There are several well-known choices (decisions) that a medical entrepreneur must typically make: whether to bring a therapeutic or diagnostic idea to market, whether to keep the initial idea unchanged or to pivot to a more rewarding solution, and so on. This chapter examines how medical entrepreneurs can minimize decision-making biases when evaluating, developing, and launching innovations. It contrasts non-predictive approaches such as effectuation and bricolage—based on experimentation and improvisation—with predictive approaches grounded in structured hypothesis testing. Non-predictive methods support learning, but they also expose entrepreneurs to cognitive biases like overconfidence and selective attention. The chapter suggests adopting a scientific approach to decision-making: formulating hypotheses, testing them through field evidence, and interpreting results rationally. Supported by the Stage-Gate Model, the suggested approach provides a disciplined methodology for mapping, prioritizing, and addressing high-priority decision-related problems, improving accuracy, reducing risk, and enhancing venture performance.