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Comment & Response
November 3, 2015

Risk Prediction for Individuals

Author Affiliations
  • 1Department of Development and Regeneration, KU Leuven–University of Leuven, Leuven, Belgium
  • 2Department of Public Health, Erasmus MC–University Medical Center Rotterdam, Rotterdam, the Netherlands
  • 3Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee
JAMA. 2015;314(17):1875. doi:10.1001/jama.2015.12215

To the Editor A Viewpoint by Dr Sniderman and colleagues1 discussed how risk estimates from prediction models should be interpreted in the era of predictive analytics. We would like to expand on 2 statements.

First, we disagree that “probability is not meaningful in an individual context.” Historically, the concept of individual risk has been vigorously debated. This discussion arises from the fact that a patient will or will not develop the disease or experience the event of interest. However, risk can be thought of as the subjective level to which one “believes in” or is “prepared to bet on” the occurrence of a disease or event,2 just as one bets on future 1-time events in games of sport. Acting on risk minimizes mistakes and maximizes clinical outcomes: one must play the odds to be successful.3 Hence, risk assessment is highly meaningful for the individual.

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