Why evaluating risk factors might not always lead to the best medical advice

Most health-conscious people are familiar with the concept of risk factors for disease. We’re too familiar, in fact. A risk factor is like the guest that nobody invited to the party, a spoiler. Though we might feel fine now, our individual risk for (fill in the blank) tells us that our wellbeing might not last. That vague and remote prospect of a stroke or a tumour has taken on a sharply numerical precision, thanks to screening tests that expose and quantify our risk factors.

Dozens of risk calculators are in service today, covering all medical specialties and organ systems. But risk factors have acquired an unwarranted power. Doctors try to manage them as if they’re the disease itself and, as a result, patients are subjected not only to undue worry but also to the harmful side effects of preventive medications and testing.

What’s more, in medicine’s version of mission-creep, the thresholds for many risk factors have been lowered so as to encompass ever larger pools of patients. People who believed they were normal in a particular health category abruptly learn that they are not – and that they probably need treatment. That they lack symptoms is misleading. Today’s patient is declared to be in good health not because she feels well, but because her latest scan or blood work indicates no abnormalities.

Read full, original article: Risky medicine



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