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136 Combating overdiagnosis- too much medicine. Turning citizens into patients unnecessarily
  1. Ebtisam Elghblawi
  1. Private practice, Tripoli, Libya


Sickness, pain and death, are all component of any living human beings. All cultures have adopted a different means to help people cope with all the three realities.

Sometimes we come across many general practitioners who just send patients for unnecessary screening of asymptomatic findings, with over testing of those with symptoms, too much reliance on some well-known biomarkers, which incur consequently on over diagnosis, yielding over treatment, causing cost-ineffectiveness, boosting the marketing medicines intake who will grow rich on the medicalisation of risk, lots of unnecessary side effects, questioning compliance and reliability, leading to meaningless follow ups. Ultimately causing more harm than benefit.

It’s easy to create new diseases with new treatments. The harmful consequences of over diagnosis could have important physical, psychological, social, and financial consequences.

Objectives To draw boundaries around what is over diagnosis is and to exclude what it is not.

To avoid expensive treatments that achieves marginal benefits.

To advocate and implement simple measures.

Method We need to weigh the costs and benefits of the ‘medicalisation’ of our patient lives, and to be armed with enhanced information about the natural course of common conditions.

Emphasis the importance of the internet searching and looking for needed data and patients’ empowerment.

Results Over diagnosis is not a false-positive result. False positives are abnormalities that turn out not to be diseases after further investigation. In over diagnosis, the abnormality meets the currently agreed criteria for pathological disease (eg, microscopic criteria for cancer), but the disease detected is not destined to cause symptoms or death per se.

Conclusions Over diagnosis is one of the most harmful and costly problems in any modern healthcare settings. It often triggers a cascade of overtreatment with unnecessary follow ups, although the two are not identical. We need to ensure that new disease definitions are based on evidence and not merely of any financial interests. Medicine after all meant to produce more good than harm. There is however no clear answers, but we need to weighing the costs and benefits of the ‘medicalisation accordingly and according to that we can reach a definitive solution.

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