Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long. Surgeon and writer, Atul Gawande, explores the medicalization of ageing and death in Being Mortal. Gawande points to a glaring deficiency in […]
Category: Too much medicine
Saurabh Jha: The overdiagnosed party/ the false positives rave
Consider this equation. Early Diagnosis = Early Diagnosis + Overdiagnosis (1.1) This sort of unequal algebra will fail GCSE mathematics. A new NHS initiative is arithmetic defying as well. Patients who think they have symptoms of cancer will be allowed to book medical imaging directly, without seeing their GP. This is to catch cancer early. The logic […]
William Cayley: Overdiagnosis, uncertainty, and epistemology
Many thanks to Anita Jain for reporting on the “Overdiagnosis” session at the Cochrane Colloquium—I wish I could have been there. The suspicion that overdiagnosis (or at least over testing) is driven in part by the quest for certainty, is corroborated by an implementation study of the Vancouver chest pain rule. When the Vancouver chest […]
Anita Jain: Overdiagnosis—when is it too much care?
“Come over for a discussion on overdiagnosis and contribute your ideas to tackle it,” was the invitation. A diverse mix of doctors, nurses, researchers, public health practitioners, and students from countries across the world got together for our workshop at the 22nd Cochrane Colloquium in Hyderabad. Overdiagnosis, like many medical conditions, lacks clear parameters. How […]
Helen Macdonald: Too much medicine—not a NICE business
David Haslam, chair of the National Institute for Health and Care Excellence, anticipated a difference of opinion as he addressed his audience at the Preventing Overdiagnosis conference last week. He knew that the audience would bring it up eventually, so he went head on into the controversial NICE guideline that lowered the threshold for cardiovascular […]
Duncan Jarvies: Preventing Overdiagnosis 2014—I am not legion
I’m against overdiagnosis, overcooked food, and over long films, said David Haslam, chair of the National Institute for Health and Care Excellence. All of us probably agree—especially when it comes to overcooked food—which is part of the problem. At the Preventing Overdiagnosis conference in Oxford, the big topics are diabetes, hypertension, and statins. Lifestyle diseases that we […]
Georgios Lyratzopoulos: Overdiagnosis—is informed decision making by patients the way forward?
I enrolled for the Preventing Overdiagnosis conference assuming that the focus would be on cancer screening, but I was thankful that the conference covered every clinical specialty, including paediatrics, psychiatry, and cardiology, as well as surgical specialties and emergency medicine. After all, and as recounted by Jim Guest, it is possible for patients attending the […]
Leana Wen: Where to begin the conversation on overdiagnosis
One of the many takeaways from this week’s excellent Preventing Overdiagnosis Conference is that it’s hard for doctors to tell their patients that too much care is bad. For so long, the rhetoric has been about the danger of too little care. Newspapers brim with stories of death from missed diagnosis and lack of access […]