New links to slow overdiagnosis
A new alliance has formed with the aim of reversing the harms of overdiagnosis.
Dr Ray Moynihan, a senior research fellow at Bond University, says too many Australians are “receiving diagnoses unlikely to benefit them”.
“In 2016, for example, researchers estimated that over 500,000 people may have been overdiagnosed with thyroid cancer across 12 nations over two decades,” Dr Moynihan says.
“An ongoing series of articles has raised concerns about overdiagnosis across a wide range of conditions, including pulmonary embolism, attention deficit/hyperactivity disorder and pre-diabetes.
“There is increasing recognition of the need for some form of coordinated national response to develop evidence-informed strategies that can fairly and safely deal with the problem of overdiagnosis.
“As a result, new relationships are being built between clinicians, researchers, stakeholders and decision makers around this counterintuitive health challenge, and a national response is emerging.”
The alliance is called the Wiser Healthcare research collaboration on overdiagnosis.
The experts are looking at possible drivers of overdiagnosis, including cultural beliefs that more tests and treatments are better, financial incentives at the health system level, technological change enabling identification of smaller and more minor abnormalities, professional fear of missing disease and cognitive biases in decision making, and public expectations that clinicians will “do something”.
Possible solutions include evidence-based public awareness campaigns, reformed system incentives to reward quality rather than quantity, better management of the problem of expanding disease definitions, better evaluation of the accuracy and utility of diagnostic tests, more professional education about overdiagnosis, and greater promotion of shared decision making.