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Problems and pitfalls of risk assessment in antenatal care
Author(s) -
LILFORD R. J.,
CHARD T.
Publication year - 1983
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1983.tb08956.x
Subject(s) - bayes' theorem , reliability (semiconductor) , risk assessment , dependency (uml) , outcome (game theory) , interdependence , risk analysis (engineering) , medicine , computer science , bayesian probability , mathematics , artificial intelligence , power (physics) , physics , computer security , mathematical economics , quantum mechanics , political science , law
Summary. Current obstetric risk‐scoring systems do not make a precise prediction of the chances of an abnormal outcome and so cannot be used in formal decision analysis. We examine here the feasibility of using Bayes' theorem to provide an accurate assessment of fetal risk and conclude that two severe limitations effectively exclude this approach as a useful contribution to antenatal care: (1) inaccuracy of .the data base: geographical variations and the ‘treatment paradox’ conspire to reduce the reliability on which any assessment may be made; (2) ‘dependency’ of the risk factors: most obstetric variables are interdependent and are not therefore amenable to analysis by means of Bayes' theorem. Although fetal risk will be assessed subjectively for the foreseeable future, obstetricians should be aware of the essentially mathematical nature of decision‐making.