Focusing on overdiagnosis as a driver of too much medicine

  title={Focusing on overdiagnosis as a driver of too much medicine},
  author={John Brodersen and Barnett S. Kramer and Helen Macdonald and Lisa M. Schwartz and Steven Woloshin},
  journal={British Medical Journal},
Why overdiagnosis is hard to spot and to explain to individuals 

Sarcopenia: early prevention or overdiagnosis?

Sarcopenia has recently been included in the international classification of diseases despite lack of evidence to support essential diagnostic aspects and it is argued that the change is a step towards overdiagnosis.

TOO MUCH MEDICINE Sarcopenia: early prevention or overdiagnosis?

This work states that sarcopenia treatment has not been shown to have better outcomes than general recommendations for physical exercise and diet and that overdiagnosis is inevitable since treatment does not differ from general health recommendations.

Screening for scoliosis - New recommendations, old dilemmas, no straight solutions

This opinion review considers the prevailing question of whether to screen or not to screen for adolescent idiopathic scoliosis, and presents one more crucial, but underrepresented, issue of understanding and implementation of the contemporary principles of person-centred care, standards of preventive screening, and guideline development, in the context of screening for scolia.

Media Coverage of the Benefits and Harms of Testing the Healthy: a protocol for a descriptive study

This study will examine the media coverage of the benefits and harms of testing the healthy, and coverage of potential conflicts of interest of those promoting the testing, to examine five tests.

Journalists’ views on media coverage of medical tests and overdiagnosis: a qualitative study

Effectively communicating overdiagnosis is a challenge in light of common beliefs about the benefits of testing and the culture of current journalism practices, and providing journalists with training, support and better access to information about potential harms of tests could aid critical reporting of tests.

Reflections on Diagnosis and Diagnostic Errors: a Survey of Internal Medicine Resident and Attending Physicians

From June 2016 through March 2017, the authors surveyed 484 residents and attendings from nine Connecticut internal medicine training programs about frequency of diagnostic uncertainty, diagnostic errors, and method of notification about diagnostic errors.

Higher order thinking about differential diagnosis.

Mapping the evidence of experiences related to adolescent idiopathic scoliosis: a scoping review protocol

The objective of this planned scoping review is to explore and map the available evidence from various sources to address a broad question of what is known about experiences of all those touched, directly and indirectly, by the problem of adolescent idiopathic scoliosis.

International Continence Society white paper on ethical considerations in older adults with urinary incontinence

This International Continence Society white paper aims to provide healthcare professionals with an ethical framework to promote best care practices in the care of older adults with urinary incontinence.

Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

The clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended.



The challenge of overdiagnosis begins with its definition

S M Carter and colleagues argue that the authors should use a broad term such as too much medicine for advocacy and develop precise case by case definitions of overdiagnosis for research and clinical purposes.

Assessment of changes to screening programmes: why randomisation is important

The best way to assess changes in screening programmes is through randomised trials within the programmes, according to Katy Bell and colleagues.

Casting the net too wide on overdiagnosis: benefits, burdens and non-harmful disease

The authors raise important points about the social harms of overdiagnosis and the need for structural interventions; their typology is useful for discussing ethical issues in specific cases of over diagnosis and may ground legal and institutional actions; and they contribute to investigation of the psychological and sociological processes that lead to over diagnosis.

How to conduct research on overdiagnosis. A keynote paper from the EGPRN May 2016, Tel Aviv

  • J. Brodersen
  • Medicine
    The European journal of general practice
  • 2017
Overdiagnosis is a growing problem worldwide and research about the consequences of overdiagnosis in at least eight different areas: financial strain, hassles/inconveniences, medical costs, opportunity costs, physical harms, psychological harms, societal costs and work-related costs.

Overdiagnosis: what it is and what it isn’t

Overdiagnosis means making people patients unnecessarily, by identifying problems that were never going to cause harm or by medicalising ordinary life experiences through expanded definitions of diseases.

Population-based screening for cancer: hope and hype

A dynamic framework for continuous improvements in the field of cancer screening is outlined, aimed at identifying the individuals who are most likely to benefit from screening, increasing the yield of consequential cancers on screening and biopsy, and using molecular tests to improve the understanding of disease biology.

Use of Molecular Tools to Identify Patients With Indolent Breast Cancers With Ultralow Risk Over 2 Decades

The ultralow-risk threshold of the 70-gene MammaPrint assay can identify patients whose long-term systemic risk of death from breast cancer after surgery alone is exceedingly low.

Overdiagnosed: Making people sick in the pursuit of health

“Primum non nocere.” I first heard those words very early in my medical school experience. “First do no harm” became a guiding principle during my professional career and, I hope, served me and my

Screening: evidence and practice

This is a book that clinicians, public health officers and others who are introducing a screening programme should read, even though their own circumstances may differ from those described in this book, since they need to understand the many common pitfalls that confront programme managers no matter what the setting.