The pseudo-high-risk prevention strategy

Key Messages: A fundamental failure of high-risk prevention strategies is their inability to prevent disease in the large part of the population at a relatively small average risk and from which most cases of diseases originate. The development of individual predictive medicine and the widening of high-risk categories for numerous (chronic) conditions lead to the application of pseudo-high-risk prevention strategies. Widening the criteria justifying individual preventive interventions and the related pseudo-high-risk strategies lead to treating, individually, ever healthier and larger strata of the population. The pseudo-high-risk prevention strategies raise similar problems compared with high-risk strategies, however on a larger scale and without any of the benefit of population-based strategies. Some 30 years ago, the strengths and weaknesses of population-based and high-risk prevention strategies were brilliantly delineated by Geoffrey Rose in several seminal publications (Table 1).1,2 His work had major implications not only for epidemiology and public health but also for clinical medicine. In particular, Rose demonstrated the fundamental failure of high-risk prevention strategies, that is, by missing a large number of preventable cases.

Economic Methodology: A Historical Introduction.

Ever since the inception of economics over two hundred years ago, the tools at the discipline's disposal have grown more and more more sophisticated. This book provides a historical introduction to the methodology of economics through the eyes of economists. The story begins with John Stuart Mill's seminal essay from 1836 on the definition and method of political economy, which is then followed by an examination of how the actual practices of economists changed over time to such an extent that they not only altered their methods of enquiry, but also their self-perception as economists. Beginning as intellectuals and journalists operating to a large extent in the public sphere, they then transformed into experts who developed their tools of research increasingly behind the scenes. No longer did they try to influence policy agendas through public discourse; rather they targeted policymakers directly and with instruments that showed them as independent and objective policy advisors, the tools of the trade changing all the while. In order to shed light on this evolution of economic methodology, this book takes carefully selected snapshots from the discipline's history. It tracks the process of development through the nineteenth and twentieth centuries, analysing the growth of empirical and mathematical modelling. It also looks at the emergence of the experiment in economics, in addition to the similarities and differences between modelling and experimentation. This book will be relevant reading for students and academics in the fields of economic methodology, history of economics, and history and philosophy of the social sciences.