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112 Pediatric overdiagnosis: latest evidence, challenges, and future directions
  1. Rutvij Khanolkar1,
  2. Ricardo Quinonez2,
  3. Eric Coon3,
  4. Alan Schroeder4,
  5. Eddy Lang1
  1. 1University of Calgary, Calgary, Canada
  2. 2Baylor College of Medicine, Houston, USA
  3. 3University of Utah, Salt Lake City, USA
  4. 4Stanford University, Palo Alto, USA

Abstract

Seminar Proposal Although an emerging body of literature on overdiagnosis exists in adults, it remains a relatively underrecognized phenomenon in pediatric populations. The authorship of this seminar was involved in publishing the first comprehensive review of overdiagnosis in pediatrics (DOI: 10.1542/peds.2014–1778) and previously gave a seminar talk at the 2018 Preventing Overdiagnosis Conference. We are currently in the process of developing an updated scoping review on this topic — preliminary findings from which suggest that pediatric overdiagnosis is widespread but general understanding remains poor among both healthcare providers and patients. This is problematic given that the vulnerability of pediatric populations coupled with a longer life expectancy creates the potential for greater harm from the application of an unnecessary diagnostic label and subsequent overtesting and overtreatment.

This seminar aims to provide an updated account of recent evidence on overdiagnosis in pediatrics. Established and emerging evidence in conditions such as neuroblastoma, bacteremia, incidental MRI findings, and asthma will be used to support that pediatric overdiagnosis is both widespread and underrecognized. This seminar will also map the issue of overdiagnosis to potential solutions in order to guide future research studies and clinical decision guidelines.

Objectives

  1. Review established and emerging evidence for overdiagnosis in children

  2. Discuss gaps in the literature on pediatric overdiagnosis

  3. Aim to map the issue of pediatric overdiagnosis to potential solutions in order to guide future research studies and clinical decision guidelines.

Methods 20-minute talks on each of the three objectives with discussion/Q&A integrated throughout.

Results Increased awareness of overdiagnosis in pediatrics.

Conclusions Pediatric overdiagnosis is both prevalent and underrecognized. Better education is needed to increase awareness of this issue and additional research studies are required to address gaps in the literature and inform clinical decision guidelines.

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