Abstract
In communicating chronic risks, there is increasing use of a metaphor that can be termed ‘effective-age’: the age of a ‘healthy’ person who has the same risk profile as the individual in question. Popular measures include ‘real-age’, ‘heart-age’, ‘lung-age’ and so on.Here we formally define this concept, and illustrate its use in a variety of areas. We explore conditions under which the years lost or gained that are associated with exposure to risk factors depends neither on current chronological age, nor the period over which the risk is defined. These conditions generally hold for all-cause adult mortality, which enables a simple and vivid translation from hazard-ratios to years lost or gained off chronological age. Finally we consider the attractiveness and impact of this concept.Under reasonable assumptions, the risks associated with specific behaviours can be expressed in terms of years gained or lost off your effective age. The idea of effective age appears a useful and attractive metaphor to vividly communicate risks to individuals.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0342-z) contains supplementary material, which is available to authorized users.
Highlights
The meaning of ‘effective age’ Given a specified measure of ‘risk’, your effective age can be defined as the age of a typical ‘healthy’ person who matches your risk profile
If your chronological age is 50, but your effective age is 60, this means that you are in the same risk category as a 60-year old who has ‘healthy’ risk factors, or at least the ones that are potentially modifiable
Appropriate methods for communicating risk information is a subject of intense current interest [1], but attention tends to focus on risks expressed as simple probabilities of adverse events
Summary
Communicating statistical risk information plays a vital part in the process of shared-care and informed health choices, whether using patient decision-aids or in more informal dialogue with health professionals. There has been recent guidance on communication tools for the risks of treatment outcomes [1], but these measures are concerned with the chances of events occurring within a fixed time period, say death following surgery. Communicating chronic risks, associated with an increased chance event of an adverse event throughout the whole life-course, is more complex. We define precisely what is meant by effective age, give examples of its use as a communication tool, and relate it to previous work on ‘risk advancement periods’. The difference between an individual’s effective and chronological age is an attractive measure of either. Spiegelhalter BMC Medical Informatics and Decision Making (2016) 16:104 premature ageing or continued youthfulness, and we derive conditions under which this difference is independent of both chronological age and the horizon over which the risk is measured. We summarise experience of the impact of this metaphor, and consider its future use
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