
In marginal decisions, favour action over inaction - ChrisHardman29
https://www.sivv.io/article/5ecededf46cc9f76d4639b24/In-marginal-decisions,-favour-action-over-inaction
======
LatteLazy
Counter point...

There's a famous study about what happens when medical professions (eg
cardiologists) have major conferences. The juniors and non specialists are
left running the wards for a week or so. And survival rates go up not down.

The leading theory is that more junior doctors are more likely to wait to and
see while seniors intervene and trust in the skills. But their skills aren't
as good as they think for the marginal patient...

[https://www.newscientist.com/article/mg22530032-100-death-
ra...](https://www.newscientist.com/article/mg22530032-100-death-rate-drops-
when-top-heart-surgeons-are-away/)

~~~
medymed
The other leading theory is that major (non emergent) operations and
management changes (like starting chemotherapy) will often be postponed until
the senior physicians get back.

~~~
taeric
That sounds easily testable in the data.

~~~
6gvONxR4sf7o
It's only testable in the data if these decisions are being made based on
factors that are adequately represented in your statistics (no unobserved
confounding). Maybe there's patient A, a smoker who says they're a non-smoker
but seems like a liar to the doctor, and an otherwise identical patient B who
is actually a non-smoker. Patient A is probably higher risk, so there's a
difference between doing A during conference week then B later, versus B
during conference week than A later. Even supposing that the doctor wrote that
they think A might be lying and actually maybe a smoker, it's going to be hard
to control for those notes in a t-test. It's a shitty example, but hopefully
demonstrates the idea. It's always super hard to make the argument that
there's no unobserved confounding.

~~~
Retric
Conference dates are independent of patient heath, so you can just look at the
numbers directly across many healthcare systems and several decades. Vastly
more data generally trumps better analysis.

~~~
6gvONxR4sf7o
> Vastly more data generally trumps better analysis.

If you mean more data in the sense of more covariates, sure. If you mean more
data in terms of just more observations, no way. Not when it comes to causal
inference.

~~~
lowdose
Could you elaborate on this point "no way", for more observations?

~~~
6gvONxR4sf7o
Think about getting a helicopter to the hospital. It's probably pretty
serious, right? You're more likely to die if you get a helicopter evac than if
you don't. If all you have recorded is whether they got to the hospital via
helicopter or not, and whether they died or not, then you're going to see that
helicopters are associated with death. If you could control for what's wrong
with the person, you might see that helicopters save lives. If you don't have
that data, then just having more observations of (helicopter y/n, died y/n)
will just look like helivac is murder. No matter what you do with that data,
you just can't control for what you'd need to, because what you need was an
unobserved confounder. When you're trying to establish causation, you have to
rule out unobserved confounders, which is tricky. There's always something
where someone might say "well what if it was X?" and the data doesn't contain
that answer.

In this particular case, that commenter said that conference dates are
independent enough from patient health to say that aside from the important
things, everything else is equal. As in, the only difference between the
treatments is who is doing the treatment. I disagree with that assertion, but
that's the kind of argument you need for causation: Once we've dealt
with/controlled for XYZ, the only difference left is the one we're interested
in.

It's very difficult to demonstrate that the only difference left is what you
care about when you can't even see certain variables. Someone says "what if
people in group A are more likely to be left handed and it's patient
handedness instead of doctor quality that's causing death here" but you didn't
measure left handedness. More and more observations of group A without
measuring handedness can't rule out that maybe they were lefties. So you
either measure handedness, or argue that your setup will even it out (via
randomization for example), or argue that handedness just doesn't matter here.
And not just for handedness, but for everything imaginable.

~~~
Retric
While intuitively that reasoning seems valid, having more data makes signals
more clear. If your sample sizes is say 99.8% of all doctors that’s going to
be representative in ways a carefully crafted representative sample of 1,000
doctors simply isn’t.

Sampling always loses out to having the entire population.

But you say missing data makes the interpretation incorrect. That’s always
possible but only in ways that also fit the original data. Thus, you can then
preform a study that improves upon the understanding of the correlation, but
it’s not going to disprove the original correlation.

PS: And even here it’s easy to test with more data, just compare total deaths
for the month around conferences.

