Often people post cost-effectiveness analyses of potential interventions, which invariably conclude that the intervention could rival GiveWell's top charities. (I'm guilty of this too!) But this happens with such frequency, and I am basically never convinced that the intervention is actually competitive with GWTC. The reason is that they are comparing ex-ante cost-effectiveness (where you make a bunch of assumptions about costs, program delivery mechanisms, etc) with GiveWell's calculated ex-post cost-effectiveness (where the intervention is already delivered, so there are much fewer assumptions).
Usually, people acknowledge that ex-ante cost-effectiveness is less reliable than ex-post cost-effectiveness. But I haven't seen any acknowledgement that this systematically overestimates cost-effectiveness, because people who are motivated to try and pursue an intervention are going to be optimistic about unknown factors. Also, many costs are "unknown unknowns" that you might only discover after implementing the project, so leaving them out underestimates costs. (Also, the planning fallacy in general.) And I haven't seen any discussion of how large the gap between these estimates could be. I think it could be orders of magnitude, just because costs are in the denominator of a benefit-cost ratio, so uncertainty in costs can have huge effects on cost-effectiveness.
One straightforward way to estimate this gap is to redo a GiveWell CEA, but assuming that you were setting up a charity to deliver that intervention for the first time. If GiveWell's ex-post estimate is X and your ex-ante estimate is K*X for the same intervention, then we would conclude that ex-ante cost-effectiveness is K times too optimistic, and deflate ex-ante estimates by a factor of K.
I might try to do this myself, but I don't have any experience with CEAs, and would welcome someone else doing it.
During the animal welfare vs global health debate week, I was very reluctant to make a post or argument in favor of global health, the cause I work in and that animates me. Here are some reflections on why, that may or may not apply to other people:
I'm deliberately focusing on emotional/psychological inhibitions as opposed to analytical doubts I have about animal welfare. I do have some analytical doubts, but I think of them as secondary to the personal relationship I have with GHD.