Health risk appraisal: the estimation of risk.

Abstract

describes a person's chances of becoming ill or dying from selected diseases. The procedure generates a statement of probability, not a diagnosis. Identifying the variables known to influence individual risk, quantifying their effect and interaction, and constructing algorithms to estimate risk are fundamental to risk appraisal. The accurate estimation of risk presents a challenge to both research workers and clinicians. Existing risk-appraisal instruments have been reviewed elsewhere, for example, by Hettler and coauthors (1) and in a 1978 survey of health promotion conducted by the Washington [D.C.] Business Group on Health. We treat here the methodological and research issues relating to the current state and future development of risk estimation. Risk Estimation If one can accurately estimate a person's risk of (a) getting specific diseases, both physical and mental (for example, having a myocardial infarction), (b) dying from certain diseases (for example, from breast cancer), and (c) dying within a defined period (for example, within 10 years), then it is appropriate to ask of what use these estimates are. To adequately answer this question, it is essential to recognize the underlying hypotheses that require substantiation.