------
andersource
Not based on any sources, but I believe that these results say more about our
subjective experience of decisions (specifically in situations of action vs.
inaction) rather than the actual likelihood of outcomes. In other words, I'm
not convinced that statistically in a situation of action / inaction an action
is always more likely to lead to a more favourable outcome, but it _is_ more
likely to be later considered in a more positive light. Some of the reasons
for that would be:

* Empowered sense of agency

* Taking action requires resources which would be "wasted" if the action is later considered the wrong choice, which potentially creates rationalization to avoid that (the sunk cost fallacy)

* When you take an action to change a status quo you've probably prepared for the expected negative aspects of the change, diminishing their effect

* When you stay inactive the potential to act is always there nagging

In purely personal decisions the subjective experience might actually be more
important than the real outcome (barring extreme circumstances), so taking an
action might indeed be the right choice regardless. However, I do believe that
these effects are also present in decisions that affect others (organizations,
families etc.), in which the outcome is more important, and also affected
others don't share the decision-maker's perspective and may subjectively
experience the decision completely differently as a result.

~~~
gnicholas
Excellent point. There’s research showing that people that make irrevocable
decisions are happier than people who make the same decision but are told they
can change their mind later.

Sticking with the status who is like making a revocable decision not to make a
change, where as deciding to do something else is a less-irrevocable decision.

[https://www.npr.org/2019/08/30/755850405/you-2-0-decide-
alre...](https://www.npr.org/2019/08/30/755850405/you-2-0-decide-already)

~~~
andersource
Very interesting, thanks!

------
asymmetric
The book “Transformative Experiences” by LA Paul argues that it’s impossible
to rationally decide what to do when faced with a life-altering (aka
epistemically transformative) decision, because you have no way of knowing the
person you’ll be after the choice, and what their preferences will be (“what
it’s like to be them”)

~~~
artsyca
The great leap of faith -- you have to trust in the transformation and that
you won't remember who you used to be anyway

Try getting a tattoo for an example of this

Edit; it's very right you can't decide rationally and that's why we're
emotional beings but on the other hand given you have already done it once you
emerge on the other side chances are you'll be pleased

If you don't want to get a tattoo try wearing professional clothing to work
for a month

Those who don't believe in magic will never find it -- Roald Dahl

~~~
wintermutestwin
Some interesting statistics on tattoo regret:
[https://www.advdermatology.com/blog/statistics-
surrounding-t...](https://www.advdermatology.com/blog/statistics-surrounding-
tattoo-regret)

Personally, I would have regretted each of the tattoos I would have gotten
during each era of my past life.

I am looking forward to visiting Japan and being allowed in to a bath house
(onsen) because I am tattoo free:
[https://www.kashiwaya.org/e/magazine/onsen/tattoos.html](https://www.kashiwaya.org/e/magazine/onsen/tattoos.html)

~~~
Fargren
I have tattoos and went to some very nice public Onsen in Japan. It's more
work to find them, for sure.

~~~
artsyca
Tattoo regret? I regret not getting more. I got a sweet piece in San Francisco
it was a good trade-off for leaving my heart there.

~~~
sukilot
Did you leave it with one of the cardiologists mentioned above?

------
mprovost
This [0] is another take on the same research that sums it up better: "If
you’re genuinely unsure whether to quit your job or break up, then you
probably should." I was quite influenced by this post when deciding to switch
jobs - in the end I figured that if I couldn't make up my mind then I should
go for the change. So far it's worked out, but of course you can't ever go
back and know whether you would have been happier staying put. Life isn't a
series of randomised trials. I think the fact that you're considering a new
job (or a new partner) tells you that at least some part of you wants to make
a change though.

[0] [https://80000hours.org/2018/08/randomised-experiment-if-
your...](https://80000hours.org/2018/08/randomised-experiment-if-youre-really-
unsure-whether-to-quit-your-job-or-break-up-you-really-probably-should/)

~~~
sytelus
I have lived by quote “change is better” and for jobs it has almost always
worked out because fortunately there are plenty of equal or better jobs in IT.
But I am not sure this would work out for an aeronautical engineer at Boeing
in same way, for example, given there are so few well paying jobs in that
field. Similarly I am not sure this would work out great if you were thinking
about divorce and had kids. In those situations, much more rationalization
than simple “always make change” directive is necessary.

~~~
abraae
I'd say if you have kids and are wondering strongly about divorce, then you
definitely should make a change - it just might not be to actually get
divorced. Could be counseling, couples therapy, 3 day retreat for self
analysis. Small changes before the biggest change.

------
twic
Am i right in thinking that the study shows that those who took action were
happier, but not that they were actually better off? Does it attempt to
account for a bias towards rationalising your actions?

In reality, the alternative to taking action is usually not simply taking no
action, it is collecting more information and then deciding whether to take
action. Does the study get at this at all?

~~~
ChrisHardman29
It does address the potential role of a number of biases, including self-
deception / rationalising. As a result it compares responses against third
party assessments (finding little evidence of self-deception being a major
factor).

I agree that decisions aren't typically binary but I suppose even if you are
actively researching after 6 months, for the purposes of this comparison you
have remained with the status quo.

------
code-faster
This only holds in convex payoff distributions where risk has a positive
expected value.

