This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Add to My Marked Citations Google Scholar Articles by Nexøe, J. Articles by Kristiansen, I. S. PubMed Articles by Nexøe, J. Articles by Kristiansen, I. S. Social Bookmarking                   What's this?

Review Article: Critiques of the risk concept — valid or not?

The Research Unit of General Practice, University of Southern Denmark, Odense C, Denmark, jnexoe{at}health.sdu.dk

Peder Andreas Halvorsen

The Research Unit of General Practice, University of Southern Denmark, Odense C, Denmark, National Centre of Rural Medicine, Institute of Community Medicine, University of Tromsø, Norway

Ivar Sønbø Kristiansen

The Research Unit of General Practice, University of Southern Denmark, Odense C, Denmark, Institute of Health Management and Health Economics, University of Oslo, Norway

The increasing use of the risk concept in healthcare has caused concern among medical doctors, especially general practitioners (GPs). Critics have claimed that risk identification and intervention create unfounded anxiety, that the concept of risk is not useful at the individual patient level, that patients' risk concept is different from an epidemiological one, that resources are better spent elsewhere, or that commercial interests take advantage of risk information to promote sales. In this paper the authors discuss the concept of risk and address the critique. There is evidence that commercial interests promote risk interventions, that patients may misunderstand risk information, and that risk information can cause unnecessary anxiety. The authors have found no empirical data on the amount of time primary healthcare providers spend on risk interventions, and have not identified any valid arguments that risk information is not useful for the individual patient. Decision-making under uncertainty is a core element of medical practice, and GPs need to be suitably trained to inform patients such that they make good decisions when they are faced with uncertainty. The concept of risk is therefore useful for GPs, and in fact a key issue. It is concluded that risk critique should be based on sound theory and empirical data. Critics may do well in making clear distinctions between facts and value judgements.

Key Words: Risk • medical decision-making • preventive healthcare • general practice

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?