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Friday, August 18, 2017

"Mapping the drivers of overdiagnosis to potential solutions" (re-)mapped to Hodges' model

humanistic --------------------------------------- mechanistic
 the patient 

Beliefs: “More is better,” “new is better,” “early is better,” “wants to know/screen”—even if currently healthy, imperative of possibility (we have to test because we can)

overtreatment - emotional cost

Ethics: medical awareness of benefits vs harms

risk of overtreatment - as psycho-(somaticpathology)

 the patient 

the health system

industry, professionals

Rigorous assessment of impact of ever more precise tests and investigations

Medicalisation of life;
 fear of ageing, sickness, or death

QUANTITY (less is more)

Update medical curricula and -
culture - Beliefs: “More is better,” “new is better,” “early is better,” “wants to know -
screen”—even if currently healthy, imperative of possibility (we have to test because we can)

patients and the public

(social evolution of 'illness behaviour'?)

QUALITY - outcomes

overtreatment - social cost

Role of social media
- continuing education

  Ecological economics to frame overdiagnosis as overconsumption

Application of the 'precautionary principle'
(as adopted as a universal policy foundation?)

industry, professionals

medicolegal concerns regards 
missing or delayed diagnosis

overtreatment - economic cost

drivers of overdiagnosis
solutions of overdiagnosis
 (I have overlapped these.)

The medicalisation of life also fits with Hodges' model and the concept of the 'health career'.


See also: BBC Radio 4 22 August 2017
Too Much Medicine? The Problem of Overtreatment

My source:

Dear List
Ray Moynihan, a member of our list, sent me the following email about his very important work on Overdiagnosis:
---------- Forwarded message ----------
From: Ray Moynihan
Hi Mohammad,
Just wondering if you wanted to send this to the email list/s you run - we've put a bit of work into it- and it may be of interested to many of the people on the list.

Dear colleagues,
This piece of BMJ Analysis, based on explicit search of literature, just out in BMJ this morning, may be of interest:
Mapping the drivers of overdiagnosis to potential solutions


Cheers, Ray

Mohammad Zakaria Pezeshki, M.D.
Associate Professor
Department of Community Medicine,
Tabriz Medical School, Golgasht Avenue, Tabriz, Iran,