[HN Gopher] Possibly a Serious Possibility
___________________________________________________________________
Possibly a Serious Possibility
Author : samclemens
Score : 246 points
Date : 2025-05-05 19:11 UTC (1 days ago)
(HTM) web link (kucharski.substack.com)
(TXT) w3m dump (kucharski.substack.com)
| mempko wrote:
| It's strange to map language to probability ranges. The guidance
| should be to just say the probability range. No ambiguity. Clear.
| Actionable and also measurable.
| throwaway81523 wrote:
| It's still a subjective estimate, but Samosvety (predictor
| group) does seem to work that way, and HPMOR suggested
| something similar. Basically assign probabiltiies to less
| complex unknowns using numbers pulled out of your butt if
| that's all you can do. Then you can compute conditional
| probabilities of various more complicated events using those
| priors. At least then, a consistent set of numbers has carried
| through the calculation, even if those numbers were wrong at
| the outset. It's suppose to help your mental clarity. I guess
| you can also perturb the initial numbers to guess something
| like a hyperdistribution at the other end.
|
| I haven't tried this myself and haven't run across a situation
| to apply it to lately, but I thought it was interesting.
| andrewflnr wrote:
| > a consistent set of numbers has carried through the
| calculation, even if those numbers were wrong at the outset
|
| I kind of see how this _might_ be useful, but what I 've
| actually seen is an illusion of certainty from looking at
| numbers and thinking that means you're being quantitative
| instead of, you know, pulling things out of your butt.
| Garbage in, garbage out still applies.
| throwaway81523 wrote:
| Yes, the potential illusion is most dangerous if you show
| someone else the numbers and they take them seriously. If
| they're only for your own calculations then you can
| remember what they are made of.
| plorkyeran wrote:
| In practice people seem to be very bad at remembering
| that. Pretty universally people act as though doing math
| on made up numbers makes them less erroneous rather than
| more.
| widforss wrote:
| That's the whole point of Fermi estimates. Find a
| plausible number given uncertain inputs.
| chrisweekly wrote:
| Yeah, mistaking precision for accuracy is a common
| fallacy.
| JadeNB wrote:
| > Yeah, mistaking precision for accuracy is a common
| fallacy.
|
| I remember an appealing description of the difference
| being that a precise archer might sink all their arrows
| at the same spot on the edge of the target, whereas an
| accurate archer might sink all their arrows near the
| bull's eye without always hitting the same spot.
| Jach wrote:
| If you don't perturb the initial numbers to see what changes
| to help construct a richer model (as well as one with tighter
| bounds on what it predicts or forbids), you're leaving out a
| lot of the benefits of the exercise. Sometimes the prior
| doesn't matter that much because you find you already have or
| can easily collect sufficient data to overcome various
| arbitrary priors. Sometimes different priors will result in
| surprisingly different conclusions, some of them you can even
| be more confident in ruling out because of absence of data in
| their predictions. (Mathematically, absence of evidence is
| evidence of absence, though of course it's just an inequality
| so the proof says nothing on whether it's weak or strong
| evidence.) And of course some priors are straight from the
| butt but others are more reasonably estimated even if still
| quite uncertain; in any case much like unit testing of
| boundary conditions you can still work through a handful of
| choices to see the effects.
|
| Someone mentioned fermi calculations, a related fun exercise
| in this sort of logic is the work on grabby aliens:
| https://grabbyaliens.com/
| Muromec wrote:
| That's the other way around -- there was no probability range
| to begin with.
| csours wrote:
| Or use a histogram.
| layer8 wrote:
| How would you possibly measure the "Probability of an Invasion
| of Yugoslavia in 1951", in March 1951?
| konstantinua00 wrote:
| 9/12
|
| 3 months have passed, 9 to go :)
| hlieberman wrote:
| It's not just the UK who has standardized on these language; the
| U.S. intelligence community also has a list of required
| terminology to use for different confidence levels and different
| likelihoods -- and distinguishing between them. It's all laid out
| in ICD-203, publicly available at
| https://www.dni.gov/files/documents/ICD/ICD-203.pdf
|
| I've found it very helpful in the same vein as RFC 2119
| terminology (MUST, SHOULD, MAY, etc.); when you need your
| meanings to be understood by a counterparty and can agree on a
| common language to use.
| bo1024 wrote:
| Interesting. This terminology really makes no sense without
| more shared context, in my view. For example, I would not
| describe something that happens to me every month as a "remote
| possibility". Yet for a 3% chance event, repeated every day,
| monthly occurrences are what we expect. Similarly, someone who
| describes events as "nearly certain" would surely be
| embarrassed when one of the first 20 fails to happen, no?
| randallsquared wrote:
| A 1-in-a-million chance seems quite remote, yet if you are
| rolling the dice once a millisecond...
|
| This applies to any repeated chance, so it probably doesn't
| need to be called out again when translating odds to verbal
| language.
| bo1024 wrote:
| I'm not only talking about repeated events, though. If
| someone told me about 20 different events that they were
| almost certain, and one failed to happen, I would doubt
| their calibration.
| Nevermark wrote:
| 19 out of 20 could easily mean they get 119 right out of
| every 120 "almost certainties" and they just rolled a 1
| on a die 6 for the "luck" component.
|
| One off, 1 out of N errors are really hard to interpret,
| even with clear objective standards.
