chetan2u wrote:
Hi mike,
Neither I am looking for literal links nor being stubborn.
I have gone through few of your SC explanations and they are great but the assumptions or the fact that have been used must have global recognition os atleast its usage in medical parlance must be beyond doubt....
I am not talking of just the dictionaries but also talking of the discussions on this word...
I did not see the meaning "at risk" as highly likely of losing life, meaning that if 10 person "at risk" come to a hospital, atleast 7-8 are likely will lose their life.
Because that is what your reasoning stands on..
Won't ask for much but if there are any articles which give credence to this reasoning that if 10 person "at risk" come to a hospital, atleast 7-8 are likely will lose their life.
Dear
chetan2u,
My friend, I will begin by saying that I genuine appreciate the intelligence and authenticity with which you are diving into this question.
With all due respect, I think you are distorting my position a bit. You suggested the statement:
If 10 person "at risk" come to a hospital, at least 7-8 will lose their life.I find that statement patently absurd. This is
not my contention and
not a necessary assumption of my position.
I will try to explain my position in another way.
Right now, this very day . . .
There is a certain probability that I will catch a cold.
There is a certain probability that I will break a bone.
There is a certain probability that I will require major surgery.
There is a certain probability that I will require an amputation.
There is a certain probability that I will be permanently incapacitated.
There is a certain probability that I will that I will die.
Imagine this long list of probabilities, these and other bad things. There is one long list of numerical probabilities for me. All the probabilities have different numerical values for you, and still different values for each other person on the planet. Presumably many of these probabilities are relatively small.
At this writing, I am not "at risk" in any sense of the word, but there is a small probability that today will be my last day alive on this planet. The same is true of you and of each living being. Each one of us has some probability of dying today. Folks like to pretend that this probability is zero, but it's not. Even young and healthy people die every single day. The folks who make actuarial tables for insurance companies know this well.
Now, if I become "at risk" in any way --- get a cold, get cancer, get in an auto accident, etc., then most of the probabilities of bad things increase: they all become at least marginally more likely. Similarly, with you or with anyone else. Being "at risk" increases the likelihood of a number of bad things. It's inherently a statement about probabilities. Say when I am healthy, my chance of dying today is 1/100,000. Let's say that when I get a common cold, my chance of dying today is 1/10,000 ---- still very low, but now ten times more likely! You see, mathematically, it's perfectly possible even for a common cold to make death ten times more likely, even those the risk of dying is relatively low.
Any increase in probability means "more likely."
In some sense, everyone going to a hospital for something is already "at risk." When we look at one group of people going to the hospital and call that particularly group "at risk" compared to other people going to the hospital, then we are saying that these people are "more at risk" --- in other words, all the probabilities of all the bad things will go up more. They are more "at risk" because there are additional risk factors, additional factors that increase the probabilities of bad things, however slightly.
Consider two groups of people. Group #1 are all the people who woke up this morning not "at risk" in any significant way, but something happened to them in the course of the day such that they had to go to the hospital. For example, this would be the 100% healthy person who is in a car accident. These are the people going to the hospital who are in the "not at risk" group.
Group #2 are the people who, when they woke up this morning, were already "at risk" in any of the meanings this word can have --- living in poverty, or malnourished, or already have a disease, or very old, or etc. They were "at risk" already, and for whatever reason, either a worsening of their condition or a new bad thing, they wound up in the hospital. For example, this the person who already has cancer or diabetes or HIV or something, and then is in a car accident. These are the people going to the hospital who are "at risk."
It's a scientific and undeniable fact that some people in each group will die during the course of this trip to the hospital; this would depend on the severity of the accident or injury or sickness that put them in the hospital. Just given the typical random variation in severity of accidents, severity of injuries, etc. we absolutely know that some people in each group will die every day. All I'm saying is that people in Group #2 will be more likely to die than those in Group #1. All I'm doing is making a statement about relative values of probabilities. It is not that "at risk" inherently means that death is imminent. It simply is the statement that "at risk" increases the probabilities of various bad things happening, including the probability of death happening. Since we are presumably dealing with a large sample, all the people who go to the hospital, we will see these probabilities play out statistically. In the group with a higher probability of death, more people will die. That's just how probability works.
Simplify it even further. Suppose we look at 100 healthy people who get in a car accident, and 100 people who already have cancer and are being treated for it, who then get in a car accident. Assume that the severity of car accidents is randomly distributed, and that the distribution is approximate the same for both groups. For the folks who are minor fender benders, probably almost everyone in both groups would survive. In the worst crashes, passengers killed instantly, being "at risk" before the crash wouldn't matter---everyone would die, irrespective of prior health. Then there's the in-between severity, enough to do serious injury, critical injury, but not instant death. People who start out healthy have a higher probability of surviving a critical injury: survival is not guaranteed, but the odds are on their side. People who already have cancer, who are getting chemotherapy or whatever treatment, are more likely to develop complications and therefore less likely to survive a critical injury; death is not certain, but the odds are against them. The "at risk" people are more likely to die. The probability for them is higher. It may or may not mean likely----again, an increase from 0.2% to 0.7% is an increase in probability; 0.7% is "more likely" than 0.2%. All we are saying is "more likely."
I am not saying that "at risk" automatically is a death sentence. That is not a proper understanding of the probabilities. Being "at risk" marginally increases one's probability of dying, but the important thing to appreciate is that NO ONE, nobody on this planet, has a zero probability of dying today. For each one of us, no matter how young or healthy, there is some probability that we will die. This is not theoretical. Again, the folks who make actuarial tables for insurance companies could tell you your exact probability of dying this day, this year, etc. In fact, it is rarely appreciated that the probability of dying on any given day is usually much higher than the probability of winning the lottery that day: people fantasize about winning the lottery, but it doesn't occur to them that death is even more likely. Each one of us has some actuarial probability of dying, and being "at risk" in any way simply increases that probability. Even an increase from 1/100,000 to 1/10,000 makes something "more likely" --- in fact, ten times more likely!
That's all I'm saying. "More likely" simply means a higher probability. The probability may be very big or very small. The increase from 3% to 30% and the increase from (1 in ten billion) to (1 in a billion) are both changes that make something 10x more likely, but it doesn't necessarily mean that something winds up very likely even after the increase. Again, I would remind you that even for a perfectly healthy young person, the probability of death is considerably higher than you would think. "At risk" simply makes it a little more likely.
Your questions have caused us to dive much deeper into the mathematical underpinnings of this question than typically would be necessary. Most people would not have to consider all this, but I am going through these arguments to answer your questions.
Does all this make sense?
Mike
close
10 Jan 2016, 20:03
