Reflections on risk prediction

This Monday evening our next podcast becomes available. Dr. Gustavo Heudebert and I discuss another article about risk prediction. This topic has become a recurring theme on the Annals On Call podcast. Why is risk prediction so important? In 2019 we make many decisions about prevention and testing based on risk prediction. In addition we also estimate harms and benefits. All these predictive models have advantages and flaws. In making a decision for statin use (another upcoming episode), we have to estimate the risk of cardiovascular events, how much taking a statin will decrease that risk, and the probability and type of side effects from taking a statin. These predictions all come from mathematical modelling. Mathematical modelling is fraught with many hazards. One can apply the same modelling techniques to different databases and develop significantly different models. The episode with Dr. Rod Hayward – Improving Estimation of Cardiovascular Risk – gave a great example of how including different databases and even different time periods changes our risk prediction for cardiovascular events. In that episode, he also explained the problem of temporal trends. Cardiovascular risk has decreased over the past 30+ years. Thus, our predictions should change. He also pointed out that we never have data on all the risk factors that one would want in a model. The cardiovascular risk prediction models do not take into consideration family history, renal disease o...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs