Article on Risk Management
DEFINITIONS OF RISK
Brian A. Burt, BDS, MPH, PhD
Correpondence: Dr. Brian A. Burt Department of Epidemiology School of Public Health University of Michigan 109 Observatory Street Ann Arbor, MI 48109-2029 Phone: 734-764-5478 Fax: 734-764-3192 E-mail: bburt@umich.edu Reprints will not be available.
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Abstract: Risk-related terms such as risk factor, modifiable risk factor, demographic risk factor, risk indicator, determinant, and risk marker are often not well defined in the literature. This short report supports the use of a 1996 definition of risk factor, as probably the most commonly-used term related to risk, for the Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life, March 26-28, 2001. Keywords: risk factor, risk indicator, risk marker, determinant.
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Risk is the probability that an event will occur. In epidemiology, it is most often used to express the probability that a particular outcome will occur following a particular exposure.1 There are very few conditions that constitute a sufficient cause in chronic and infectious disease (a sufficient cause being one where a specific exposure will always result in a particular outcome). If there were, it would not be necessary to deal with risk, which often deals with varying degrees of necessary cause (a necessary cause being an exposure which must always precede a particular outcome), though it can also deal with exposures that are neither necessary nor sufficient causes.2 This brief report is to support the uniform use of a previously-stated definition of a risk factor in an effort to standardize terminology for this conference.
There is general agreement that the term risk factor means an exposure that is statistically related in some way to an outcome, e.g., smoking is a risk factor for periodontitis. But beyond that broad generality there is little agreement. There is uncertainty in the literature on whether a risk factor should be truly causal, i.e., a link in
Brian A. Burt, BDS, MPH, PhD
Correpondence: Dr. Brian A. Burt Department of Epidemiology School of Public Health University of Michigan 109 Observatory Street Ann Arbor, MI 48109-2029 Phone: 734-764-5478 Fax: 734-764-3192 E-mail: bburt@umich.edu Reprints will not be available.
2
Abstract: Risk-related terms such as risk factor, modifiable risk factor, demographic risk factor, risk indicator, determinant, and risk marker are often not well defined in the literature. This short report supports the use of a 1996 definition of risk factor, as probably the most commonly-used term related to risk, for the Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life, March 26-28, 2001. Keywords: risk factor, risk indicator, risk marker, determinant.
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Risk is the probability that an event will occur. In epidemiology, it is most often used to express the probability that a particular outcome will occur following a particular exposure.1 There are very few conditions that constitute a sufficient cause in chronic and infectious disease (a sufficient cause being one where a specific exposure will always result in a particular outcome). If there were, it would not be necessary to deal with risk, which often deals with varying degrees of necessary cause (a necessary cause being an exposure which must always precede a particular outcome), though it can also deal with exposures that are neither necessary nor sufficient causes.2 This brief report is to support the uniform use of a previously-stated definition of a risk factor in an effort to standardize terminology for this conference.
There is general agreement that the term risk factor means an exposure that is statistically related in some way to an outcome, e.g., smoking is a risk factor for periodontitis. But beyond that broad generality there is little agreement. There is uncertainty in the literature on whether a risk factor should be truly causal, i.e., a link in
References: 1. Last JM, ed. A dictionary of epidemiology. 4th edition. New York: Oxford University Press, 2001. 2. Susser M. Causal thinking in the health sciences. New York: Oxford University Press; 1973:41-7. 3. Burt BA. Risk factors, risk markers, and risk indicators... [editorial]. Community Dent Oral Epidemiol 1998;26:219. 4. Beck JD. Risk revisited. Community Dent Oral Epidemiol 1998;26:220-5.