Epidemiological risk scores are calculative devices that mediate and enact versions of accountability in public health and preventive medicine. This article focuses on practices of accountability by following a cardiovascular risk score widely used in medical counselling in Germany. We follow the risk score in the making, in action, and in circulation to explore how the score performs in doctor-patient relations, how it recombines epidemiological results, and how it shapes knowledge production and healthcare provision. In this way, we follow the risk score’s various trajectories – from its development at the intersection of epidemiology, general medicine and software engineering, to its usage in general practitioners’ offices, and its validation infrastructures. Exploring the translations from population to individual and back that are at work in the risk score and in the primary prevention of cardiovascular disease, we examine how versions and distributions of accountability are invoked and practiced as the score is developed and put to use. The case of a simple risk score used in everyday counselling brings into relief some key shifts in configurations of accountability with emerging versions of ‘health by the algorithm’. While there is an increasing authority of algorithmic tools in the fabric of clinical encounters, risk scores are interwoven with local specificities of the healthcare system and continue to be in the making.
The chapter uses the self-monitoring of menstrual cycles via an app as an example for an exploration of the ways in which people engage with data and its ambivalences in their daily lives. Period-tracking apps allow for the tracking and visualising of all kinds of personal data and offer a digitised, ‘smart’ version of the well-known menstruation calendar. In addition to insecurities emerging from ‘taming’ the uncertainties of (menstruating) bodies via quantification and algorithms, Sociology Compass, 8(12), 1344–1359 (2014)], the unanticipated collection of user data by private companies and the potential surveillance[Levy, Idaho Law Review, 51, 679–693 (2015)] raise issues of privacy and data security. This chapter will address these two forms of insecurity by drawing on material from an ongoing empirical study into the everyday use and discussion of period-tracking apps in Germany. For those interviewed, the negotiation of data insecurities can encompass an increased body competence, idiosyncratic interpretations of data or ignoring predictive deficiencies just as attempts of sidestepping dubious data collection or impositions of an algorithmic understanding of menstrual normalcy. Hence, the chapter gives insight into the multi-faceted ways people live with datafication and contributes to everyday perspectives in critical data studies.
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