Risk illiteracy creating new diseases - claim
Tuesday November 17th, 2015
Being at "high risk" of disease has become an illness in its own right, it was claimed today.
Both
doctors and patients are suffering from "risk illiteracy" -
and this stops people taking responsibility for their own health, according
to Professor Teppo Järvinen, of the Department of Orthopaedics and
Trauma, Helsinki University Hospital, Finland.
He has set out his concerns in the British Journal of Sports Medicine.
At one point, ten years ago, guidelines set the threshold for hypertensive treatment so low that almost all adult Norwegians would have been deemed at risk, he said.
New US guidelines on osteoporosis would mean 90% of women over the age of 75 receiving drug treatment - as the threshold for risk was set at a probability of 3% of suffering a hip fracture within ten years.
New cholesterol guidelines would "colonise" the entire elderly population as sick, he says.
He cites the example of a "huge increase" in prescriptions for osteoporosis when a treatment increased the probability of suffering a hip fracture from 97.9% to 98.9%. This was because the treatment was marketed as halving the risk - from 2.1% to 1.1%.
He writes: “If we assume doctors are truly more competent in making value judgments about the lives of their patients than the patients sitting in front of them, should we not have proof that doctors can do the job.
“Sadly despite medical education and clinical experience, doctors do not seem to possess the required skill."
He adds: “Despite laudable efforts to improve the communication and comprehension of both the concept of risk and the anticipated treatment benefit, risk-illiteracy of the gravest magnitude still affects both doctors and patients.
“But without accurate and common comprehension of these key aspects, there is no basis for shared decisions. And without shared decision-making, pharmacological primary intervention becomes a tyranny of eminence."
Labelling people as ‘high risk’: a tyranny of eminence? British Journal of Sports Medicine 17 November 2015 [abstract]
Tags: Europe | Fitness | Heart Health | Pharmaceuticals
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