EBM papers to read: The concept of risk

Every course of action or inaction in medical care can be associated with both risks and benefits which are often constrained by gaps in medical knowledge. The idea of risk generally embodies at least two distinct concepts: first, an unwanted outcome, and second, some uncertainty about the occurrence of that outcome.

The term risk thus corresponds to two terms unwanted outcome and probability.

Bogardus’ work, published in JAMA, is a must read for those interested in talking about medical risk. It highlights the importance of understanding more than just the identity of the risk. Thus the concept of risk has several fundamental dimensions, and explicit consideration of these dimensions may facilitate more appropriate discussion.

Reproduced from JAMA. 1999;281(11):1037-1041. doi:10.1001/jama.281.11.1037.

Bogardus reports that, the fifth and perhaps most important dimension of risk is its value to the patient, its subjective “badness”. Thus the ultimate determination of the relative importance of risk to the patient is a subjective decision. The first four dimensions of risk identity, permanence, timing, and probability; may help patients determine a personal value for the risk.

Take a read, it’s a great EBM paper.