How similar is similar enough?

Ippolito, Michela

doi:10.3765/sp.9.6

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…Measurement of “similarity” (how similar is similar enough?) is an important open question [ 46 ]. More research is needed to understand the core elements of case management (to identify similar programs) and to streamline identification of similar populations.…”

Section: Discussionmentioning

confidence: 99%

Impactability Modeling for Reducing Medicare Accountable Care Organization Payments and Hospital Events in High-Need High-Cost Patients: Longitudinal Cohort Study

Smith

Huling

et al. 2022

J Med Internet Res

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Background Impactability modeling promises to help solve the nationwide crisis in caring for high-need high-cost patients by matching specific case management programs with patients using a “benefit” or “impactability” score, but there are limitations in tailoring each model to a specific program and population. Objective We evaluated the impact on Medicare accountable care organization savings from developing a benefit score for patients enrolled in a historic case management program, prospectively implementing the score, and evaluating the results in a new case management program. Methods We conducted a longitudinal cohort study of 76,140 patients in a Medicare accountable care organization with multiple before-and-after measures of the outcome, using linked electronic health records and Medicare claims data from 2012 to 2019. There were 489 patients in the historic case management program, with 1550 matched comparison patients, and 830 patients in the new program, with 2368 matched comparison patients. The historic program targeted high-risk patients and assigned a centrally located registered nurse and social worker to each patient. The new program targeted high- and moderate-risk patients and assigned a nurse physically located in a primary care clinic. Our primary outcomes were any unplanned hospital events (admissions, observation stays, and emergency department visits), count of event-days, and Medicare payments. Results In the historic program, as expected, high-benefit patients enrolled in case management had fewer events, fewer event-days, and an average US $1.15 million reduction in Medicare payments per 100 patients over the subsequent year when compared with the findings in matched comparison patients. For the new program, high-benefit high-risk patients enrolled in case management had fewer events, while high-benefit moderate-risk patients enrolled in case management did not differ from matched comparison patients. Conclusions Although there was evidence that a benefit score could be extended to a new case management program for similar (ie, high-risk) patients, there was no evidence that it could be extended to a moderate-risk population. Extending a score to a new program and population should include evaluation of program outcomes within key subgroups. With increased attention on value-based care, policy makers and measure developers should consider ways to incorporate impactability modeling into program design and evaluation.

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Section: Discussionmentioning

confidence: 99%

Impactability Modeling for Reducing Medicare Accountable Care Organization Payments and Hospital Events in High-Need High-Cost Patients: Longitudinal Cohort Study

Smith

Huling

et al. 2022

J Med Internet Res

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“…Possible worlds semantics for counterfactuals is widely used in linguistics and philosophy (Portner, 2009;Kratzer, 2012), because by placing weak constraints on the similarity relation-e.g., of all worlds, w is most similar to itself (strong centering)-it allows the formulation of several counterfactual logics (Lewis, 1973). Yet, it turns out to be a very difficult task to explicate this similarity relation in a way that would permit the evaluation of ordinary counterfactuals in light of a set of strenuous counterexamples, and the inevitable context-sensitivity of such assessments (Rescher, 2007;Nickerson, 2015;Ippolito, 2016;Starr, 2019). To illustrate, a case can be made for either one of the following counterfactuals concerning the Korean War (Quine, 1960, p. 222;Spohn, 2013):…”

Section: Difficulties In Testing Possible World Semanticsmentioning

confidence: 99%

“…Like Pearl (2009), this focuses more on underlying causal structure than on physical resemblance but is much broader. In linguistics and philosophy, endeavors to improve upon these qualitative criteria continue (Rescher, 2007;Ippolito, 2016;Starr, 2019).…”

Section: 𝑐𝑜𝑠(𝜃) = 𝐀 • 𝐁 ‖𝐀‖‖𝐁‖mentioning

confidence: 99%

Possible worlds truth table task

2023

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“…This is a bit of a simplification. But seeEdgington (2003) andKment (2006, §3) for more in-depth discussions of why cases like this one are problematic for the miracles account.20 Thanks here to an anonymous referee, who points out that all of the following authors reject the miracles account in favor of an account of similarity that's more "contextualist" (note, however, that none of these accounts are exactly like the one I'll give below, nor do they ultimately get applied to CDT):Stalnaker (1968Stalnaker ( , 1981aStalnaker ( , 1984Stalnaker ( , 2021,Ichikawa (2011),Lewis (2015),Ippolito (2016),Steele and Sandgren (2020). Additionally, even some philosophers who are broadly sympathetic to the miracles account-likeKment (2006) andKhoo (2022)-are critical of the version I gave in §2, and opt for a more contextualist version instead.…”

mentioning

confidence: 97%

“…SeeLewis (1973aLewis ( , 1986Lewis ( , 2000.23 The contextualist view of similarity I sketch in this section has a lot in common with views espoused by, e.g.,Kaufmann (2004), Ippolito (2016,Khoo (2016),Boylan and Schultheis (2021), andDorr and Hawthorne (MS). It also has something in common with so-called causal modelling approaches to counterfactuals, like those ofHiddleston (2005),Santorio (2019),Gallow (2022), orKhoo (2022).…”

mentioning

confidence: 99%

Causal decision theory, context, and determinism

McNamara

2023

Philos Phenomenol Research

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The classic formulation of causal decision theory (CDT) appeals to counterfactuals. It says that you should aim to choose an option that would have a good outcome, were you to choose it. However, this version of CDT faces trouble if the laws of nature are deterministic. After all, the standard theory of counterfactuals says that, if the laws are deterministic, then if anything—including the choice you make—were different in the present, either the laws would be violated or the distant past would be changed. And as several authors have shown, it's easy to transform this upshot of the standard theory of counterfactuals into full‐blown counterexamples to CDT. In response to these counterexamples, I argue here that the problem lies, not so much with CDT's guiding idea—that it's the expected causal consequences of your actions that matter for rational decision‐making—but with the fact that the classic formulation of CDT doesn't pay sufficient attention to the context‐sensitivity of counterfactuals. I develop a contextualist version of CDT which better accounts for this context‐sensitivity. And I show that my theory avoids the problems faced by the classic formulation of CDT in determinstic worlds.

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How similar is similar enough?

Cited by 4 publications

References 17 publications

Impactability Modeling for Reducing Medicare Accountable Care Organization Payments and Hospital Events in High-Need High-Cost Patients: Longitudinal Cohort Study

Impactability Modeling for Reducing Medicare Accountable Care Organization Payments and Hospital Events in High-Need High-Cost Patients: Longitudinal Cohort Study

Possible worlds truth table task

Causal decision theory, context, and determinism

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