Finding what matters

The U.S. Preventive Services Task Force is a group of scientists and physicians given the formidable responsibility of sorting through the wide array of tests available for major diseases and deciding which should be part of the national standard of care. These are weighty decisions, because in the world’s most expensive health system insurers are required to pay for those tests the group deems beneficial.1 Fine-tuning when to recommend diagnostic screenings is especially fraught, as getting these decisions wrong leads to unnecessary, costly, and painful medical interventions. Conversely getting them right can help catch disease earlier when treatment is more effective, giving patients greater quality of life.

This group’s decisions often hinge on what is known as clinical significance: if knowing something makes zero difference for a therapeutic approach or is as likely to cause harm as benefit, then it is not worth investing resources to get that data. For instance DNA tests can fall into this category, as the impact of certain genes is currently unknown. For those possessing some unusual variant, finding that out would engender agita but not much else. Read more…

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an obscure expression apparently of British military origin that suggests a degree of crudeness of analysis such that finer details are glossed over, as when someone with particularly meaty paws attempts to point out a location on a smaller map; failing to assess the exact geographical features of a particular area can lead to significant complications when battle strategies are executed; in a business context the term may suggest imprecision, lack of nuance, tact, or subtlety; can be a way to derogate a leader whose big picture perspective is too lofty to be useful when it comes to implementation; related to slice butter with an ax, which indicates a more willfully overbearing approach

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Only one shot

The magazine National Geographic was a pioneer in the use of photographs as a way of capturing and presenting the essence of a subject to new audiences. Its contributors would spread out to obscure locations equipped with an array of cameras and related equipment, carrying hundreds of rolls of film.1 When shooting was done the exposed film would be carefully transported home, developed, and reviewed in detail at editorial meetings at headquarters. Only a select few photos would make it into an article, and every month just one would merit the cover, framed by the iconic yellow border. A photographer could literally take thousands of frames to produce the dozen or two that would ultimately make it into print.

But for a 1997 cover article on Minnesota’s northern wilderness, veteran photographer Jim Brandenburg upended this entire paradigm. His concept was typical save for one critical, self-imposed constraint: he could only take one picture per day, for 90 days straight. All of them were to be printed in a complete series. This raised the stakes considerably, given the vagaries of an outdoor environment where little was controllable. There would be no do-overs, no opportunity to retake a poorly-lit or out-of-focus shot, no chance to switch lenses or fix an equipment failure, no backup if wildlife behaved unpredictably. This being the pre-digital era, there wasn’t even a way to check the outcome of a shutter press until the film was processed back in the darkroom. Read more…

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analyses or work products that are prepared but kept in reserve for intense times when additional output will be required, as in, “We don’t need to share the findings from the customer survey at tomorrow’s meeting, let’s keep some dry powder for the next quarterly business review”; more generally the term refers to a resource of some kind that is kept at the ready for immediate deployment when needed; commonly used in finance to refer to liquid reserves or assets that can be readily converted (for investments, debt payments, etc.); drawn from the former military need to manufacture sufficient quantities of gunpowder, transport it, and maintain it in firing condition wherever needed in the theater of battle; powder that became wet from rain, improper storage, etc., would no longer be suitable for use, a condition which could be discovered at inopportune moments

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Rise and shine

At the turn of the twentieth century the new category of ready-to-eat breakfast cereals was blossoming. One of the newer entrants was a product named Grape-Nuts, created by an entrepreneur named C. W. Post and still available on shelves today. It was notable then and now for containing neither grapes nor nuts, but also for being the first target of an innovation that has gone on to influence industries around the world: the coupon. Bearers of these incentives issued by Post would receive 1 cent off the price when purchasing a box.1

This is a roundabout way of providing a discount; instead of requiring shoppers to keep and produce a slip of paper at the store, why not simply reduce the price and make life easier for both buyer and seller? The answer is fairly straightforward, especially for anyone who has spent significant time hunting through junk mail or the internet in search of minor savings. Coupons are designed to identify those people who value the potential discount more than the time they spend acquiring it. The effort they demonstrate through this process means they can ultimately pay less than others who make a different calculation.

This is known as price discrimination, and it’s an effective way of sorting customers according to their ability to afford your product.2 Read more…

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this rare specimen (only two reported usages in the wild) means to convene together to agree on a plan of action; evokes the practice of a huddling sports team forming a circle, with each member placing one hand in the center, as it prepares for an important game or decides on a specific play; the leader or captain’s hand is usually the first in the stack, with all others placed on top of it one-by-one; in this manner each person signals their alignment with and commitment to the agreed approach; this phrase may be followed by the object of discussion, as in: “Let’s stack our hands around the new Middle East strategy”

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Costly signals

In 1519 explorer Hernando Cortés landed on the eastern coast of present-day Mexico with the mission of continuing the Spanish conquest of the empires covering Central America. The task was daunting given his small crew, the unfamiliar terrain, and natives who understandably weren’t so keen on being colonized. Discontent and thoughts of outright mutiny brewed among his soldiers. In response he ordered that the ships on which they arrived be scuttled, ensuring that retreat to safety would be impossible for anyone harboring second thoughts.

Now all else being equal, coming out of battle with a victory while keeping your fleet of expensive boats afloat is preferable to the alternative of contemplating how to sail back across the Gulf of Mexico once you’re done conquering. Yet this wasteful act was actually productive, because it sent the unmistakable signal to Cortés’s men that retreat would not be an option. They had to fight and win or else be destroyed. Read more…

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to assert a point of view or take decisive action at a relatively early stage, where much remains unknown but a working hypothesis must be adopted for progress to be made, as in, “I know all the options are risky, but you need to put a stake in the ground for where we invest next”; the phrase may be interjected when a deliberative process has so far yielded waffling or equivocation and a more robust, confident plan is required; derives from the former practice of claiming unsettled territory by driving wooden stakes into the ground, thus marking off the area claimed as one’s own; the one who puts his or her metaphorical stake in the ground is similarly defining a position that will then need to be managed and defended; when used as an imperative this expression can be a roundabout way of telling someone “We don’t have the facts yet, so make a guess by the deadline”

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to assess the quality of a particular idea or analysis by subjecting it to more intense scrutiny of some sort; derives from engineering, when the structural soundness or seaworthiness of a vessel is determined by applying atmospheric or liquid pressure up to its design limits, at which point poorly-designed objects can fail dramatically; in the business context a pressure test can send metaphorical shards in the direction of the unwary creator of the tested work; similar to stress test; the variant kick the tires has less serious connotations, and suggests a more cursory review

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(adjective) a word indicating that the referenced work or analysis is thorough or complete, perhaps by allusion to food that is fully prepared, as in, “You should hold off on releasing those projections until Brad has a chance to weigh in, we want them to be crisp”; usually employed in the context of preparing something for release to a broader audience or to more senior levels of the organization where greater scrutiny is expected; it is duly noted that crisp objects, while ostensibly finished, are also far more brittle and prone to shattering

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