|
| And emphasizes why mapping regular language to objective
| meanings is a necessity for anything serious, but can
| still lead to problematic interactions.
|
| Probability assessments are will almost always sometimes
| certainly could be considered likely hard!
| MichaelZuo wrote:
| I think the parent was suggesting a much higher
| percentage for "almost certain"... like >99.9%
| voidUpdate wrote:
| If something happens to you every month, that's a certainty.
| If it has a 3% chance to happen to you on any given day, its
| a remote possibility that it will happen to you on any given
| day
| handsclean wrote:
| The terms aren't causing this confusion, it's that you're
| applying them to less specific subjects, in particular
| omitting periods. "3% chance per day" makes sense, "remote
| chance on any particular day" makes sense, "remote chance"
| does not make sense, "3% chance" does not make sense. You'd
| also need to say "nearly certain over any 30 day period",
| though if the odds are 3%/day then it's only (just into)
| probable, not nearly certain--60%. It'd have to be 10%/day
| (not a remote chance, but highly improbable) to be nearly
| certain (96%) over 30 days.
| photochemsyn wrote:
| This problem crops up everywhere, especially when it's a
| consequential claim. Eg when the US Department of Energy says
| with 'low confidence' that the Sars-COV2 outbreak and pandemic
| was 'most likely' was the result of a laboratory leak, what
| number does that translate to on the certainty scale?
|
| Also, what likelihood can we assign to claims that the virus was
| deliberately modified at the furin cleavage site as part of a
| gain-of-function research program aimed at assessing the risks of
| species-jumping behavior in bat coronaviruses? This is a separate
| question from the lab escape issue, which dould have involved
| either a collected wild-type virus or one that had been
| experimentally modified.
|
| Perhaps experts in the field 'misinterpreted the evidence' back
| in the early months of the pandemic, much as happened with the
| CIA and its 'intelligence on Iraq'?
|
| https://interestingengineering.com/health/us-doe-says-covid-...
| nightpool wrote:
| I highly recommend that you read through
| https://www.astralcodexten.com/p/practically-a-book-review-r...
| and watch the underlying debate (starting here
| https://www.youtube.com/watch?v=Y1vaooTKHCM), it does a really
| good job of laying out the arguments for and against lab leak
| in a very thorough and evidence-based way like you're asking
| for here.
| photochemsyn wrote:
| "Viral" by Alina Chan and Matt Ridley is worth reading. But I
| don't think there's much doubt now that Sars-CoV2 was the
| result of reckless gain-of-function research conducted
| jointly between China's Wuhan Institute of Virology,
| America's Baric Lab in North Carolina, and facilitated by
| funding through EcoHealth Alliance, the NIH and the NIAID.
| Whoopsie.
| nightpool wrote:
| There's a lot of doubt, actually. Peter responds to this
| possibility in a lot of detail in the debate I linked:
| Even if WIV did try to create COVID, they couldn't have. As
| Yuri said, COVID looks like BANAL-52 plus a furin cleavage
| site. But WIV didn't have BANAL-52. It wasn't discovered
| until after the COVID pandemic started, when scientists
| scoured the area for potential COVID relatives. WIV had a
| more distant COVID relative, RATG-13. But you can't create
| COVID from RATG-13; they're too different. You would need
| BANAL-52, or some as-yet-undiscovered extremely close
| relative. WIV had neither. Are we sure they
| had neither? Yes. Remember, WIV's whole job was looking for
| new coronaviruses. They published lists of which ones they
| had found pretty regularly. They published their last list
| in mid-2019, just a few months before the pandemic.
| Although lab leak proponents claimed these lists showed
| weird discrepancies, this was just their inability to keep
| names consistent, and all the lists showed basically the
| same viruses (plus a few extra on the later ones, as they
| kept discovering more). The lists didn't include BANAL-52
| or any other suitable COVID relatives - only RATG-13, which
| isn't close enough to work. Could they have
| been keeping their discovery of BANAL-52 secret? No. Pre-
| pandemic, there was nothing interesting about it; our
| understanding of virology wasn't good enough to point this
| out as a potential pandemic candidate. WIV did its gain-of-
| function research openly and proudly (before the pandemic,
| gain-of-function wasn't as unpopular as it is now) so it's
| not like they wanted to keep it secret because they might
| gain-of-function it later. Their lists very clearly showed
| they had no virus they could create COVID from, and they
| had no reason to hide it if they did. COVID's
| furin cleavage site is admittedly unusual. But it's unusual
| in a way that looks natural rather than man-made. Labs
| don't usually add furin cleavage sites through nucleotide
| insertions (they usually mutate what's already there). On
| the other hand, viruses get weird insertions of 12+
| nucleotides in nature. For example, HKU1 is another
| emergent Chinese coronavirus that caused a small outbreak
| of pneumonia in 2004. It had a 15 nucleotide insertion
| right next to its furin cleavage site. Later strains of
| COVID got further 12 - 15 nucleotide insertions. Plenty of
| flus have 12 to 15 nucleotide insertions compared to other
| earlier flu strains.
