Rising concern about over-diagnosis can see healthy people treated as sick.
Expanding definitions of some diseases have led to rising concerns about healthy people being diagnosed as ‘sick’ and receiving treatments they don’t need.
According to the Consumers Health Forum of Australia (CHF), over-diagnosis can often do more harm than good.
To avoid unnecessary treatments, CHF recommends patients discuss any decisions with their doctor to ensure they are well-informed.
CHF has joined other health organisations in endorsing the Wiser Healthcare collaboration promoting the development of a national action plan to prevent over-diagnosis and over-treatment in Australia.
CHF Chief Executive Leanne Wells says the emergence of this issue is a further good reason why patients should feel comfortable asking their doctor about a new treatment and about evidence for its efficacy.
“Medical advances have brought huge benefits, of course, but that has also increased the risk of doctors going a step too far in treating patients,” Ms Wells explained.
“The British Medical Journal has raised concerns about the over-diagnosis of common conditions including pulmonary embolism, chronic kidney disease, depression, high blood pressure and osteoporosis,” she said.
“This not only exposes patients unnecessarily to risk but also generates extra costs at a time when health budgets are under pressure.
“The more patients are engaged and informed about their treatment the more likely their outcomes will be positive.”
The five questions patients should ask their doctors and healthcare providers to avoid being over-diagnosed are:
• Do I really need this test or procedure?
• What are the risks?
• Are there simpler, safer options?
• What happens if I don’t do anything about the condition?
• What are the costs?
Andy Carr, a professor of surgery at the University of Oxford, found that many surgeries don’t perform much better than a placebo.
Mr Carr and his colleagues reviewed 53 trials of less invasive surgical interventions (ones that did not include cutting open entire cavities or lots of dissection) and found that, for half of the surgeries tested, there was little sign that they were any better than a placebo.
Some of the surgical interventions that have been tested worldwide and have failed to convince include: arthroscopy for arthritic knee; spinal cement injections for vertebral fractures; some gastric balloon procedures for obesity; meniscectomy (the surgical removal of all or part of a torn meniscus in the knee); sphincterotomy to reduce pain after gall stone removal; and laser surgery for angina.
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