Talk:Risk factor (epidemiology)/Archive 1

Thanks
i dont know if it is allowed to do this, but i would like to thank the author of the article, for the derivation of the term. i had always wondered who invented the term 'risk factor' and had given up hope of ever finding out. thanks.

Cleobolus (talk) 16:49, 28 April 2010 (UTC)

Ambiguous term
The use of this term should be strongly discouraged because it is ambiguously defined and routinely misused.

The medical literature is replete with articles in which "risk factor" initially means only that the authors have found a correlation. Later in the same article, the "risk factor" definition changes to become "causal". And finally, reduction of a "risk factor" through some newly identified intervention is presented as a treatment for the original malady. The use of "association", "correlation", and, where appropriate, "causal" ought to be recommended and "risk factor" actively discouraged.

One real example involves HDL cholesterol. Although there may be some positive association (identified as a risk factor) between low levels of HDL and arterial plaque buildup, causality has never been established and, in fact, the association is not strong. Studies uniformly drift from this risk factor (association) to causality to the assumption that pharmacological elevation of HDL "ought" to reduce or stabilize plaque buildup. All this, it seems, made easier to believe because "risk factor" is ambiguously defined. — Preceding unsigned comment added by RockyBob (talk • contribs) 14:36, 1 November 2012 (UTC)
 * Hi RockyBob! If this is your personal opinion, I'm afraid we cannot do anything with it. However, if there is a discussion about the term "risk factor" in one or more reliable sources, you could summarize the discussion and add it to the article. With friendly regards,  Lova Falk     talk   19:03, 1 November 2012 (UTC)

Move discussion in progress
There is a move discussion in progress on Talk:Risk factor (disambiguation) which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 11:15, 3 November 2017 (UTC)

Risk factor vs. Determinant
This page has been flagged up on WT:MED with specific reference to the difference between the terms "Risk Factor" and "Determinant". Disclaimer - I'm not an epidemiologist or in any way an expert in these definitions. Anyway, it's hard to find clear definitions that separate out these two concepts. Here's my thoughts:

The 6the edition of the Dictionary of Epidemiology (ISBN 9780199976720) describes the two like this:


 * Determinant


 * A collective or individual Risk factor (or set of factors) that is causally related to a health condition, outcome, or other defined characteristic. The concept is probabilistic, and thus the term does not imply a deterministic philosophy of health; e.g., it does not embody genetic, environmental, or social determinisms. In human health —and, specifically, in Diseases of complex etiology— sets of determinants often act jointly in relatively complex and long-term processes. They commonly operate both at aggregate (e.g., social, regional, global) and distal levels, as well as at the individual, personal level; i.e., across macro- and micro-levels, Systemically.14, 17, 28, 158, 213, 215, 279, 302303, 304, 306 See also causality; causes in public health sciences.


 * Risk factor


 * A factor that is causally related to a change in the Risk of a relevant health process, outcome, or condition. The causal nature of the relationship is established on the basis of scientific evidence (including, naturally, evidence from epidemiological research) and Causal Inference. The causal relationship is inherently probabilistic, as it happens in many other spheres of nature and human life.101 If the relationship is noncausal the factor is just a Risk marker. Examples of types of risk factors are offered throughout this book; they may be a socioeconomic characteristic, personal behavior or lifestyle, environmental exposure, inherited characteristic, or another Trait. Risk factors for human health often have individual and social components; even when individual and social risk factors can be separated, they often interact. A Determinant that can be modified by intervention is a modifiable risk factor.

This definition seems to suggest that the two are pretty much synonymous. However, other sources seem to use Risk Factor as a term for variables relating to an individual (e.g. Diabetes as a risk factor for an individual's chance of developing ischaemic heart disease) but Determinant as a term for variables relating to a society (e.g. poverty leading to poor diet as a determinant of a population's prevalence of ischaemic heart disease). In this light some variables can be determinants or risk factors (e.g. smoking).

Others acknowledge that multiple definitions for Risk Factor exist e.g. Kindig 2007 PMCID: PMC2690307


 * Risk factor: An aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic that, on the basis of epidemiologic evidence, is known to be associated with health-related condition(s) considered important to prevent. The term risk factor is rather loosely used, with any of the following meanings: (1) An attribute or exposure that is associated with an increased probability of a specific outcome, not necessarily a causal factor. (2) An attribute or exposure that increases the probability of disease or other specified outcome, a determinant. (3) A determinant that can be modified by intervention, thereby reducing the probability of disease or other specified outcomes. To avoid confusion, it may be referred to as a modifiable risk factor

What do others think about bringing these varied definitions together in the article? PeaBrainC (talk) 07:47, 22 July 2019 (UTC)