|
| .... COVID's furin cleavage site is a
| mess. When humans are inserting furin cleavage sites into
| viruses for gain-of-function, the standard practice is
| RRKR, a very nice and simple furin cleavage site which
| works well. COVID uses PRRAR, a bizarre furin cleavage site
| which no human has ever used before, and which virologists
| expected to work poorly. They later found that an adjacent
| part of COVID's genome twisted the protein in an unusual
| way that allowed PRRAR to be a viable furin cleavage site,
| but this discovery took a lot of computer power, and was
| only made after COVID became important. The Wuhan
| virologists supposedly doing gain-of-function research on
| COVID shouldn't have known this would work. Why didn't they
| just use the standard RRKR site, which would have worked
| better? Everyone thinks it works better! Even the virus
| eventually decided it worked better - sometime during the
| course of the pandemic, it mutated away from its weird
| PRRAR furin cleavage site towards a more normal form.
| COVID is hard to culture. If you culture it in most
| standard media or animals, it will quickly develop
| characteristic mutations. But the original Wuhan strains
| didn't have these mutations. The only ways to culture it
| without mutations are in human airway cells, or
| (apparently) in live raccoon-dogs. Getting human airway
| cells requires a donor (ie someone who donates their body
| to science), and Wuhan had never done this before (it was
| one of the technologies only used at the superior North
| Carolina site).
| photochemsyn wrote:
| It's equally likely that the Wuhan Institute of Virology
| was testing constructs created in the Baric Lab in their
| bat and mice models, and this was initiated during the
| 2014-2017 ban on gain-of-function research in the USA
| that Fauci vocally opposed.
|
| The reality here is that there are thousands of mammalian
| viruses that don't infect humans that could be modified
| to infect humans via specific modifications of their
| target mammalian cell-surface receptor proteins, as was
| done in this specific case of a bat coronavirus modified
| at its furin cleavage site to make it human-targetable.
| Any modern advanced undergrad student in molecular
| biology could explain this to you, if you bothered to
| listen.
|
| So first, we need an acknowledgement of Covid that vastly
| embarrasses China and the USA, and second we need a
| global treaty banning this generation of novel human
| pathogens from wild mammalian viral types... I guess I
| won't hold my breath.
| fc417fc802 wrote:
| > there are thousands of mammalian viruses that don't
| infect humans that could be modified to infect humans via
| specific modifications of their target mammalian cell-
| surface receptor proteins
|
| Are you claiming that's what happened here? What virus do
| you propose was modified in such a manner? Where was it
| sourced from? Why was it not on the published lists of
| discovered viruses?
|
| > as was done in this specific case of a bat coronavirus
| modified at its furin cleavage site to make it human-
| targetable
|
| Did you even read the comment you're responding to? It
| details why the furin cleavage site does not resemble
| something that you would expect humans to have produced.
| dejobaan wrote:
| That was a good read (and short, with a cool graph--I want to
| know who tagged "Almost No Chance" as 95% likely; a would-be
| Pratchett fan, perhaps). In biz, that's part of why I like to
| separate out goals ("we'll focus on growing traffic") and
| concrete objectives ("25% audience growth between now and June
| 1st").
| patrickmay wrote:
| But is it EXACTLY a million to one chance?
| forrestthewoods wrote:
| I hate "one in a million" because its meaning depends on how
| many times you're rolling the die!
|
| I'll never forgot old World of Warcraft discussions about
| crit probability. If a particular sequence is "one in a
| million" and there are 10 million players and each player
| encounters hundreds or thousands of sequences per day then
| "one in a million" is pretty effing common!
| gpcz wrote:
| In functional safety, probabilities are usually clamped to
| an hour of use.
| JadeNB wrote:
| > I hate "one in a million" because its meaning depends on
| how many times you're rolling the die!
|
| I'd argue that it doesn't depend on that at all. That is,
| its _meaning_ is the same whether you 're performing the
| trial once, a million times, ten million times, or
| whatever. It's rather whether the _implication_ is "the
| possibility may be disregarded" or "this should be expected
| to happen occasionally" that depends on how many times
| you're performing the trial.
| forrestthewoods wrote:
| I accept your terminology as more precise.
| pmontra wrote:
| One in a million is more than rolling 4 doubles in a row in
| backgammon (it's played with two 6 sided dice.) So if a
| backgammon app or server starts having about 10 thousands
| players it's not uncommon that every single month (or day)
| there is such a sequence. Some players will eventually
| write in a review or in a support forum that the server,
| the bot, the app cheats against them because of the
| impossible odds of what just happened. The support staff
| have to explain the math with dubious results, which is
| ironic because every single decision in backgammon should
| be made with probabilities in mind.
| ninalanyon wrote:
| Sounds like a quote from pTerry's Guards! Guards!
|
| Sergeant Colon adjusted his armor haughtily.
|
| "When you really need them the most," he said, "million-to-
| one chances always crop up. Well-known fact."
| ModernMech wrote:
| My feeling is it's a measure of the number of people who read
| the question wrong.
| chaps wrote:
| The City of Chicago's lawyers went the opposite direction in
| response to @tpacek's affidavit that the release of table/column
| names would have "marginal value" to an attacker. The city
| latched onto that to get a trial that eventually went to the IL
| Supreme Court and lost. [I]n my affidavit, I
| wrote that SQL schemas would provide "only marginal value" to an
| attacker. Big mistake. Chicago jumped on those words and said
| "see, you yourself agree that a schema is of some value to an
| attacker." Of course, I don't really believe that; "only marginal
| value" is just self-important message-board hedging. I also
| claimed on the stand that "only an incompetently built
| application" could be attacked with nothing but it's schema. Even
| I don't know what I meant by that.
