Risk probability impact4/3/2023 In healthcare, prior to introducing a new intervention or diagnostic threshold, professionals and policy makers have to consider what level of risk they would accept and what the expected effect of a newly introduced intervention is. Nonetheless, risk is an objective existence which can never be eliminated, is abrupt and often harmful with people suffering loss, may be uncertain in whether and when the event will happen, and is constantly developing with science and technology. Therefore, decisions are affected by estimating chances and taking the characteristics of these taken chances into account. The impact of that event can be either beneficial or detrimental, ranging from minor to major. However, risk is generally described as the combination of the linked likelihood of occurrence times the impact of a certain event. Although objectively presented data structured group discussions, decisions in guideline development are affected by several other factors than risk reduction alone.Äuring clinical guideline development, healthcare professionals discuss risk and usually weigh the probability of an event occurring. Professionals are willing to change policies at much lower level of anticipated effectiveness than defined upfront. Professionals weighed other aspects besides risk reduction, as financial aspects and practical consequences for daily practice in this guideline-making process. Nonetheless, when making guidelines, interventions were introduced without reaching the predefined threshold of desired risk reduction. Upfront, professionals opinioned that non-invasive interventions should decrease the general population risk, whereas invasive interventions should decrease the risk in high-risk groups. Second, qualitative assessment of possible additional factors affecting final decisions, that followed from group discussion and guideline development were evaluated. First, professionals’ opinion on required performance characteristics on risk were evaluated by a qualitative online survey. A risk matrix showed the probability and impact of an intervention, together with the corresponding risk category. To improve care outcomes, we developed new guidelines in which care professionals had to decide upon novel interventions and diagnostic thresholds. We evaluated the effect of interventions and diagnostic thresholds on modeled risk, by using the risk matrix approach (RMA) in a clinical guideline development process, and investigated which additional factors affected choices. This combination of probability and impact can be visualized in a risk matrix. However, in daily practice, risk is perceived as the combination of probability and the impact of desired and adverse events. Clinical guidelines are developed to lower risks, mostly viewed upon as probability.
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