All models are wrong…

… but some are more wrong than others. It’s emerged that a risk calculator for cholesterol-related heart disease risk is giving some highly dubious results. So completely healthy people could start taking unnecessary drugs. It’s not clear if the problem is in the specification or the implementation: but either way, the results seem rather dubious.

The answer was that the calculator overpredicted risk by 75 to 150 percent, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment — the guidelines that say treatment is advised for those with at least a 7.5 percent risk and that treatment can be considered for those whose risk is 5 percent.

According to the New York Times (may be gated), questions were raised a year ago, before the calculator was released, but somehow the concerns weren’t passed on to the right people. It’s difficult to tell from a press article, but it appears as if those responsible for the calculator are reacting extremely defensively, and not really admitting that there’s anything wrong with the model.

 while the calculator was not perfect, it was a major step forward, and that the guidelines already say patients and doctors should discuss treatment options rather than blindly follow a calculator

Of course they’re right, in that you should never believe a model to the exclusion of all other evidence, but it’s very difficult for non-experts not to. Somehow, something coming out of a computer always seems more reliable than it actually is.

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