|
| His post: https://sockpuppet.org/blog/2025/02/09/fixing-illinois-
| foia/ My post: https://mchap.io/losing-a-5yr-long-illinois-foia-
| lawsuit-for...
| snitty wrote:
| >The City of Chicago's lawyers went the opposite direction
|
| Not really.
|
| >I wrote that SQL schemas would provide "only marginal value"
| to an attacker. Big mistake. Chicago jumped on those words and
| said "see, you yourself agree that a schema is of some value to
| an attacker."
|
| The City of Chicago's argument was that something of ANY value,
| no matter how insignificant, would help an attacker exploit
| their system, and was therefore possible to keep secret under
| the FOIA law.
| fc417fc802 wrote:
| Such a literal interpretation isn't reasonable. There are all
| sorts of patterns that can be indirectly leaked through
| supposedly unrelated data. Yet FOIA exists and is obviously
| intended to be useful.
|
| So obviously there must be some threshold for the value to an
| attacker. He attempted to communicate that schemas are
| clearly below such a threshold and they used his wording to
| attempt to argue the opposite.
| mcphage wrote:
| > The City of Chicago's argument was that something of ANY
| value, no matter how insignificant, would help an attacker
| exploit their system, and was therefore possible to keep
| secret under the FOIA law.
|
| I'm glad that argument lost, since it totally subverts the
| purpose and intention of the FOIA. Any piece of information
| could be of value to _some_ attacker, but that doesn't
| outweigh the need for transparency.
| numpad0 wrote:
| > "only marginal value" to an attacker
|
| > "see, you yourself agree that a schema is of some value to
| an attacker."
|
| IANAL, it appears justice systems universally interpret this
| type of "technically yes if that makes you happy but honestly
| unlikely" statements as "yes with technical bonus", not a "no
| with extra steps" at all, and it has to be shortened as just
| "unlikely from my professional perspective" or something
| lawyer approved for intended effect. Courts are weird.
| tptacek wrote:
| To be clear: I think it was dumb of me to have written
| those hedges in my testimony, but they didn't really impact
| the case.
| chaps wrote:
| Yes really. Our argument, upheld by a judge, was that there
| was no value to an attacker. Their point stands legally, but
| nothing else.
|
| Despite all that, Chicago still pushes back aggressively.
| Here's a fun one from a recent denial letter they sent for
| data within the same database: "When DOF
| referred to reviewing over 300 variable CANVAS pages, these
| are not analog sequential book style pages of data. Instead,
| they are 300 different webpages with unique file layouts for
| which there is no designated first page."
|
| This is after I requested every field reflected in within the
| 300 different pages because it would be unduly burdensome to
| go through. I'm waiting for the city's response for the _TOP_
| page rather than the _FIRST_ page. It 's asinine that we have
| to do this in order to understand how these systems can
| blindly ruin the lives of many.
|
| They also argued the same 7(1)(g) exemption despite me being
| explicit about not wanting the column names. Effectively
| turning their argument into them saying that the release of
| information within a database, fullstop, is exempt because it
| could be used to figure out what data exists within a
| database. That's against the spirit of IL FOIA, which
| includes this incredibly direct statutory language:
| Sec. 1.2. Presumption. All records in the custody or
| possession of a public body are presumed to be open to
| inspection or copying. Any public body that asserts that a
| record is exempt from disclosure has the burden of proving by
| clear and convincing evidence that it is exempt.
|
| https://www.documentcloud.org/documents/25930500-foia-
| burden...
|
| https://www.documentcloud.org/documents/25930501-foia-
| burden...
| tptacek wrote:
| Upheld by several judges, in fact. :)
| tptacek wrote:
| You can just read the posts before trying to rebut the
| plaintiff in the case. The City of Chicago argued a bunch of
| stuff, but what matters is what the judges decided. Chicago's
| "no matter how insignificant" argument failed in Chancery
| Court and wasn't revived either in Appeals Court or at the
| Supreme Court.
|
| Ultimately, we lost because the Illinois Supreme Court
| interpreted the statute such that "file layouts" were _per
| se_ exempt, regardless of how dangerous they were(n 't), and
| then decided SQL schemas were "file layouts".
|
| (SQL schemas are basically the opposite of file layouts, but
| whatever).
| xnorswap wrote:
| You shut down someone disagreeing because:
|
| > [...] what matters is what the judges decided
|
| But then say
|
| > SQL schemas are basically the opposite of file layouts
|
| Which is you disagreeing with what a judge has decided?
|
| It seems hypocritical to shut-down someone arguing with one
| aspect of the case on that basis, only to end with your own
| disagreement with a judge's decision.
| tptacek wrote:
| No, I think you're mistaken. That the case didn't turn on
| how marginal a security risk was isn't a matter of
| opinion. That a SQL schema isn't a file layout is
| (though: there's clearly a right answer to that: mine).
| jMyles wrote:
| > Since then, some governments have tried to clean up the
| language of probability. After the Iraq War--which was influenced
| by misinterpreted intelligence
|
| While I laud the gracious application of Hanlon's Razor here, I
| also think that, for at least some actors, the imprecision was
| the feature they needed, rather than the bug they mistakenly
| implemented.
| christiangenco wrote:
| I've had the same sort of difficulty with phrases like "most" or
| "almost all" or "hardly any"--I crave for these to map to
| unambiguous numbers like the probability yardstick referenced in
| this article.
