About Humans

We are not as smart as we think we are

Μedical error is estimated by the Institute of Medicine to be the third leading cause of death in the United States* (30, 5, 29).

Our failure to link decisions with best evidence is due in part to cognitive limitations [and biases] of human decision-makers, including, clinician decision-makers. Human short-term or working memory was estimated to be limited to 7 ± 2 variables in the 1950s (17). A more current estimate is 4 ± 1 constructs (18). Decision quality generally becomes degraded once this limit of four constructs is exceeded (18). The limit of four constructs seems surprising to humans, who commonly overestimate their performance (10).This is a widespread human shortcoming (9). Humans commonly overestimate their performance (9,10,11). In addition, clinicians fail to perform at desired levels, when assessing data quantitatively. For example, a clear pulmonary artery balloon occlusion pressure tracing was correctly interpreted by expert nurses and physicians only one-half of the time (12,13,14). Clinicians [fail] to consistently link their decisions to best evidence (4, 5). Cardiologists do not consistently apply evidence-based treatments for heart failure clinic patients who seem to be appropriate candidates (8). In fact, clinicians’ opinions frequently poorly reflect their actual performance.

The above expert is from a 2018 medical article that discusses how human cognitive limitations affect the U.S. health system (and cause a huge number of deaths)

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Human cognitive capabilities are significantly constrained in their functioning. What we perceive of as reality is largely an illusion constructed by our brains.(1) [...] Attention is very significant to our construction of reality because we are constantly overloaded with a vast amount of sensory information, and it is not possible to pay attention to even a significant fraction of it at any given instance. As a result, we place a huge filter on most of the sensory information that reaches us and pay attention to only what our brains see as being important. [...] The end result is a story that is largely constructed by our brain, altered based on comparison with what others believe, and subject to manipulation in order to reduce cognitive dissonance; making it conform with our other beliefs and experience. Likewise, human memory is very much flawed in its workings. Like our perception, our memory is not a passive recorder; instead, our memories are constructed entirely by our brains. In fact, they are very much conditioned and contingent upon everything that we think and our overall conception of reality. (3).

The above expert is from an open web platform to innovate new solutions to complex social, economic, technical and environmental challenge.

More information

A good (as of 2012) coverage of the subject can be found in the book "You Are Not So Smart" by David McRaney