Overdiagnostikk – norske allmennleger viser vei

Roksund, Gisle; Brodersen, John; Johnson, Georg Espolin; Hjörleifsson, Stefán; Laudal, M; Swensen, Elisabeth

doi:10.4045/tidsskr.16.0572

Cited by 10 publications

(7 citation statements)

References 7 publications

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“…Given limited total capacity for healthcare delivery, overtreatment of one patient may limit healthcare access for another person who may truly need care, causing harm to people other than the overtreated patient, which on a broad scale amounts to societal harm 64. In addition, health system investment in overtreatment deflects resources from other pressing medical needs and represents lost opportunity to improve the health of the public 6566…”

Section: Consequences Of Overdiagnosismentioning

confidence: 99%

Overdiagnosis in primary care: framing the problem and finding solutions

Kale

Korenstein

2018

BMJ

122

108

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Overdiagnosis, is defined as the diagnosis of a condition that, if unrecognized, would not cause symptoms or harm a patient during his or her lifetime, and it is increasingly acknowledged as a consequence of screening for cancer and other conditions. Because preventive care is a crucial component of primary care, which is delivered to the broad population, overdiagnosis in primary care is an important problem from a public health perspective and has far reaching implications. The scope of overdiagnosis as a result of services delivered in primary care is unclear, though overdiagnosis of indolent breast, prostate, thyroid, and lung cancers is well described and overdiagnosis of chronic kidney disease, depression, and attention-deficit/hyperactivity disorder is also recognized. However, overdiagnosis is a known consequence of all screening and can be assumed to occur in many more clinical contexts. Overdiagnosis can harm patients by leading to overtreatment (with associated potential toxicities), diagnosis related anxiety or depression, and labeling, or through financial burden. Many entrenched factors facilitate overdiagnosis, including the growing use of advanced diagnostic technology, financial incentives, a medical culture that encourages greater use of tests and treatments, limitations in the evidence that obscure the understanding of diagnostic utility, use of non-beneficial screening tests, and the broadening of disease definitions. Efforts to reduce overdiagnosis are hindered by physicians' and patients' lack of awareness of the problem and by confusion about terminology, with overdiagnosis often conflated with related concepts. Clarity of terminology would facilitate physicians' understanding of the problem and the growth in evidence regarding its prevalence and downstream consequences in primary care. It is hoped that international coordination regarding diagnostic standards for disease definitions will also help minimize overdiagnosis in the future.

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Section: Consequences Of Overdiagnosismentioning

confidence: 99%

Overdiagnosis in primary care: framing the problem and finding solutions

Kale

Korenstein

2018

BMJ

122

108

View full text Add to dashboard Cite

show abstract

“…of blood cholesterol) and to the use of various methods for additional risk determination, which often have insufficient documentation (16). Problems associated with overdiagnosis in Norwegian medical practice have been discussed recently in this journal (17).…”

Section: Knowledge Base and Clinical Considerationsmentioning

confidence: 99%

Nye retningslinjer for forebygging av hjerte- og karsykdom

Klemsdal¹,

Gjelsvik²,

Elling³

et al. 2017

Tidsskriftet

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“…Institusjonelle forandringer har i løpet av de siste 10-15 årene blitt studert ved hjelp av begrepet the paradox of embedded agency (Battilana, Leca og Boxenbaum 2009;Hardy og Maguire, 2008, 2017. Begrepet brukes for å undersøke «how organizations or individuals whose beliefs and actions are determined by existing institutions can break with these very same institutions and innovate» (Battilana mfl., 2009, s. 72).…”

Section: Synnøve Jansenunclassified