|
| I spun up a quick survey[1] that I sent out to friends and family
| to try to get some numbers on these sorts of phrases. Results so
| far are inconclusive.
|
| 1. https://www.vaguequantifiers.com/
| jbaber wrote:
| "Almost all" in math can mean "except at every integer or
| fraction" :)
| layer8 wrote:
| The semantics are almost always reasonable:
| https://en.wikipedia.org/wiki/Almost_all
| tejtm wrote:
| I would expect almost NO numbers are rational (integer or
| fraction) with an infinite number of Reals between each.
| JadeNB wrote:
| > I would expect almost NO numbers are rational (integer or
| fraction) with an infinite number of Reals between each.
|
| You're right (technically correct, which is the best etc.)!
| That is why "almost all" can mean everything _except_
| rational numbers.
| noqc wrote:
| in between any two real numbers, there is a rational
| number, and vice versa.
| concordDance wrote:
| And yet somehow there are infinity times more reals than
| rationals...
|
| Very hard to get your head around!
| noqc wrote:
| An fun, immediate, horrifying, consequence.
|
| If I remove n elements from R, the remainder has n+1
| connected components.
|
| The complement of Z in R has |Z| connected components.
|
| The complement of Q in R has |R| connected components.
| JadeNB wrote:
| > "Almost all" in math can mean "except at every integer or
| fraction" :)
|
| I am a mathematician, but, even so, I think that this is one
| of those instances where we have to admit that we have
| mangled everyday terminology when appropriating it, and so
| non-measure theoretic users should just ignore our
| definition. (Similarly with "group," where, at the risk of
| sounding tongue-in-cheek because it's so obvious, if I were
| trying to analyze how people usually understand its everyday
| meaning I wouldn't include the requirement that every element
| have an inverse.)
| dullcrisp wrote:
| Sure but that's because 100% of real numbers, by any standard
| measure, aren't integers or fractions. It bothers me if it's
| used to mean 95% of something though.
| SAI_Peregrinus wrote:
| "Almost all" is an interesting one, because it has family of
| mathematical definitions in addition to any informal
| definitions. If X is a set, "almost all elements of X" means
| "all elements of X except those in a negligible subset of X",
| where "negligible" depends on context but is well-defined.
|
| If there's a finite subset of an infinite set, almost all
| members of the infinite set are not in the finite set. E.g.
| Almost all integers are not 5: the set of integers equal to
| five is finite and the set of integers not equal to five is
| countably infinite.
|
| Likewise for two infinite sets of different size: Almost all
| real numbers are not integers.
|
| Etc.
| mannykannot wrote:
| The more precisely they are defined, the less frequently will
| you see them used correctly.
| SoftTalker wrote:
| I have a habit of saying "almost definitely" which I have tried
| to break but I still fall back to it occasionally. And I know
| several people who will say something is "definitely possible" or
| "certainly a possibility" or something along those lines. It's
| all insecure language we use to avoid making a statement that
| might turn out to be wrong.
| rekenaut wrote:
| I often say "definitely possible" when I am not sure what the
| chance of something happening is but I ought to acknowledge
| that it is possible. It is definitely possible that I should
| choose better language to communicate this.
| smitty1e wrote:
| When they won't quit asking, I'm "willing to commit to a
| definite maybe".
| hunter2_ wrote:
| "Rare" versus "common" is an interesting one. They sound like
| antonyms, but I don't think the typical probabilities are really
| symmetrical. Maybe something like 0%-10% for rare (although some
| sources say 5%) and something like 40%-100% for common.
| konstantinua00 wrote:
| "common" has such a large spread because meaning behind it is
| sort of "at least one in each sample", where that sample can be
| anything (graspable)
|
| if you're a teacher and one student per class does the same
| thing - it's common. Even though it's only 1/25 or 1/30 of all
| students
| Macha wrote:
| Maybe it's my amount of video games played in childhood that
| influenced that, but common and rare are just two points on a
| spectrum (with at least "uncommon" in between)
| senderista wrote:
| I was so frustrated when I tried to get doctors to quantify their
| assessment of risk for a surgery my sister was about to undergo.
| They simply wouldn't give me a number, not even "better or worse
| than even odds". Finally an anesthesiologist privately told me
| she thought my sister had maybe a one-third chance of dying on
| the table and that was enough for me. I'm not sure how much fear
| of liability had to do with this reluctance, or if it was just a
| general aversion to discussing risk in quantitative terms (which
| isn't that hard, gamblers do it all the time!).
| chychiu wrote:
| Doctor here
|
| 1. It's generally difficult to quantify such risks in any
| meaningful manner
|
| 2. Provision of any number adds liability, and puts you in a
| damned-if-does, damned-if-it-doesn't-work-out situation
|
| 3. The operating surgeon is not the best to quantify these
| risks - the surgeon owns the operation, and the
| anaesthesiologist owns the patient / theatre
|
| 4. Gamblers quantify risk because they make money from accurate
| assessment of risk. Doctors are in no way incentivised to do so
|
| 5. The returned chance of 1/3 probably had an error margin of
| +/-33% itself
| fc417fc802 wrote:
| > It's generally difficult to quantify such risks in any
| meaningful manner
|
| According to the literature 33 out of 100 patients who
| underwent this operation in the US within the past 10 years
| died. 90% of those had complicating factors. You [ do / do
| not ] have such a factor.
