Medicine and Risk Transfer

Foresight's Winter 2019 issue featured the article "Predicting Medical Risks and Appreciating Uncertainty" by Spyros Makridakis, Ann Wakefield, and Richard Kirkham. Here are the paper's Key Points as they appeared in that issue: Although great strides have been made over the last 20 years to improve clinicians' recommendations, errors remain in preventive and curative medicine that pose considerable risks that patients may not be aware of. We can no longer ignore the uncertainty surrounding all but the simplest forms of medical decisions. Clinicians need to identify and clearly communicate to their patients the uncertainties and risks associated with clinical decision making so all parties can make rational treatment choices. When faced with complex cases, many practitioners tend to be overconfident in their judgments, underestimating the possibility their decisions might be wrong and thereby failing to examine additional evidence to refute or further substantiate those decisions. We offer several recommendations to reduce uncertainty and the risk of harm when making clinical decisions. These include recognizing the cognitive bias that may lead to overconfidence in diagnosis and treatment, improving the integrity of medical research, and containing the undue influence of vested interests. Foresight now presents two commentaries on the article-the first is from John Ioannidis, a professor of medicine and health policy and the other from Nassim Nicholas Taleb, author of The Black Swan and other works on risk management. Copyright International Institute of Forecasters, 2019