Making Decisions under Conditions of Extreme Uncertainty

Source: Pixabay

Harry Rutter, Miranda Wolpert and Trisha Greenhalgh are British professors in the areas of public health, mental health, and primary care health respectively.   They have written a blog post titled, "Managing Uncertainty in the COVID-19 Era."   The post appeared on the British Medical Journal website.  They offer five rules for coping with high degrees of uncertainty and making sound decisions in that context.  I think the rules are incredibly applicable in a wide array of settings, not simply in healthcare.  Here are the five rules:  

1. Most data will be flawed or incomplete. Be honest and transparent about this.
2. For some questions, certainty may never be reached. Consider carefully whether to wait for definitive evidence or act on the evidence you have.
3. Make sense of complex situations by acknowledging the complexity, admitting ignorance, exploring paradoxes and reflecting collectively.
4. Different people (and different stakeholder groups) interpret data differently. Deliberation among stakeholders may generate multifaceted solutions.
5. Pragmatic interventions, carefully observed and compared in real-world settings, can generate useful data to complement the findings of controlled trials and other forms of evidence.