Surrogate Endpoints and the true value of testing.

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Getting Tested

When most people think about taking tests they often thing of showing off what they learned in class and the quest to get everything right. The problem is that test taking is an art form and most tests means better results not because someone is smarter but because they are better at taking tests. However, if you ask me the point of tests isn't getting the best mark or a perfect score. Tests are important but for reasons that aren't always obvious.

Which brings me up to the idea of surrogate endpoints.

Surrogate Endpoints

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In a couple of weeks I'll be going to the lab to get my cholesterol levels checked. I'll see what my HDL, LDL, and triglyceride numbers are. Now, many people believe that high cholesterol levels are bad. They want to fight the cholesterol with diet and medication to get the levels down. In short they want the numbers to be proper and do well on their "Cholesterol test".

But here is the thing.

Cholesterol isn't dangerous ... It is just a fat that the body uses to make all sorts of useful things. However, it is noted that high cholesterol corresponds with clogged arteries. If cholesterol is lower then arteries tend to be less clogged. Ideally we would look at how clogged the arteries are to look for imminent strokes and heart attacks. That's not really possible though. Checking for cholesterol? Much much easier.

We check for cholesterol because its easier than checking clogged arteries.

Checking for one thing to infer another thing is a surrogate endpoint. Honestly I think that is why regular tests mean something even if it is done through memorization and test taking skill.




High School Graduation

Guess how much of high school education gets used in the real world? Not that much unfortunately. It is not entirely useless as basic math skills, being able to read, and knowing about the world and how things work is pretty useful. However, knowing how many moles of atoms are in a gram of silver? Not something that will ever be needed in everyday life.

However, getting high marks and passing each course means something more important. It gives insight into how quickly someone picks up ideas. It gives insight into how hard the student it willing to press on through hard parts to figure something out. It gives insight on how willing the person is to conform to the classroom rules and ideals in order to get the marks to pass. In short it gives a glimpse into the character of the student. Dimwitted people? Lazy people? People who won't follow classroom rules or attendance? They may very useful in their own way but they may not be a good fit for a 9-5 job where you need to follow corporate guidelines.

A 98% on a test may not mean the person is brighter than someone who got an 85% but it does mean they are much more likely to be studying hard, treating the goal with serious effort, and be bright enough to grasp the concept. The grade is just a "surrogate endpoint" on Is this person going to do well if I give them a task.




Baseline competence

Of course some tests are either pass or fail. When my son took his Japanese proficiency test he passed and got N4 certification (low conversational). That certification means that he has a basic level of proficiency in Japanese language. When I wrote my pharmacy licensing exam it tells the world that I have met a minimum standard. It does not say that I will be a good pharmacist but only that I operate at a minimum standard to fulfil requirements.

Or perhaps I can point to a drivers test. Getting a license typically requires a driving exam. The exam is scored and there is a minimum pass/fail mark. Getting the minimum number or the maximum number doesn't mean one is good and the other is barely acceptable. It means both meet the minimum standards. Who will be a good driver and who will be bad? That is not reflected in their results only over their driving record over time.




Entrance exams

Unfortunately many places have formal entrance exams which determine a students future. The USA has SAT scores. Medical school has MCAT scores. I believe both China, Japan, and South Korea have some brutal tests to decide who gets put into which University.

Does a perfect score mean that the person will thrive in University? Nope. Does a perfect score mean that the person is a genius? Nope. Does a perfect score mean that the person is bright, knows how to take a test, and works their butt off? Yes. Does it mean that the person likely comes from a supportive family that is affluent enough to get them into the best tutors? Probably.

End result: Those high tests scores don't make someone smart. Those high test scores DO show that the person is highly likely to have the finances, the determination, the work ethic and baseline intelligence to make it through the grueling workload of challenging university subjects.




The Hive Learners post prompt

To answer the Hive Learners prompt directly?

**Weekly Featured Contents**
*Are exams really a measure of intelligence or just a test of memory? Why are they so important as proof for knowledge when the application of the knowledge is entirely different?*

No. Exams don't measure intelligence directly but they give us a glimpse into whether someone is bright or not. No. Tests aren't always just memory. I know my cholesterol test has nothing to do with memory. My neighbors welding proficiency test also had nothing to do with welding either. Are they important as proof of knowledge? Not directly but they do show that the person took the time to learn the underlying material.

The most important part isn't the score. The important part is that the score shows that the person is likely to do well at the task. It is a surrogate endpoint but sometimes that is the easiest indicator on whether the person will succeed in the task given to them.

Just my thoughts but thanks for listening to them and I would love to get comments as always.

Surrogate Endpoints and the true value of testing. | Ecency