Clicked off

Doom beckons for online ads

They pop up without warning, distract attention and clog computers. Users have many reasons to shun online ads—and find it easy to do so. Though global online-advertising revenues rose by 22% in 2011, websites that depend on selling their viewers’ eyeballs are worried. Around 9% of all online page views come from browsers armed with ad-blocking software, such as Adblock Plus, downloaded nearly 180m times since 2007, and 3.5m times in October alone.

Few sites have tried to fight back. In 2010 Ars Technica, a technology-news outlet, found that 40% of its users were blocking its ads. So it blocked their access for a day, but signed up only 200 users (out of 5m a month) for its ad-free version. Media firms are now opting for paywalls. Press+, a paywall provider set up in 2010, now has over 300 clients.

Till Faida, co-founder of Eyeo, which owns Adblock Plus, agrees that ads are needed to pay for content. Users of his plug-in can choose to allow “acceptable ads”: no animation and no tiresome clicking to dodge them. “You cannot annoy someone into liking you,” says Norm Johnston of Mindshare, a media-buying agency. But for many users the only good ad is an invisible one.

First published in The EconomistAlso available in audio here.

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Grim and bear it


The subjective study of suffering


Controversy about pain relief is usually between those who worry about addiction, black markets and over-prescription, and those who just want patients with long-running or fatal diseases to get the best pills. But a lesser-known issue is gaining attention, too: the treatment of acute pain.


Despite big advances in medical care in most other respects, pain relief after surgery has not improved in the past 60 years. A study in 2003 found that 80% of adults reported moderate to severe pain after surgery, just as many did in 1950. Pain does not just cause anguish: the stress-hormone cortisol it releases can damage the body. The end result may be heart attacks or internal blood clots.


The dispute is not about the drugs themselves, but concerns their type, quantity and timing. Medical opinion is surprisingly divided on this, chiefly because it is so hard to measure pain accurately. Attempts to determine a global pain scale have failed, because pain tolerance varies from country to country. In nations with stiff upper lips, a dose may be too high. In those with trembling lower ones, the same amount may be too little. Stereotypes are misleading: on average Germans, for instance, rate pain for similar conditions worse than Spaniards or Italians do.


Such comparisons are rare, but a global study called Pain Out is trying to make them more systematic. It records data across 16 rich and poor countries. Patients fill in forms after operations and doctors make notes of given treatments. The data are fed into a central server and can be accessed freely by researchers. In Berlin this month Ruth Zaslansky, of the Jena Medical Centre in Germany, will present the results of the study and actions taken.


One finding is that Rwandan women undergoing Caesarean sections get worse therapy than those in any other rich or poor country. As a result, says Antoine Bahati Kabeza, an anaesthetist at Kigali University Hospital, the medical staff are changing its pain-relief policies, and the university is changing the way it teaches pain management.


Medical care inevitably varies between rich and poor countries. But pain relief, administered correctly, costs relatively little given the good it does. The psychology of national character does not feature in pharmacological thinking. Perhaps it should.

First published in The Economist. Also available in audio here.

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Geek philanthropy

An innovative charity rallies geeks for a good cause

Businesses avidly mine data to improve their efficiency. Non-profit groups have plenty of information, too. But they can rarely afford to hire number-crunchers. Now a bunch of philanthropic geeks at DataKind, a New York-based charity, are helping other do-gooders work more productively and quantify their achievements for donors, who like to see that their money is well spent.

A typical DataKind two-day “hackathon” last month in London attracted 50 people who worked in three teams. One pored over the records of Place2Be, which offers counselling to troubled schoolchildren. Crunching the data showed that boys tend to respond better than girls, though girls who lived with only their fathers showed the biggest improvements of all. The charity did not know that.

The expertise is far beyond what is available to a typical charity. The small-talk among the volunteers was of dizzyingly complex statistical and artificial-intelligence techniques. Volunteers included an analyst at Teradata, a data-analytics firm. Around 20 employees attended from Aimia, a firm that mines data from consumer-loyalty programs.

In a previous hackathon in San Francisco, DataKind volunteers analysed the data from Mobilising Health, a non-profit group that connects rural patients in India with doctors in cities that are usually many hours away. Volunteers record symptoms and relay them by cellphones. The doctors then may prescribe drugs or recommend a hospital visit. The charity wanted to use the many months’ worth of accumulated text messages to evaluate the medics’ performance. Thanks to DataKind the charity was able to rejig the system to take more account of urgency and to direct requests to the most responsive doctors.

Thomas Levine, a data scientist at ScraperWiki, a provider of data-processing services, says he has attended DataKind events out of altruism but also for education. Would anyone care to measure that benefit?

First published in The Economist. Article written with Kenn Cukier. Also available in audio here.

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