693

RESUMEN

We review research that measures time preferences-i.e., preferences over intertemporal tradeoffs. We distinguish between studies using financial flows, which we call "money earlier or later" (MEL) decisions and studies that use time-dated consumption/effort. Under different structural models, we show how to translate what MEL experiments directly measure (required rates of return for financial flows) into a discount function over utils. We summarize empirical regularities found in MEL studies and the predictive power of those studies. We explain why MEL choices are driven in part by some factors that are distinct from underlying time preferences.

4.
J Public Econ ; 1832020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32189814

RESUMEN

Previous research has shown that some people voluntarily use commitment contracts that restrict their own choice sets. We study how people divide money between two accounts: a liquid account that permits unrestricted withdrawals and a commitment account that is randomly assigned in a between-subject design to have either a 10% early withdrawal penalty, or a 20% early withdrawal penalty, or not to allow early withdrawals at all (i.e., an infinite penalty). When the liquid account and the commitment account pay the same interest rate, higher early-withdrawal penalties attract more commitment account deposits. This pattern is predicted by the hypothesis that some participants are partially- or fully-sophisticated present-biased agents. Such agents perceive that higher penalties generate greater scope for commitment by disincentivizing (penalized) early withdrawals. The experiment also shows that when the commitment account pays a higher interest rate than the liquid account, the positive empirical slope relating penalties and commitment deposits is flattened, suggesting that naïve present-biased agents or agents with standard exponential discounting are also in our sample. Across all of our experimental treatments, higher early withdrawal penalties on the commitment account sometimes increase and never reduce allocations to the commitment account.

5.
J Econ Behav Organ ; 179: 743-756, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33424063

RESUMEN

How well do pre-school delay of gratification and life-course measures of self-regulation predict mid-life capital formation? We surveyed 113 participants of the 1967-1973 Bing pre-school studies on delay of gratification when they were in their late 40's. They reported 11 mid-life capital formation outcomes, including net worth, permanent income, absence of high-interest debt, forward-looking behaviors, and educational attainment. To address multiple hypothesis testing and our small sample, we pre-registered an analysis plan of well-powered tests. As predicted, a newly constructed and pre-registered measure derived from preschool delay of gratification does not predict the 11 capital formation variables (i.e., the sign-adjusted average correlation was 0.02). A pre-registered composite self-regulation index, combining preschool delay of gratification with survey measures of self-regulation collected at ages 17, 27, and 37, does predict 10 of the 11 capital formation variables in the expected direction, with an average correlation of 0.19. The inclusion of the preschool delay of gratification measure in this composite index does not affect the index's predictive power. We tested several hypothesized reasons that preschool delay of gratification does not have predictive power for our mid-life capital formation variables.

6.
Proc Natl Acad Sci U S A ; 111(38): 13790-4, 2014 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-25201988

RESUMEN

We identify common genetic variants associated with cognitive performance using a two-stage approach, which we call the proxy-phenotype method. First, we conduct a genome-wide association study of educational attainment in a large sample (n = 106,736), which produces a set of 69 education-associated SNPs. Second, using independent samples (n = 24,189), we measure the association of these education-associated SNPs with cognitive performance. Three SNPs (rs1487441, rs7923609, and rs2721173) are significantly associated with cognitive performance after correction for multiple hypothesis testing. In an independent sample of older Americans (n = 8,652), we also show that a polygenic score derived from the education-associated SNPs is associated with memory and absence of dementia. Convergent evidence from a set of bioinformatics analyses implicates four specific genes (KNCMA1, NRXN1, POU2F3, and SCRT). All of these genes are associated with a particular neurotransmitter pathway involved in synaptic plasticity, the main cellular mechanism for learning and memory.


