44 Back to basics: overdiagnosis is about wrongful diagnosis

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Abstract

Objectives

Clear definitions are crucial for measuring and handling the challenges of overdiagnosis. So far no unified definitions or measures of overdiagnosis exist. This spurs great controversies. Accordingly, the objective of this study is to analyze overdiagnosis in terms of diagnosis and thereby make it easier to comprehend and measure.

Method

Literature search (for conceptions, definitions and measures of overdiagnosis), qualitative content analysis, and philosophical concept analysis.

Results

Etymologically, overdiagnosis means too much diagnosis. However, etymology also points to another challenge with overdiagnosis: the difficulty to differentiate between what is important and not. One practical reason for this is that new indicators and increased precision de-couples diagnosis from manifest disease resulting in inflation in diagnosis. Thus, overdiagnosis is a result of (conceptually) removing diagnosis from disease. As such, diagnosis deflects medicine from its original goal: to help people who are suffering by identifying what is bothering them and by treating it to alleviate their pain.

Conclusions

We must revive medicine’s original goal and re-connect diagnosis to what matters to professionals (knowledge) and to patients (avoid suffering). Only then can we measure and handle overdiagnosis.

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