Good Decision Making Requires Frugality

Published on August 14, 2005

I have come across a fascinating book, Blink - The Power of Thinking without Thinking by Malcolm Gladwell (Check out excerpts from the inside cover). While Gladwell discusses many interesting topics, I found his focus on decision making quite relevant to the realms of medicinal chemistry, and project management in general.

In project management, “we take it as a given that the more information decision makers have, the better off they are. For example, if a doctor says he/she needs to do more tests or examine a patient in more detail to diagnose a heart attack, few of us think that’s a bad idea.”

Less is More“Take the hypothetical case of a man who comes into the ER complaining of intermittent left-side chest pain that occasionally comes when he walks up the stairs and that lasts from five minutes to three hours. His chest exam, heart exam and ECG are normal, and his systolic blood pressure is 165, meaning it doesn’t qualify as an urgent factor. But he’s in his sixties. He’s a hard-charging executive. He’s under constant presssure. He smokes. He doesn’t exercise. He’s had high blood pressure for years. He’s overweight. He had heart surgery two years ago. He’s sweating.

It certainly seems like he ought to be admitted to the coronary care unit right away. Undoubtedly, all those factors certainly matter in the long term. The patient’s condition and diet and lifestyle put him at serious risk of developing heart disease over the next few years. It may even be that those factors pay a very subtle and complex role in increasing the odds of something happening to him in the next 72 hours.”

However, the role of all those factors - beyond ECG, blood pressure, fluid in the lungs, and unstable angina - is so small in determining what is happening to the man right now that an accurate diagnosis can be made without anything else. Research by many scientists has shown that all that extra information isn’t actually an advantage at all. “It’s harmful. It confuses the issues. What screws up doctors when they are trying to predict heart attacks is that they take too much information into account.”

“In good decision making, frugality matters - taking a complex problem and reducing it to its simplest elements. Time and again, it has been shown that even the most complicated of relationships and problems have an identifiable underlying pattern. In picking up these sorts of patterns, less is more. Overloading the decision maker with information makes picking up that signature harder, not easier. So to be a successful decision maker, we have to edit.”

Going back to the recent post on Getting more from your Data, it is clear that applying medicinal chemistry successfully relies a good deal on knowing what parameters and properties are important for a given problem.



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