Focusing on overdiagnosis as a driver of too much medicine

@article{Brodersen2018FocusingOO,
  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},
  year={2018},
  volume={362}
}
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References

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The challenge of overdiagnosis begins with its definition

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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.

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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

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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

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TLDR
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.

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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.

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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

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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

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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.