Researcher issues warning: Overdiagnosis damages our health – University of Copenhagen

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14 March 2016

Researcher issues warning: Overdiagnosis damages our health

Overdiagnosis

We are completely unaware of the extent and harmful effects of it. Making healthy people ill through overdiagnosis is a problem that has been neglected, and which may have major consequences for our health. In a new, international study published in the British Medical Journal, a Danish researcher warns about overdiagnosis and focuses on how we can communicate our way out of the problem.

A diagnosis is intended to help doctors ensure that patients receive effective treatment. Today, however, the number of diagnoses has exploded, and far from everyone with a diagnosis has been diagnosed correctly – instead, they have been overdiagnosed. Overdiagnosis has serious implications which may have a major impact on the healthy people that are made ill. This is the finding of a new analysis conducted by John Brodersen, professor and general practitioner from the Faculty of Health and Medical Sciences at the University of Copenhagen, who appears on the front page of the renowned British Medical Journal.

"Our study challenges the idea that diagnoses are for the benefit of all. Obtaining a diagnosis that you may have to struggle with for the rest of your life, and which can have a negative impact on your development and social behaviour, may have terrible consequences. A good example is the increasing number of children who are diagnosed with ADHD. Wrongful diagnosing means that a lot of children are turned into patients and given a stigma, which, at worst, can affect them for the rest of their lives. Furthermore, we prescribe medicine for healthy patients, who may end up with poorer health due to the side effects of the medicine. As a society, we are facing a problem – a serious and growing problem – and we need to act now," warns professor John Brodersen.

He also mentions osteoporosis as an example. If all women over the age of 80 were examined, most of them would probably be showing signs of osteoporosis. Nevertheless, this does not mean that they will suffer a bone fracture, and it would therefore be completely unnecessary to provide treatment.

Strong interest in making us ill
There are many reasons why society makes healthy people ill. The healthcare sector has experienced a technological development which makes it easier to discover changes in our body. Patients' associations have grown large and powerful and are running campaigns focusing on signs of disease and preventive screening, and the pharmaceutical industry has invented false diagnoses to promote the sale of medicine.

"There are many players with an interest in more people obtaining a diagnosis. Therefore, as a researcher, I have to issue a warning, because we need to be aware of the major public health consequences. We should not regard all changes and deviations as diagnoses. Instead, we should concentrate on providing people with information enabling them to understand and decide, on a well-documented basis, what is happening to their body. We know that dialogue, communication and information have an effect, and this is the path we have to follow in future to avoid distorting our health sector and making all of us patients," says John Brodersen.

Information, education and 'cervical dysplasia' instead of 'cancer'
In his recent study, John Brodersen mentions a number of examples which can help increase our understanding of overdiagnosis. The common denominator is better communication and dialogue with citizens. For instance, a conversation between the doctor and patient during consultation can help us decide whether we want to be examined, if we have been informed about the pros and cons. It could also be a leaflet providing information, by means of graphics, of the uncertainty related to screening, and the level of risk associated with the screening not giving a true picture and thereby unnecessarily making us worried and ill. Another model is how we actually talk about our body. Studies show that if the doctor uses the term cervical dysplasia instead of cancer, we are far more critical of receiving treatment that may prove unnecessary.

"Everything seems to indicate that better communication gives people the necessary tools to enable them to help solve the problem. In addition, healthcare professionals need to be better trained, so they can be more critical of diagnoses and preventive measures that may do more damage than good if we fail to think carefully about our decisions," says John Brodersen.

Contact:
Professor and general practitioner John Brodersen, email: jobr@sund.ku.dk, mobile: +45 20 27 61 81