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The base concept of trying to do the most good with your charity dollars by researching the causes you want to give to and doing the math on what will have the most impact per dollar spent, that makes sense.
The problem is when it turns into a paperclip-maximizing scenario where if mosquito nets are deemed to be the most efficient cause, all other causes are seen as 'wrong' and should be ignored. Or the extra stupid answer where the most efficient cause is developing the super AI that will someday solve infinite problems, because hey if it works it will become infinite expected value per dollar and the math says that's good even if the probability is low... all while accomplishing nothing now with no guarantee that it ever actually will work.