Over the past several decades, there has been a growing enthusiasm for early diagnosis – engaging many physicians in a systematic search for abnormalities in people who are well. While most consider only the potential benefits, in this talk, Dr. Welch exposes the often-ignored harm: overdiagnosis. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades, yet many of the individuals given these diagnoses are not destined to ever develop symptoms (or die) from their condition.
They are overdiagnosed. And overdiagnosed patients, Dr. Welch points out, cannot benefit from treatment – since there is nothing to fix. But they can be harmed. Understanding the trade-offs involved is critical so that health care systems don’t further narrow the definition of normal and – ironically – turn more and more people into patients.
In this talk, Dr. Welch will 1) define overdiagnosis: the detection of an “abnormality” that would have otherwise never become evident during the individual’s lifetime; 2) describe the proximate mechanisms for overdiagnosis: a) changing rules, b) seeing more, c) looking harder, and d) stumbling onto things; 3) explore the evidence for overdiagnosis and subsequent harm; and 4) consider approaches to mitigate the problem.