# 1999 Porkka: If we meet the criteria and no FH mutation is found, it might be FCH

Nordestgaard et al’s logic in the 2013 EAS’ authoritative report makes identification of FH consistent with indefinability. Just speaking mathematically, if the FCH outnumber the FH by 5 to 1, then using the characteristics shared between them as “FH identification” we end up with an 80% chance that we have misdiagnosed FCH as FH.  This is the classic base rate fallacy that Kahneman and Tversky warned us about, and upon which Williams found a mathematical advantage (page 11). Why are the unidentifiable the more precisely defined FH and not the less precisely defined FCH? Given that the prevalence of FCH is 5 times greater than FH, in the absence of a mutation, and after de-emphasizing TG, FCH is probable at this point.  There is not even a mention of the alternative probability: FCH. Once acquainted with FH history, its absence here is conspicuous. Rather than consideration for other diseases, we find the tacit admission that the unclassifiable are presented in euphemism as if there were a nonclassical FH. Also, if I refer to a “classical” definition, I imply a newly created definition – but this new definition … lacks definition.