In concave payoff distributions, where risk has a negative expected value,
inaction is favored.

~~~
sytelus
Why this should depend on convexity at all? The study’s premise is marginal
benefit, i.e., estimated risk difference is either minimal or perhaps too
poorly known to call it out as marginal. If it was known to be positive or
negative, action should be obvious. I am not defending this study because
authors seem to rely heavily on survey where participants satisfaction
measured only after 6 months. Typically, people tend to comfort themselves in
short term for making big decisions such as divorce or job change even though
in longer run they may higher accumulated regret. Economists need to develop
good models instead of just keep doing surveys.

~~~
sukilot
> Typically, people tend to comfort themselves in short term for making big
> decisions such as divorce or job change

What about "buyer's remorse" and "honeymoon period"?

------
supernova87a
Maybe this has some applicability for personal, individual decisions. But to
translate this to larger, more important things, affecting way more people?

Take great caution.

If you find yourself to be a leader, CEO, president, or whatever, facing
really hard, ambiguous decisions, sometimes the right thing is _not to act_ ,
yet this is very hard to do and resist the temptation to act. We end up
disincentivizing leaders from hesitating to act, when that might be the
appropriate thing, because it might be seen as weakness or indecision.

All too often the bias towards action (for anything but personal decisions) is
a quick way to get in a lot of trouble.

------
nabla9
The study itself looks like it's well done, result is statistically highly
significant, but it was still just an internet study where people were self
reporting. All you end with is suggestive evidence not be taken too seriously.

~~~
JacobAldridge
> it was still just an internet study where people were self reporting

And I wonder whether it would largely have been people contemplating a
decision because they were dissatisfied/ unhappy with the status quo?

My immediate thought it to Nassim Taleb’s _via negativa_ \- not necessarily
any more well researched, but the view that in uncertainty do nothing or
indeed do less to create a better outcome. That inaction is to be preferred
where change and action has no clear benefit.

~~~
ChrisHardman29
Interesting point. I haven't read that but maybe the appropriate approach
depends on the situation / level of uncertainty. For example, in situations
where we have little clarity on the options or what the outcomes will look
like, it perhaps makes sense to resist any urge to take action because we
can't make any sensible comparison between the change and the status quo (and
'action bias' may be more of a factor). In other situations, like leaving one
job to go to another, we have a better (though definitely imperfect) idea of
what the options / outcomes look like and so may be better placed to make a
comparison (in which case loss aversion may be more important). This is just a
theory though - I may be totally wrong!

------
keiferski
This can really go both ways, which makes it complicated. I feel like
contemporary human beings have a massive bias toward action, often to their
own detriment. "Do nothing and wait" is often a good piece of advice, but I
can't see any political leader, entrepreneur, or 'thought leader' advocating
for that. Patience seems to have lost out to instant gratification and the
desire to do something, _anything_.

 _..those who had opted for the choice that involved making a change (as
opposed to sticking with the status quo) were more satisfied with their
decision and generally happier._

If you study history, specifically military history, you'll see the "be
patient" strategy employed successfully (and ignored, unsuccessfully) quite
often. Fabius defeated Hannibal by essentially out-waiting him. [1] One of the
Thirty-Six Stratagems from ancient Chinese warfare is _Wait at leisure while
the enemy labors._ [2] So I would amend the advice to be, _In marginal
decisions, don 't be rash, but don't over-analyze. Wait for the right moment,
then act._

The example cited in the article could also just be retroactive
rationalization. I.e. people want to rationalize their decisions as being the
right one.

1\.
[https://en.wikipedia.org/wiki/Fabian_strategy](https://en.wikipedia.org/wiki/Fabian_strategy)

2\. [https://en.wikipedia.org/wiki/Thirty-
Six_Stratagems#Wait_at_...](https://en.wikipedia.org/wiki/Thirty-
Six_Stratagems#Wait_at_leisure_while_the_enemy_labors)

~~~
phkahler
Timing a specific action is different than not taking an action. Unless you
lie to yourself that you're waiting for the right time in order to not take
action. ;-)

------
karmakaze
> The findings may be explained by 'loss aversion', a cognitive bias that
> causes potential losses to be weighed more heavily than potential gains (the
> ratio is somewhere around 2:1, meaning that most people will feel
> comfortable with a decision only when the likely gains are double the likely
> losses). As a result, in situations where the benefits and drawbacks of
> making a change appear to be evenly matched, it may be sensible to take
> action.

This loss aversion ratio of 2:1 is an average or other. How do you find your
own ratio? It's the only one that matters. I'm always switching tracks and on
to the next new (or old and new to me) thing.

A better reason is most people toward the ends of their lives regret the
things they didn't do, rarely any of the things they've done. Do more things.
Change is good.

