The subject of overdiagnosis and overtreatment is close to the hearts of us GPs. In our own practice we are frustrated with the limited resources with which to apply the multiple guidelines which devolve from evidence often far apart from the population we serve and distant from the reality of multimorbity. It is a travesty that so many guidelines and invitations (e.g. to NHS Healthchecks) have been produced with so little recourse to information for patients with which to enable high quality shared decisions.
At a recent council meeting of the RCGP, a new standing group on Overdiagnosis was approved and will launch later this year. We plan to help to provide resources for GPs and patients to assist with avoiding unwanted treatment as well as raising issues over the structural impediments to getting the right amount of medicine for Goldilocks - just right.
One project already in progress, stemming from work at last year's Preventing Overdiagnosis conference, is the development of a new web-based evidence tool for GPs to use alongside existing guidelines. This aims to bring together the best available evidence (albeit derived from single condition research) for use in chronic disease management in the real world of multimorbidity, polypharmacy and limited primary care time.
What GPs need is rapid access to evidence that matters, expressed in a way which is useful from a patent perspective (ARR, NNTs) and can be found within a matter of seconds during a consultation. We hope the resource will have an expanding structure to allow a more nuanced exploration of evidence when needed (and time allows) and also operate as an educational tool.
We are hopeful that this may be a joint project with NICE who have expressed interest and already provided some help in exploring evidence reviews from their existing guidelines.
We would like to hear from anyone in the EBM world who might be interested in getting involved such a project.
Competing interests:
MMcC:Freelance writing and broadcasting for BBC, BMJ, lay press, book royalties, and consultancy work for Which? the consumer organisation. I am a member of MedAct and patron of Healthwatch. I give a small amount of money monthly to Keep our NHS Public. I was nationally elected to the council of the RCGP in 2013. I am an NHS GP partner. My income depends in part on QOF points. JT: Is a sessional GP and member of the RCGP Standing Group on Overdiagnosis. He gives occasional educational talks to GP groups on Overdiagnosis.
Rapid Response:
The subject of overdiagnosis and overtreatment is close to the hearts of us GPs. In our own practice we are frustrated with the limited resources with which to apply the multiple guidelines which devolve from evidence often far apart from the population we serve and distant from the reality of multimorbity. It is a travesty that so many guidelines and invitations (e.g. to NHS Healthchecks) have been produced with so little recourse to information for patients with which to enable high quality shared decisions.
At a recent council meeting of the RCGP, a new standing group on Overdiagnosis was approved and will launch later this year. We plan to help to provide resources for GPs and patients to assist with avoiding unwanted treatment as well as raising issues over the structural impediments to getting the right amount of medicine for Goldilocks - just right.
One project already in progress, stemming from work at last year's Preventing Overdiagnosis conference, is the development of a new web-based evidence tool for GPs to use alongside existing guidelines. This aims to bring together the best available evidence (albeit derived from single condition research) for use in chronic disease management in the real world of multimorbidity, polypharmacy and limited primary care time.
What GPs need is rapid access to evidence that matters, expressed in a way which is useful from a patent perspective (ARR, NNTs) and can be found within a matter of seconds during a consultation. We hope the resource will have an expanding structure to allow a more nuanced exploration of evidence when needed (and time allows) and also operate as an educational tool.
We are hopeful that this may be a joint project with NICE who have expressed interest and already provided some help in exploring evidence reviews from their existing guidelines.
We would like to hear from anyone in the EBM world who might be interested in getting involved such a project.
Competing interests: MMcC:Freelance writing and broadcasting for BBC, BMJ, lay press, book royalties, and consultancy work for Which? the consumer organisation. I am a member of MedAct and patron of Healthwatch. I give a small amount of money monthly to Keep our NHS Public. I was nationally elected to the council of the RCGP in 2013. I am an NHS GP partner. My income depends in part on QOF points. JT: Is a sessional GP and member of the RCGP Standing Group on Overdiagnosis. He gives occasional educational talks to GP groups on Overdiagnosis.