Overdiagnosis

The latest buzz word in the medical blogosphere is ‘overdiagnosis‘. This iatrogenic neologism is increasingly being seen as a significant threat to human health.

Overdiagnosis is the diagnosis of “disease” that will never cause symptoms or death during a patient’s lifetime.

Evidence is mounting that medicine is potentially harming healthy people through ever earlier detection and ever wider definition of disease. In Ray Moynihan’s latest article published in the British Medical Journal, he and co-authors (Jenny Doust, and David Henry) lay out the nature of the problem, describe some examples, explore causes and flag some possible solutions.

Overdiagnosis happens when people get a diagnosis they don’t need. It can happen when people without symptoms are diagnosed and then treated for a disease that won’t actually cause them any symptoms, and it can happen for people whose symptoms or life experiences are given a diagnostic label which will bring them more harm than good.

Fierce debates are raging in many specialist areas, from psychiatry to kidney medicine, over whether the boundaries defining illness have been pushed too wide and whether too many people are being turned into patients unnecessarily. To this end an international conference - Preventing Overdiagnosis will take place on September 10-12, 2013, at Dartmouth College in the United States.

Certainly, in Australia we are quickly heading down the hypochondriacal path to investigation cornucopia – a land filled with plethoric neologisms and myriad acronyms designed to make us all sleep well at night, assured in the knowledge that our behaviour has been labelled, categorised and thank goodness is treatable by a little blue/white/pink/green pill.

Thanks to a new government initiative we will now be able to medicalise normal behaviour from the age of three, so thankfully our children will be able to leave kindergarten without the ability to kick a ball, but with a diagnosis they are unable to read or write. Soon the only things left inadequately labelled with be our food products and those too young to talk…

Useful reading:

Overdiagnosis

Overdiagnosis

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Comments

  1. says

    Is that so many patients are also over medicated? Where does one draw the line on taking meds to prevent diseases from happening? It may be because taking a pill is much easier than watching one’s diet and exercise.

  2. says

    The question is, as parents become busier is their perception of normal behaviour being altered? i.e. ADHD vs a child wanting attention.

    Also, if anxiety creates many psychosomatic symptoms, are people generally more amenable to being diagnosed? The culture of the quick fix, a label is better than no label, an active placebo makes them feel better at a rate the drug never could? Interesting.

      • Duncan says

        Until there’s a RCT disproving the synergistic effects simultaneous music therapy with magnets applied and a magnesium infusion, it’ll still be my go-to treatment option for AF, asthma, marine envenomation, STI (both the injury and the infection variants of the acronym), suspected malaria, and orf.

        • says

          So glad to have you onside…
          Looking forward to presenting some trials that go some of the way to demonstrating the utility of the three M’s in emergency medicine…
          But for now I agree with your statement, though not sure about the validity of combination therapy in orf…

  3. Nick Martin says

    I’m particularly concerned at the explosion of psychiatric diagnoses. When was it ever normal to be happy and well adjusted?

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