The concept of Risk-Benefit Ratio and Application of Personalized Medicine

Dr. Adam Tabriz
Photo by Cristofer Jeschke on Unsplash

For centuries human evolution has centered itself within the concept of survival and betterment of life. As a result, He has made astonishing progress. Also, the human being has been able to efficiently direct his achievements towards safety, validity, and cost of rendering medical services within the process. However, despite all the efforts, one thing seemingly has been lost in the continuum. That is the concept of factual weighing risks against benefits of the medical intervention.

“Although the risk-benefit ratio has been pragmatic under the population health, beneath certain circumstances like immunization, preventative medicine or end of life care it has encountered certain obstacles as bureaucratically forces citizenry into accepting what that don’t require” - Dr. Adam Tabriz

By definition, the benefit is a valued or desired outcome, an advantage. The risk is the probability of harm or injury (physical, psychological, social, or economic) occurring due to participation in treatment. Both the likelihood and magnitude of possible damage may vary from minimal to significant. On the other hand, a risk-benefit ratio is the fraction of the risk of an action to its potential benefits. Thus, the risk-benefit analysis is an analysis that seeks to quantify the risk and benefits.

The risk-benefit ratio in medicine is the cornerstone of clinical judgment. Every physician continuously weighs the risks against the benefits of a particular treatment or intervention during clinical evaluation. Therefore, the clinical decision may vary from patient to patient, even among those who carry the same diagnosis. That is the standard by which every physician is trained by, abide and practice according to the Hippocratic Oath.

Despite all that mentioned, over the last century, many determinants have inevitably influenced the true meaning of the risk-benefit ratio. Those factors have little to do with the practice of authentic medicine. The trend was pretty much the consequence of overtakes of public health and healthcare in general by the government administrations in progressive micromanagement, over-regulation, excessive protocols, and bureaucracy. Hence personalized medicine was gradually replaced by the Officialdom of population health model.

Although the risk-benefit ratio has been pragmatic under population health, certain circumstances such as immunization, preventative medicine, or end-of-life care have encountered certain obstacles. Such as entire citizens of a community have been forced in one way or the other to receive vaccinations to prevent a communicable disease or hard-pressed from taking statins medications for cardiovascular event prevention.

The Recent outcome has been many backfires by a group of activists protesting questionable efficacy and risks involved with administering such treatments. One of the most recent controversies pertains to the correlation between autism and vaccination in children, which the personalized approach could effectively unravel. Indeed, it would be premature to blame the entire trend on population health since as citizens become more educated, free flow of information becomes readily available, and healthcare hits the political grounds, and patients developed higher quality expectations.

Patients today are more vigilant and are making extra-educated decisions than ever before. Every so often, they demand additional guarantees. Today, the era of trusting all the findings in the hands of physicians and government agencies is obsolete.

We live in an era when consumerism has matured beyond the boundaries of commodities and services well into the healthcare arena. Nevertheless, politics and legislatures have been invariably evolving by compelling the healthcare delivery in the conflicting direction. For the sake of argument, let us dive into ARRIVE, ASCEND, and ASPREE trials. The recent contribution of the ARRIVE, ASCEND, and ASPREE trials provide helpful insight into the role of aspirin use for primary prevention in the modern era. For example, it was recently recommended to shift the Aspirin use recommendation to the highest-risk populations, from individuals aged 40 to 70 years old without diabetes or patients with diabetes.

Another instance is to prescribe statins cholesterol-lowering medications where indications have been controversially narrowed despite overzealous side effects. Or, diagnostic threshold criteria for Hgb-A1c have been lowered for diabetes and pre-diabetes. Under the Personalized Healthcare delivery model, the majority of such controversies and swift changes would have been outdated.

“The risk-benefit ratio in medicine is the cornerstone of clinical judgment but Despite all that, over the last century, the true meaning of risk-benefit ratio has been inevitably influenced by countless determinants that have little to do with the practice of authentic medicine” - Adam Tabriz, MD

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Adam Tabriz is a Physician, Writer, Entrepreneur, and public health policy, expert. He is an advocate for Personal liberty. The combination of his experience and expertise underlines his passion for advocating true “Personalized Healthcare” and “Healthcare without Borders.” His favorite slogan is: “Peace of mind would come to all people through the universal respect for the basic human rights of everyone”

San Francisco, CA

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