~~~
ChrisHardman29
Happiness or wellbeing are such difficult concepts to measure and compare that
I don't think you can ever arrive at a specific, generally-applicable ratio.
But that doesn't mean that being aware of loss aversion (and the way it may be
shaping your assessment of a decision) isn't helpful in reaching better
outcomes.

I agree re regretting inaction. There are lots of nuances in how this seems to
work as well - see
[https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000326](https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000326).

------
tlarkworthy
It's the Monty Hall problem effect. When you take an action, you choose from a
small set of options. When you stay with the status quo, you are following a
Markov chain than has not been narrowed by your choices (which is worse on
average).

~~~
smegma2
This sounds wrong to me, what would be the analogue of the door being
revealed?

~~~
tlarkworthy
The door being revealed is time passing and understanding your own needs and
what the world provides. The status quo is sticking to a historical choice
made with less information. When you consider action today, you use fresh
information, but to actually realise that advantage, you need to pick one of
the new choices, even though it's outcome is stocastic

~~~
smegma2
That makes sense, thanks.

------
xenocyon
Counterpoint: the way people assess decisions after the fact is no more
rational than the way people assess them beforehand.

Some parents with _n_ children wrestle with the decision of whether to have
_n+1_. You seldom hear regret from people who choose to go ahead with having
an additional kid - yet science shows that, in aggregate, people with multiple
kids tend to be unhappier than people with just one. In this example, each
individual claimed to be happier with choosing 'action' over 'inaction', but
in aggregate the action made people unhappier.

------
karaterobot
> ... whenever you cannot decide what you should do, choose the action that
> represents a change, rather than continuing the status quo.

As a heuristic, this is kind of rough: what does it mean to say you "cannot
decide what you should do"?

How hard have you tried?

If this research was mutated into a piece of folk wisdom, I bet it would be
interpreted as advising that "change is preferable, so don't overthink it."

But, that would be the wrong conclusion to draw. It's better to make important
decisions after getting as much information as possible, and using rational
decision-making strategies. So, it's likely always more effective, though more
work, to try to push back the boundary of when the word "cannot" becomes
applicable than it is to just say "fuck it, let's do this".

------
f0ok
Overall, and depending on context, I think this is a moot point. Inaction is
as important as action and can be considered a different action in itself.
What some call inaction is not necessary a state of being inactive, but simply
observing and analyzing the outcome longer, while focusing efforts elsewhere.

Maybe "being on the fence" or staying in a frame of doubt and uncertainty for
too long, without developing future steps for a given plan could really be
considered disruptive inaction.

------
nsonha
It's not in the title but the goal here is to feel better afterward. It has
nohing to do with the statistics of making the better call.

------
JuliusPullo
Of course they are not satisfied. That's why they were considering a life-
changing decision, because they were not happy with the status-quo. Duh!

—"Levitt found that those who had opted for the choice that involved making a
change (as opposed to sticking with the status quo) were more satisfied with
their decision and generally happier."

------
ip26
This would seem to line up with some old wisdom I heard years ago, where some
researcher interviewed elders and found that his subjects regretted chances
they had not taken far more than chances they had taken, even if it didn't
work out.

That idea was a big focus of mine as I tried to get over fear in dating.

------
nraynaud
Agency has to be remembered tho, your decisions impact others, and change that
is received is generally less well tolerated than change that has been
initiated. It's real in teams where the management decides on change and
underlings can only agree or not.

~~~
ChrisHardman29
Very good point - this study relates to the personal impacts but perhaps not
to decisions that impact many people and run counter to what they would
individually have decided.

------
brudgers
siver's alternative: "Hell Yeah! or No".

[https://sivers.org/hellyeah](https://sivers.org/hellyeah)

~~~
sukilot
That's assuming you don't want to stop what you are currently doing.

------
KKKKkkkk1
What is a marginal decision? Is quitting a job or ending a relationship a
marginal decision?

~~~
nostrademons
It's whenever you have that feeling of "I just can't decide between these two
options", and don't have a strong feeling either way.

Quitting a job or ending a relationship _can_ be a marginal decision, if
you're not sure you want to do it. Sometimes you're just fed up with your
current employer, or there's an obviously good opportunity available - that's
not a marginal decision, that's an easy decision. But sometimes there's an
opportunity, but you're not sure you want to take it, but it seems intriguing,
but it'd be a big risk, but you wonder if you'll regret not taking it, etc.
That's a marginal decision, and the type that the article suggests you should
take.

------
ulisesrmzroche
Funny how the iChing says exactly the opposite, no matter how many times I
flip the e-coins

------
powersnail
Won’t this create a new margin—-slightly shifted in favor of action?

------
ccvannorman
in aggregate, this data makes sense

For people with chronic ADD who struggle to finish projects, you may easily
fall on the other side of this line ..