|
| Who knows if any given layman will appreciate the particular
| quantification you provide but I'm fairly certain that data
| exists for the vast majority of serious procedures at this
| point.
|
| I've actually had this exact issue with the veterinarian.
| I've worked in biomed. I pulled the literature for the
| condition. I had lots of different numbers but I knew that I
| didn't have the full picture. I'm trying to quantify the
| possible outcomes between different options being presented
| to me. When I asked the specialist, who handles multiple such
| cases every day, I got back (approximately) "oh I couldn't
| say" and "it varies". The latter is obviously true but the
| entire attitude is just uncooperative bullshit.
|
| > puts you in a damned-if-does, damned-if-it-doesn't-work-out
| situation
|
| Not really. Don't get me wrong, I understand that a litigious
| person could use just about anything to go after you and so I
| appreciate that it might be sensible to simply refuse to
| answer. But from an academic standpoint the future outcome of
| a single sample does not change the rigor of your risk
| assessment.
|
| > Doctors are in no way incentivised to do so
|
| Don't they use quantifications of risk to determine treatment
| plans to at least some extent? What's the alternative?
| Blindly following a flowchart? (Honest question.)
|
| > The returned chance of 1/3 probably had an error margin of
| +/-33% itself
|
| What do you mean by this? Surely there's some error margin on
| the assessment itself but I don't see how any of us
| commenting could have any idea what it might have been.
| munificent wrote:
| _> According to the literature 33 out of 100 patients who
| underwent this operation in the US within the past 10 years
| died. 90% of those had complicating factors. You [ do / do
| not ] have such a factor._
|
| _Everyone_ has complicating factors. Age, gender,
| ethnicity, obesity, comorbidities, activity level, current
| infection status, health history, etc. Then you have to
| factor in the doctor 's own previous performance
| statistics, plus the statistics of the anaesthesiologist,
| nursing staff, the hospital itself (how often do patients
| get MRSA, candidiasis, etc.?).
|
| And, of course, the more factors you take into account, the
| fewer relevant cases you have in the literature to rely on.
| If the patient is a woman, how do you correctly weight data
| from male patients that had the surgery? What are the error
| bars on your weighting process?
|
| It would take an actuary to chew through all the literature
| and get a maximally accurate estimate based on the specific
| data that is known for that patient at that point in time.
| chipsrafferty wrote:
| Don't they use quantifications of risk to determine
| treatment plans to at least some extent?
| fiddlerwoaroof wrote:
| I doubt doctors do: my guess would be most doctors follow
| a list of best practices devised by people like
| malpractice actuaries and by their sense of the outcomes
| from experience.
| fc417fc802 wrote:
| No one said anything about a maximally accurate estimate.
| This is exactly the sort of obtuse attitude I'm objecting
| to.
|
| By complicating factors I was referring to things that
| are known to have a notable impact on the outcome of this
| specific procedure. This is just summarizing what's
| known. It explicitly does not take into account the
| performance of any particular professional, team, or
| site.
|
| Something like MRSA is entirely separate. "The survival
| rate is 98 out of 100, but in this region of the country
| people recovering from this sort of thing have been
| exhibiting a 10% risk of MRSA. Unfortunately our facility
| is no exception to that."
|
| If the recipients of a procedure are predominately female
| and the patient is a male then you simply indicate that
| to them. "The historical rate is X out of Y, but you're a
| bit unusual in that only 10% of past recipients are men.
| I'm afraid I don't know what the implications of that
| fact might be."
|
| You provide the known facts and make clear what you don't
| know. No weasel words - if you don't know something then
| admit that you don't know it but don't use that as an
| excuse to hide what you _do_ know. It 's utterly
| unhelpful.
| ChadNauseam wrote:
| this is part of the mindset had by doctors that makes
| some people want to "do their own research" rather than
| trust their physician. A medical intervention has to have
| positive expected value for it to be a good idea, and
| figuring out the expected value has to involve some
| quantification of risks. If doctors don't want to do that
| because they could get sued if they don't give a
| maximally accurate estimate and producing a maximally
| correct estimate would be too much work, then fine, it's
| a free country and I don't want to make doctors do
| anything they don't feel like doing, but they are
| creating a situation where parents who want to figure out
| if something is a good idea have no choice but to start
| googling things themselves.
|
| I've undergone some surgeries that were not without risks
| and every time, i've been stonewalled by doctors when
| asking for basic information like "in your personal
| practice, what is the success rate for this surgery?".
| Always something like "Oh, everyone is different, so
| there's no way to give any estimates." The only options
| are, either they have some estimate they think is
| accurate enough that they're comfortable recommending the
| surgery but they won't tell me (in which case they're
| denying me useful information for their own benefit), or
| they have no idea and are recommending the surgery for
| some other reason (a very concerning possibility lol).
| Either way, it instantly makes our relationship
| adversarial to some extent, and means I need to do my own
| research if I want to be able to make an informed
| decision.
| Jach wrote:
| Not a lawyer but I do wonder if refusal to provide any number
| also adds liability, especially if it can be demonstrated to
| a court later that a reasonable estimate was known or was
| trivial to look up, and the deciding party would not have
| gone through with the action that ended in harm if they had
| been provided said number. I'm also not seeing how giving a
| number and then the procedure working out results in
| increased risk, perhaps you can expand on that? Like, where's
| the standing for a lawsuit if everything turned out fine but
| in one case you said the base rate number for a knee
| replacement surgery was around 1/1000 for death at the
| hospital and 1/250 for all-cause death within 90 days, but in
| another case you refused to quantify?
