How to prevent overdiagnosis.

Chiolero, Arnaud; Paccaud, Fred; Aujesky, Drahomir; Santschi, Valérie; Rodondi, Nicolas (2015). How to prevent overdiagnosis. Swiss medical weekly, 145, w14060. EMH Schweizerischer Ärzteverlag 10.4414/smw.2015.14060

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Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and that patients have no benefit to be aware of. It is neither a misdiagnosis (diagnostic error), nor a false positive result (positive test in the absence of a real abnormality). It mainly results from screening, use of increasingly sensitive diagnostic tests, incidental findings on routine examinations, and widening diagnostic criteria to define a condition requiring an intervention. The blurring boundaries between risk and disease, physicians' fear of missing a diagnosis and patients' need for reassurance are further causes of overdiagnosis. Overdiagnosis often implies procedures to confirm or exclude the presence of the condition and is by definition associated with useless treatments and interventions, generating harm and costs without any benefit. Overdiagnosis also diverts healthcare professionals from caring about other health issues. Preventing overdiagnosis requires increasing awareness of healthcare professionals and patients about its occurrence, the avoidance of unnecessary and untargeted diagnostic tests, and the avoidance of screening without demonstrated benefits. Furthermore, accounting systematically for the harms and benefits of screening and diagnostic tests and determining risk factor thresholds based on the expected absolute risk reduction would also help prevent overdiagnosis.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Aujesky, Drahomir and Rodondi, Nicolas

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Jacques Donzé

Date Deposited:

12 Feb 2016 15:58

Last Modified:

15 Jan 2017 02:04

Publisher DOI:

10.4414/smw.2015.14060

PubMed ID:

25612105

BORIS DOI:

10.7892/boris.77305

URI:

https://boris.unibe.ch/id/eprint/77305

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