This paper reviews the relationship between scientific evidence, uncertainty, risk and regulation. Risk has many different meanings. Furthermore, if risk is defined as the likelihood of an event happening multiplied by its impact, subjective perceptions of risk often diverge from the objective assessment. Scientific evidence may be ambiguous. Scientific experts are called upon to assess risks, but there is often uncertainty in their assessment, or disagreement about the magnitude of the risk. The translation of risk assessments into policy is a political judgement that includes consideration of the acceptability of the risk and the costs and benefits of legislation to reduce the risk. These general points are illustrated with reference to three examples: regulation of risk from pesticides, control of bovine tuberculosis and pricing of alcohol as a means to discourage excessive drinking.
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http://dx.doi.org/10.1098/rsta.2011.0174 | DOI Listing |
JMIR Med Inform
January 2025
Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada.
Background: While expert optometrists tend to rely on a deep understanding of the disease and intuitive pattern recognition, those with less experience may depend more on extensive data, comparisons, and external guidance. Understanding these variations is important for developing artificial intelligence (AI) systems that can effectively support optometrists with varying degrees of experience and minimize decision inconsistencies.
Objective: The main objective of this study is to identify and analyze the variations in diagnostic decision-making approaches between novice and expert optometrists.
AIDS Care
January 2025
Department of Knowledge Management, Sociedad Integral de Especialistas en Salud (SIES Salud IPS), Bogotá, Colombia.
The most significant progress in addressing the HIV/AIDS epidemic has been the development of antiretroviral therapy (ART). However, ensuring a high degree of treatment adherence is necessary to prevent resistance and disease progression. We conducted a cross-sectional study to evaluate adherence to ART through the calculation of the medication possession ratio (MPR) and to identify risk factors for suboptimal adherence in a cohort of HIV-positive patients receiving care at a Colombian healthcare institution across 16 cities.
View Article and Find Full Text PDFJAMA Cardiol
January 2025
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.
Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.
Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.
JAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
JAMA Cardiol
January 2025
Ifakara Health Institute, Ifakara Branch, Ifakara, United Republic of Tanzania.
Importance: Hypertension is the primary cardiovascular risk factor in Africa. Recently revised World Health Organization guidelines recommend starting antihypertensive dual therapy; clinical efficacy and tolerability of low-dose triple combination remain unclear.
Objectives: To compare the effect of 3 treatment strategies on blood pressure control among persons with untreated hypertension in Africa.
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