| garrickvanburen wrote:
| I would rather not have a surgeon considering failure rates
| ahead of any operation they're about to conduct.
| kmoser wrote:
| On the off chance you're not being facetious: why? Isn't it
| part of their job description to weigh the ups and downs of
| any operation before conducting it? I'd imagine failure to
| do so would open them to liability.
| garrickvanburen wrote:
| There are 2 parts:
|
| 1. Presumably, the surgeon has determined that this
| specific intervention is the best possible intervention
| of all the possible ones (fewest downsides, best outcome,
| etc). There are always alternatives - including #wontfix.
|
| 2. Once this decision has been made, I don't want them
| second guessing, I want them 100% confident in the
| decision and their abilities. If there's any lingering
| doubt - then return to step 1 and re-evaluate.
| ekianjo wrote:
| > It's generally difficult to quantify such risks in any
| meaningful manner
|
| It's not for lack of data, that's for sure...
| erikerikson wrote:
| Thanks for sharing the realities you experience. The rest of
| this is picayuni.
|
| > Doctors are in no way incentivised to do so
|
| Personal pride, care for patient, and avoiding the mess of a
| bad outcome seem like powerful incentives. That said, I
| assume you mean they are not given explicit bonuses for good
| outcomes (the best trend to attract business and the highest
| salaries).
| ninalanyon wrote:
| In Norway a pregnant woman over forty is offered genetic
| counselling because of the risk of Downs syndrome. These
| risks are definitely quantifiable and no liability is
| generated by providing them. The counsellor (a doctor)
| explains the risks and the syndrome and apart from this
| appointment is not otherwise involved.
|
| This could surely be done for other situations, especially
| surgical procedures as the statistics should be collected and
| associated not only with the procedure but also the hospital
| and surgeon.
| lwo32k wrote:
| Gamblers are a poor example. Their decisions hardly effect
| anyone else or institutions or nations.
|
| Increase the cost of the fallout of a decision (your
| relationships, your bosses job, your orgs existence, economy,
| national security etc etc) and the real fun starts.
|
| People no matter what they say about other people's risk
| avoidance, all start behaving the same way as the cost
| increases.
|
| This is why we end up with Trump like characters up the
| hierarchy, every where you look, cause no one capable of
| appreciating the odds, wants to be sitting in those chairs and
| being held responsible for all kinds of things outside their
| control.
|
| Its also the reason why we get elaborate Signalling
| (costumes/rituals/pageantry/ribbons and medals/imposing
| buildings/PR/Marketing etc) to shift focus away from
| quantifying anything. See Theory of the Leisure Class. Society
| hasn't found better ways to keep Groups together while handling
| complexity the group is incapable of handling. Even small
| groups will unravel if there is too much focus on low odds of a
| solution.
| 2rsf wrote:
| > she thought my sister had maybe a one-third chance of dying
| on the table and that was enough for me
|
| But what was the alternative? I understand that you didn't get
| an answer, but the alternative of not operating could have been
| worst
| 7402 wrote:
| I think a lot of people don't understand statistics, which may
| make it hard for doctors to choose how to communicate things,
| even if they do have important knowledge that could be helpful.
|
| I once asked a doctor how long a relative might have to stay in
| intensive care:
|
| A: Oh, I couldn't possibly say.
|
| Q: Do you think he might be home in 3 or 4 days?
|
| A: Oh, no, not that soon.
|
| Q: So it might even be as long at 3 weeks?
|
| A: I highly doubt it would be that long.
|
| Q: So a reasonable estimate might be 1-2 weeks?
|
| A: Oh, I couldn't possibly say.
|
| I started the conversation having no idea _whatsoever_ how long
| it would be, but I ended up with a good feel for a time
| estimate along with error bars.
| ninalanyon wrote:
| > ended up with a good feel for a time estimate along with
| error bars.
|
| You might have felt that but my impression is that the doctor
| in question was mostly making up something on the spot. I
| would guess that the doctor is simply saying that they have
| never encountered anyone in this situation leaving intensive
| care within four days and similarly no one who survived
| needed longer than three weeks. The last answer suggests that
| they have no actual statistics at all.
| a3w wrote:
| How was this not on lesswrong.com, they are all about ]0..1[
| Macha wrote:
| Who are the people that have a small bump of believing "better
| than even" is 10-20%? Why?
| tempestn wrote:
| You also see the opposite bump for most of the negative
| assessments. My assumption is that they're likely reading the
| question backwards. ie. "how unlikely" vs "how likely" or
| similar.
| vpribish wrote:
| maybe something like dyslexia but for semantics. I did some
| searching and couldn't find a term for this.
| didgetmaster wrote:
| "The odds are more like a million to one!"
|
| "So...you're telling me there is a chance!"
| bmurray7jhu wrote:
| Text of NIE 29-51 "Probability of an Invasion of Yugoslavia in
| 1951"
|
| Partial HTML:
| https://history.state.gov/historicaldocuments/frus1951v04p2/...
|
| Full text PDF scan: https://www.cia.gov/readingroom/docs/CIA-
| RDP79R01012A0007000...
| tempestn wrote:
| Interesting. Two things that jumped out to me were 1) why do the
| regions of the standardization line not overlap or at least meet?
