Articles

Position Paper – Overdiagnosis and Related Medical Excess
Confidence in the medical profession depends on doctors safeguarding the fundamental ethical commitment to not harm,  however, some parts of medical practice are now expanding in ways that do not promote health, leading to unnecessary use of resources and, at worst, causing harm.

Position Paper Appendix

 

How to rein in the widening disease definitions that label more healthy people as sick
In the early 1990s a small meeting of experts, part-funded by drug companies, decided on a new definition of the bone condition osteoporosis. Historically, the label was limited to people who had fractures, but with the coming of new technology that could see someone’s bone density, doctors started broadening the definition to include healthy people considered at risk of a fracture.

 

New way to define disease is needed to reduce overdiagnosis, experts agree
A new process is needed for defining diseases that takes account of the potential risks of overdiagnosis and overtreatment as well as the benefits of appropriate diagnosis and care, researchers, policymakers, and consumer groups agreed at an international congress this week.

 

Rethinking Prostate Cancer Treatments
Ten years after diagnosis, a new study found that patients simply monitored by their doctors fared as well as those undergoing surgery or radiation.

 

Bad science misled millions with chronic fatigue syndrome. Here’s how we fought back

 

Walking the tightrope: communicating overdiagnosis in modern healthcare

Communication that empowers the public, patients, clinicians, and policy makers to think differently about overdiagnosis will help support a more sustainable healthcare future for all, argue Kirsten McCaffery and colleagues

 

Academic Radiology Special edition on Overdiagnosis edited by Dr. Saurabh Jha, Assistant Professor of Radiology at the University of Pennsylvania, Philadelphia.

The issue considers both sides of the mammogram debate, the epistemological problem leading to overdiagnosis, and overdiagnosis in many areas ranging from detection of pulmonary embolism to substrates for sudden cardiac death.
A unique radiology perspective which is also the first peer review journal in radiology to have given the problem of overdiagnosis so much space.

 

Le Cancer Rose
The Risks of over diagnosis – Prof. Alex Barratt (http://cancer-rose.fr/surdiagnostic/les-risques-du-surdiagnostic-vus-a-lechelle-individuelle/)

 

 Breast Cancer Screening: testimony of a London GP – Iona Heath (http://cancer-rose.fr/presse/temoignage/)

 

Jørgensen K, Gøtzsche P. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends BMJ 2009;339:b2587

 

Moynihan R., Doust J, Henry D. Preventing Overdiagnosis, BMJ 2012;344:e3502

 

Welch G, Black W. Overdiagnosis in Cancer. JNCI 2010;102:605-13

 

L.M. Schwartz and S. Woloshin, “Changing Disease Definitions: Implications for Disease Prevalence: Analysis of the Third National Health and Nutrition Examination Survey, 1988–1994,” Effective Clinical Practice 2, no. 2 (1999): 76–85

 

BMJ Too Much Medicine series 2013

Dementia http://www.bmj.com/content/347/bmj.f5125
Thyroid cancer http://www.bmj.com/content/347/bmj.f4706
Chronic kidney disease http://www.bmj.com/content/347/bmj.f4298
Pulmonary embolism http://www.bmj.com/content/347/bmj.f3368