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454 pages, Hardcover
First published May 18, 2021
“A general property of noise is that we can recognise and measure it, when knowing nothing about the target or bias.”
“Noise is rarely recognised. Bias is always the star of the show.”
“System noise is inconsistency and inconsistency damages the credibility of the system.”
“When physicians are under time pressure, they are apparently more inclined to choose a quick-fix solution, despite its serious downsides. ”
"Another illustration of the role of fatigue among clinicians is the lower rate of appropriate handwashing during the end of hospital shifts. (Handwashing turns out to be noisy, too.) ”
"A study of nearly seven hundred thousand primary care visits, for instance, showed that physicians are significantly more likely to prescribe opioids at the end of a long day."
“Other studies showed that, toward the end of the day, physicians are more likely to prescribe antibiotics and less likely to prescribe flu shots.”
“Doctors are more likely to order cancer screening early in the morning than late in the afternoon.”
"In the words of one observer, "the reliance on the patient's subjective symptoms, the clinician's interpretation of the symptoms, and the absence of objective measure (such as a blood test) implant the seeds of diagnostic unreliability of psychiatric disorders." In this sense, psychiatry may prove especially resistant to attempts at noise reduction."
“A standard practice to reduce noise in Medical profession is to advise patients to get the second opinion.”
“Bad weather is associated with improved memory; judicial sentences tend to be more severe when it is hot outside; and stock market performance is affected by sunshine.”
"A study of thousands of juvenile court decisions found that when the local football team loses a game on the weekend, the judges make harsher decisions on the Monday (and, to a lesser extent, for the rest of the week). Black defendants disproportionately bear the brunt of that increased harshness. A different study looked at 1.5 million judicial decisions over three decades and similarly found that judges are more severe on days that follow a loss by the local city's football team than they are on days that follow a win.”
"But noisy systems do not make multiple judgments of the same case. They make noisy judgments of different cases. If one insurance policy is overpriced and another is underpriced, pricing may on average look right, but the insurance company has made two costly errors. If two felons who both should be sentenced to five years in prison receive sentences of three years and seven years, justice has not, on average, been done. In noisy systems, errors do not cancel out. They add up."
"Judgements are both less noisy and less biased when those who make them are well trained, are more intelligent and have the right cognitive style. In other words good judgements depend on what you know, how well you think and how you think. Good judges tend to be experienced and smart but they tend to be actively open mended and willing to learn from the new information."
"Uri Simonson showed that college admissions officers pay more attention to the academic attributes of candidates on cloudier days and are more sensitive to nonacademic attributes on sunnier days. The title of the article in which he reported these findings is memorable enough: "Clouds Make Nerds Look Good."
"Consumers are more affected by the calorie label if they are placed on the left of the food label rather than the right. When calories are on the left, consumers read this information first and think a lot of calories or not so many calories before they see the item."
"After a streak, or a series of decisions that go in the same direction, they are more likely to decide in the opposite direction than would be strictly justified. As a result, errors (and unfairness) are inevitable. Asylum judges in the United States, for instance, are 19% less likely to grant asylum to an applicant when the previous two cases were approved. A person might be approved for a loan if the previous two applications were denied, but the same person might have been rejected if the previous two applications had been granted. This behavior reflects a cognitive bias known as the gambler's fallacy: we tend to underestimate the likelihood that streaks will occur by chance."
“There is at least one source of occasion noise that we have all noticed: mood.”
“A good mood makes us more likely to accept our first impressions as true without challenging them.”
"From the perspective of noise reduction, a singular decision is a recurrent decision that happens only once. Whether you make a decision only once or a hundred times, your goal should be to make it in a way that reduces both bias and noise. And practices that reduce error should be just as effective in your one-of-a-kind decisions as in your repeated ones."