| And 2) What's up with the small but clear minority of people who
| took all the 'unlikely' phrasings to mean somewhere in the realm
| of 90 to 100%? My guess would be they're misreading the question
| and that is their estimate of _unlikelihood_?
| pictureofabear wrote:
| Because many people cannot or will not accept ambiguity.
| Charitably, I suppose this comes from a desire to logically
| deduce risk by multiply the severity of the consequences by the
| chance that something will happen. Uncharitably, it gives
| decisionmakers a scapegoat should they need one.
| chipsrafferty wrote:
| Why not just actually list the number you have in mind so
| everyone's on the same page "we consider it a serious possibility
| - about 60% - that bla bla bla"
| tasuki wrote:
| Because then it doesn't happen and (dumb) people will say "see
| you were wrong".
| andrewflnr wrote:
| Almost no one making these statements has an actual number in
| mind, or they _would_ just say it. Probably not even in
| intelligence, definitely not in popular usage.
| kmoser wrote:
| But if there's a standardized chart that maps the phrase to a
| number, certainly you'd expect whoever is writing the phrase
| to know what number it maps to. For the sake of simplicity,
| then, why not just use the number to avoid all doubt?
| andrewflnr wrote:
| The biggest reason is probably just that your boss told you
| to. But also downthread we were talking about the illusion
| of quantitative thought that comes from using specific
| numbers, which would be a slightly better reason to use
| words instead.
| qmr wrote:
| I don't think there is a standardized chart. Rather the
| chart shows people's subjective mental mapping of the
| description to a probability.
| andrewflnr wrote:
| The chart at the bottom of the article is explicitly a
| standard adopted by UK intelligence. (ed: well, proposed
| for adoption, it's not clear from the article how far it
| actually got.)
| dragonwriter wrote:
| > But if there's a standardized chart that maps the phrase
| to a number,
|
| The chart doesn't map each phrase to _a_ number, in fact
| given that the colored areas extend beyond the marked lines
| and fade, it doesn 't even map each to an unambiguous,
| bounded _range_ of numbers.
| qznc wrote:
| Using actual numbers requires a little bit of training but
| not much. I believe many would benefit from doing it.
| suddenlybananas wrote:
| Because that's not how the mind works. We don't have conscious
| access to our internal credence of some event in probabilities
| (unclear if we even evaluate probabilities internally at all).
| nickm12 wrote:
| Anyone else find the standard "probability yardstick" very
| misleading on the "unlikely" side? I know the whole point of the
| article is that English speakers can interpret these phrases
| differently, but calling a 1-in-3 chance "unlikely" seems off. I
| would shift that whole side down--30% as "a possibility", 10% as
| "unlikely", 5% as "highly unlikely".
| irjustin wrote:
| You're right, whatever they pick will be wrong, but that's
| "missing the forest for the tree"
|
| The goal is to remove uncertainty in the language when
| documenting/discussing situations for the state.
|
| It doesn't matter that it's wrong colloquially or "feels
| wrong". It's that when you're reading or talking about a
| subject with the government, you need to use a specific
| definition (and thusly change your mental model because
| everyone is doing as such) so that no one gets misunderstood.
|
| Would it be better to always use raw numbers? Honestly I don't
| know.
| rendaw wrote:
| Or new words unrelated to vernacular? Like "This is a cat-3
| risk". When repurposing words in common usage they're always
| going to be fighting against intuition and triggering
| confusion because of it.
| fc417fc802 wrote:
| I was thinking this while reading it as well. Why go to all
| this trouble when we know in advance there will still be
| issues? Standardize on not using casual wording for
| quantified risks and instead provide the actual numbers.
| Something like "40 (out of 100) error 10 (plus or minus)".
| No more ambiguity. My offhand example even abbreviates
| nicely as scientific notation ie 40e10. I'm sure someone
| who actually spent some time on this could come up with
| something better.
| Zanni wrote:
| I don't understand the point of standardizing language around
| specific numerical ranges when they could _just use numbers_.
| inejge wrote:
| They would have to use _ranges_ , though, and I think that the
| non-numeric phrases flow better, which should aid
| comprehension.
| voidmain wrote:
| The bonkers thing is that all of the visualizations show
| basically all of the terms pretty close to the middle on a log
| odds scale. If "highly unlikely" means 10-20%, how do you express
| 1 in 10,000??
| immibis wrote:
| Realistically? That's within the margin of error of "completely
| impossible"
| stefs wrote:
| For uncommon values you could still use exact language, i.e.
| just say "1 in 10,000".
| immibis wrote:
| Gotta love how "almost no chance" includes probabilities less
| than zero.
| ta20240528 wrote:
| The actual problem is its not possible to assign a percentage
| probability - or even a vague 'highly likely'- to a once-off
| event.
|
| As long as the prediction is not 0% or 100%, its impossible to be
| wrong.
|
| So, without hesitation, I predict with 99,999999% certainty that
| an asteroid will hit the Eiffel tower before the hour.
| mrkramer wrote:
| Yugoslav communists were pawns of Moscow from the beginning and
| all the way until the end of WW2. After WW2, they grew some balls
| and put the interests of degenerate Yugoslavian state before the
| interests of the communist international, that's what almost cost
| them their state. And also they were traitors of their peoples
| because during WW2 they didn't support national movements but
| wanted cosmopolitan socialistic Yugoslavia with the help of
| Soviet Union.
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