Medicine
A year ago, I was fortunate enough to attend the first Preventing Overdiagnosis conference in Dartmouth, New Hampshire. This annual worldwide gathering of researchers, clinicians, and laypersons aims to explore the increasing problem of overdiagnosis in modern medicine and propose strategies to restrict the identification and treatment of disease to those persons who stand to benefit, rather than others in whom unnecessary diagnosis will only lead to harm. Prostate cancer is the "poster child" for overdiagnosis, a condition that I've compared in the past to an epidemic of snipers on rooftops where aggressive efforts to "disarm the sniper" often result in devastating consequences for men who would have otherwise died with, rather than of, the condition.
The second Preventing Overdiagnosis conference in Oxford, UK began today and continues through Wednesday, September 17th. Although I didn't make it this year, I plan to follow the scientific sessions on Twitter (hashtag #PODC2014) and encourage readers to do so as well.
Speaking of overdiagnosis, my colleagues at Public Citizen have recently taken aim at direct-to-consumer cardiovascular screenings offered at 20 hospitals and medical institutions in conjunction with HealthFair, a for-profit company that provides echocardiography, electrocardiography, abdominal ultrasonography, carotid ultrasonography to all comers. As Public Citizen's experts pointed out in letters to the Federal Trade Commission, the Joint Commission, and involved hospitals and institutions, no credible medical organization supports indiscriminately providing these tests to asymptomatic patients, since they are likely to cause more harm than good by producing false positive results or leading to interventions for conditions that would not otherwise produce clinical symptoms (in other words, overdiagnosis). In fact, the U.S. Preventive Services Task Force and several primary care and cardiology groups involved in the American Board of Internal Medicine Foundation's Choosing Wisely campaign recommend against performing many of these tests.
Kudos to the organizers and participants in this year's Preventing Overdiagnosis conference, and to Drs. Michael Carome and Sidney Wolfe at Public Citizen, for their commendable efforts to protect patients from the harms of overtesting, overdiagnosis, and overtreatment.
- Overdiagnosis And The Epidemic Of Snipers On Rooftops
A 2013 editorial written by two oncologists in the Annals of Internal Medicine discussed overdiagnosis, a controversial health problem that some have called "a modern epidemic" but others, including the editorialists, feel is a minor concern. Although...
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Forty years ago, Dr. Jack Wennberg and colleagues at Dartmouth Medical School published the first of a series of groundbreaking studies of medical resource utilization and practice variations that would eventually become the Dartmouth Atlas of Health...
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How do you know when you are sick? This may seem like a silly question at first blush, but the proliferation of increasingly sensitive screening tests that aim to diagnose diseases long before they can cause symptoms (and, hopefully, deliver treatments...
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In the February 15th issue of American Family Physician, Dr. Maria Tirona reviews areas of agreement and disagreement in major organizational guidelines on screening for breast cancer. There is widespread consensus that annual or biennial mammography...
- The Best Recent Posts You May Have Missed
Every other month or so, I post a list of my top 5 favorite posts since the preceding "best of" list on this blog, for those of you who have only recently started reading Common Sense Family Doctor or don't read it regularly. Here are my favorites...
Medicine
Preventing overdiagnosis: conference (#PODC2014) and Public Citizen
A year ago, I was fortunate enough to attend the first Preventing Overdiagnosis conference in Dartmouth, New Hampshire. This annual worldwide gathering of researchers, clinicians, and laypersons aims to explore the increasing problem of overdiagnosis in modern medicine and propose strategies to restrict the identification and treatment of disease to those persons who stand to benefit, rather than others in whom unnecessary diagnosis will only lead to harm. Prostate cancer is the "poster child" for overdiagnosis, a condition that I've compared in the past to an epidemic of snipers on rooftops where aggressive efforts to "disarm the sniper" often result in devastating consequences for men who would have otherwise died with, rather than of, the condition.
The second Preventing Overdiagnosis conference in Oxford, UK began today and continues through Wednesday, September 17th. Although I didn't make it this year, I plan to follow the scientific sessions on Twitter (hashtag #PODC2014) and encourage readers to do so as well.
Speaking of overdiagnosis, my colleagues at Public Citizen have recently taken aim at direct-to-consumer cardiovascular screenings offered at 20 hospitals and medical institutions in conjunction with HealthFair, a for-profit company that provides echocardiography, electrocardiography, abdominal ultrasonography, carotid ultrasonography to all comers. As Public Citizen's experts pointed out in letters to the Federal Trade Commission, the Joint Commission, and involved hospitals and institutions, no credible medical organization supports indiscriminately providing these tests to asymptomatic patients, since they are likely to cause more harm than good by producing false positive results or leading to interventions for conditions that would not otherwise produce clinical symptoms (in other words, overdiagnosis). In fact, the U.S. Preventive Services Task Force and several primary care and cardiology groups involved in the American Board of Internal Medicine Foundation's Choosing Wisely campaign recommend against performing many of these tests.
Kudos to the organizers and participants in this year's Preventing Overdiagnosis conference, and to Drs. Michael Carome and Sidney Wolfe at Public Citizen, for their commendable efforts to protect patients from the harms of overtesting, overdiagnosis, and overtreatment.
- Overdiagnosis And The Epidemic Of Snipers On Rooftops
A 2013 editorial written by two oncologists in the Annals of Internal Medicine discussed overdiagnosis, a controversial health problem that some have called "a modern epidemic" but others, including the editorialists, feel is a minor concern. Although...
- Conservative Medicine: Why Is Now The Right Time For It?
Forty years ago, Dr. Jack Wennberg and colleagues at Dartmouth Medical School published the first of a series of groundbreaking studies of medical resource utilization and practice variations that would eventually become the Dartmouth Atlas of Health...
- Conservative Medicine: What's New About This Book?
How do you know when you are sick? This may seem like a silly question at first blush, but the proliferation of increasingly sensitive screening tests that aim to diagnose diseases long before they can cause symptoms (and, hopefully, deliver treatments...
- Should Screening Mammography Always Be A Shared Decision?
In the February 15th issue of American Family Physician, Dr. Maria Tirona reviews areas of agreement and disagreement in major organizational guidelines on screening for breast cancer. There is widespread consensus that annual or biennial mammography...
- The Best Recent Posts You May Have Missed
Every other month or so, I post a list of my top 5 favorite posts since the preceding "best of" list on this blog, for those of you who have only recently started reading Common Sense Family Doctor or don't read it regularly. Here are my favorites...