Asunto(s)
Cognición/fisiología , Aprendizaje/fisiología , Herencia Multifactorial/fisiología , Plasticidad Neuronal/genética , Polimorfismo de Nucleótido Simple , Transmisión Sináptica/genética , Proteínas de Unión al Calcio , Moléculas de Adhesión Celular Neuronal/genética , Femenino , Humanos , Masculino , Memoria/fisiología , Proteínas del Tejido Nervioso/genética , Moléculas de Adhesión de Célula Nerviosa , Factores de Transcripción de Octámeros/genética
7.
J Public Econ ; 151: 84-95, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28966407

RESUMEN

Can governments increase private savings by taxing savings up front instead of in retirement? Roth 401(k) contributions are not tax-deductible in the contribution year, but withdrawals in retirement are untaxed. The more common before-tax 401(k) contribution is tax-deductible in the contribution year, but both principal and investment earnings are taxed upon withdrawal. Using administrative data from eleven companies that added a Roth contribution option to their existing 401(k) plan between 2006 and 2010, we find no evidence that total 401(k) contribution rates differ between employees hired before versus after Roth introduction, which implies that take-home pay declines and the amount of retirement consumption being purchased by 401(k) contributions increases after Roth introduction. We reject several neoclassical explanations for our null finding. Results from a survey experiment suggest two behavioral explanations: (1) employee confusion about and neglect of the tax properties of Roth balances and (2) partition dependence.

8.
Med Care ; 54(6): 578-83, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27177295

RESUMEN

BACKGROUND: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of US adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low. OBJECTIVE: To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination. METHOD: We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee's building entry/exit swipe card data, we test whether functional proximity-the likelihood that the employee walks by the clinic for reasons other than vaccination-predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity-the inverse of walking distance from the employee's desk to the clinic-predicts vaccination probability. PARTICIPANTS: A total of 1801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic. RESULTS: A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee's desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability. CONCLUSIONS AND RELEVANCE: Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Vacunas contra la Influenza/uso terapéutico , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Probabilidad , Estados Unidos , Lugar de Trabajo/estadística & datos numéricos , Adulto Joven
9.
Psychol Sci ; 26(6): 826-33, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25911124

RESUMEN

Heuristic models have been proposed for many domains involving choice. We conducted an out-of-sample, cross-validated comparison of heuristic models of intertemporal choice (which can account for many of the known intertemporal choice anomalies) and discounting models. Heuristic models outperformed traditional utility-discounting models, including models of exponential and hyperbolic discounting. The best-performing models predicted choices by using a weighted average of absolute differences and relative percentage differences of the attributes of the goods in a choice set. We concluded that heuristic models explain time-money trade-off choices in experiments better than do utility-discounting models.


Asunto(s)
Descuento por Demora , Heurística , Juicio , Modelos Psicológicos , Recompensa , Humanos , Factores de Tiempo
10.
Proc Natl Acad Sci U S A ; 109(21): 8026-31, 2012 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-22566634

RESUMEN

Preferences are fundamental building blocks in all models of economic and political behavior. We study a new sample of comprehensively genotyped subjects with data on economic and political preferences and educational attainment. We use dense single nucleotide polymorphism (SNP) data to estimate the proportion of variation in these traits explained by common SNPs and to conduct genome-wide association study (GWAS) and prediction analyses. The pattern of results is consistent with findings for other complex traits. First, the estimated fraction of phenotypic variation that could, in principle, be explained by dense SNP arrays is around one-half of the narrow heritability estimated using twin and family samples. The molecular-genetic-based heritability estimates, therefore, partially corroborate evidence of significant heritability from behavior genetic studies. Second, our analyses suggest that these traits have a polygenic architecture, with the heritable variation explained by many genes with small effects. Our results suggest that most published genetic association studies with economic and political traits are dramatically underpowered, which implies a high false discovery rate. These results convey a cautionary message for whether, how, and how soon molecular genetic data can contribute to, and potentially transform, research in social science. We propose some constructive responses to the inferential challenges posed by the small explanatory power of individual SNPs.


Asunto(s)
Conducta de Elección/fisiología , Economía del Comportamiento/estadística & datos numéricos , Genética Conductual/métodos , Estudio de Asociación del Genoma Completo , Personalidad/genética , Política , Femenino , Estudios de Asociación Genética , Humanos , Masculino , Polimorfismo de Nucleótido Simple , Sistema de Registros/estadística & datos numéricos , Suecia/epidemiología , Gemelos Dicigóticos/genética , Gemelos Monocigóticos/genética
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