Extreme Outcomes

Extreme Outcomes

Large sample sizes are important. At this moment, the world is racing as quickly as possible toward a vaccine to allow us to move forward from the COVID-19 Pandemic. People across the globe are anxious for a way to resume normal life and to reduce the risk of death from the new virus and disease. One thing standing in the way of the super quick solution that everyone wants is basic statistics. For any vaccine or treatment, we need a large sample size to be certain of the effects of anything we offer to people as a cure or for prevention of COVID-19. We want to make sure we don’t make decisions based on extreme outcomes, and that what we produce is safe and effective.

 

Statistics and probability are frequent parts of our lives, and many of us probably feel as though we have a basic and sufficient grasp of both. The reality, however, is that we are often terrible with thinking statistically. We are much better at thinking in narrative, and often we substitute a narrative interpretation for a statistical interpretation of the world without even recognizing it. It is easy to change our behavior based on anecdote and narrative, but not always so easy to change our behavior based on statistics. This is why we have the saying often attributed to Stalin: One death is a tragedy, a million deaths is a statistic.

 

The danger with anecdotal and narrative interpretations of the world is that they are drawn from small sample sizes. Daniel Kahneman explains the danger of small sample sizes in his book Thinking Fast and Slow, “extreme outcomes (both high and low) are more likely to be found in small than in large samples. This explanation is not causal.”

 

In his book, Kahneman explains that when you look at counties in the United States with the highest rates of cancer, you find that some of the smallest counties in the nation have the highest rates of cancer. However, if you look at which counties have the lowest rates of cancer, you will also find that it is the smallest counties in the nation that have the lowest rates. While you could drive across the nation looking for explanations to the high and low cancer rates in rural and small counties, you likely wouldn’t find a compelling causal explanation. You might be able to string a narrative together and if you try really hard you might start to see a causal chain, but your interpretation is likely to be biased and based on flimsy evidence. The fact that our small counties are the ones that have the highest and lowest rates of cancer is an artifact of small sample sizes. When you have small sample sizes, as Kahneman explains, you are likely to see more extreme outcomes. A few random chance events can dramatically change the rate of cancer per thousand residents when you only have a few thousand residents in small counties. In larger more populated counties, you find a reversion to the mean, and few extreme chance outcomes outcomes are less likely to influence the overall statistics.

 

To prevent our decision-making from being overly influenced by extreme outcomes we have to move past our narrative and anecdotal thinking. To ensure that a vaccine for the coronavirus or a cure for COVID-19 is safe and effective, we must allow the statistics to play out. We have to have large sample sizes, so that we are not influenced by extreme outcomes, either positive or negative, that we see when a few patients are treated successfully. We need the data to ensure that the outcomes we see are statistically sound, and not an artifact of chance within a small sample.

Avoiding Extremes

Colin Wright is an author, podcast host, and in to some degree full time traveler writing about his experiences and the ways in which he has come to see the world through stoic principles of self-awareness and mindful consideration. In his recent book, Come Back Frayed, Wright details his experiences living in the Philippines and explains ways in which his lifestyle contribute to his being able to not just survive, but thrive in very different environments and places. One of Wright’s traits lending to a successful lifestyle of travel is his ability to avoid extremes in terms of thought, behavior, and desires. Regarding extremes he writes,

 

“Extremes are insidious because they’re incredibly valuable until they’re not. At some point on the usefulness curve, they transition, hyde-like, to harmful. Even water is deadly if you drink too much of it.
Avoiding extremes has become an integral part of my lifestyle, because I find that walking up to that line, toeing it, and then stepping back to stand on healthier, more stable ground is what allows me to work and live and enjoy the world around me without suffering the consequences of burnout, sleep-deprivation, ill-health, and fanaticism.”

 

I enjoy this passage because Wright explains the importance of remaining even and level in our actions. It is easy, tempting, and often encouraged to push toward an extreme in whatever we are doing with our lives, but in the long run the consequences of living on the extremes can be disastrous. Pursuing diets without flexibility, driving toward completing incredible amounts of work, and even participating in non-stop leisure can lead to worse outcomes than if we had been more balanced in our approach. Focusing so highly on one area may help us find incredible success, but as we push further toward the extremes, we must out of necessity, and limitations on our time and energy, give up attention for other areas of our life. Without stopping to take notice of our focus, we will find that suddenly, our laser detail on one extreme, has allowed other areas to become problematic.

 

This is the sudden change that Wright discusses in his quote above. Extremes push us to places where the supports that allow for our behavior become weakened and unable to further support our specific efforts. Because our focus is so set in one area, it also means we are oblivious to areas we have chosen to neglect, and when problems arise, we might not know where to look to find solutions.

 

Greatness and deliberate action are things to strive for, but we should recognize what we are sacrificing to reach those goals. As we drive further toward extremes in pursuit of excellence, we will notice that we must take our focus away from other areas. Being conscious of our decisions and recognizing when we are approaching extreme points will help us find a place where we can continue to seek greatness on more stable footing.