Definition Reform

Reforming Disease Definitions

Expanding disease definitions are causing more and more previously healthy people to be labelled as diseased, contributing to the problem of overdiagnosis and related overtreatment. Often the specialist guideline panels which expand definitions have close ties to industry and do not investigate the harms of defining more people as sick. Responding to growing calls to address these problems, an international group of leading researchers and clinicians is proposing a new way to set diagnostic thresholds and mark the boundaries of condition definitions, to try to tackle a key driver of overdiagnosis and overtreatment. The group proposes new evidence-informed principles, with new processes and new people constituting new multi-disciplinary panels, free from financial conflicts of interest.


A small working group convened at the Preventing Overdiagnosis meeting in Copenhagen in 2018, and produced an initial paper featuring our proposals for reform in 2019 in BMJ Evidence-Based Medicine. If you are interested to know more about the initiative, please contact one of the working group below.


ReDD Working Group

• Ray Moynihan, Assistant Professor, Bond University, Australia

• John Brodersen, Professor, University of Copenhagen, Denmark

• Iona Heath, Retired General Practitioner, Royal College of General Practitioners, Britain

• Minna Johansson, Senior Research Fellow, Cochrane Sweden

• Thomas Kuehlein, Professor,Universitätsklinikum Erlangen, Germany

• Sergio Minué-Lorenzo, Professor, WHO Collaborating Centre. Andalusian School of Public Health, Spain

• Halfdan Petursson, Senior Research Fellow, Norwegian University of Science and Technology, Norway

• Miguel Pizzanelli, Professor Adjto.,Universidad de la República de Uruguay, Convernor of Wonca Special Interest Group on Quaternary Prevention and Overmedicalization, Uruguay

• Susanne Reventlow, Professor, University of Copenhagen, Denmark

• Johann A. Sigurdsson, Professor Emeritus, NTNU, Nordic Federation of General Practice (chair), Iceland

• Anna Stavdal, Associate Professor, President-Elect Wonca World, OsloNorway

• Julian Treadwell, Doctoral Research Fellow, University of Oxford, Britain

• Paul Glasziou, Professor, Bond University, Australia

• Steven Woloshin, MD, MS, Professor of Medicine, Dartmouth Institute for Health Policy and Clinical Practice Lebanon, NH  USA