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New way to define disease is needed to reduce overdiagnosis, experts agree

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i5082 (Published 21 September 2016) Cite this as: BMJ 2016;354:i5082
  1. Susan Mayor
  1. London

A new process is needed for defining diseases that takes account of the potential risks of overdiagnosis and overtreatment as well as the benefits of appropriate diagnosis and care, researchers, policymakers, and consumer groups agreed at an international congress this week.

“The problem at the moment is that we don’t have an internationally agreed process,” said Paul Glasziou, professor of evidence based practice at Bond University, Robina, Queensland. “Disease definitions are developed on a very ad hoc basis, often by guideline panels making recommendations about tests and treatments who, along the way, incidentally change the definition of a disease,” he told the Preventing Overdiagnosis conference, co-sponsored by The BMJ and held on 20-22 September in Barcelona (www.preventingoverdiagnosis.net).

“We have a clear, internationally agreed process on what evidence is needed to recommend a particular treatment. But there has been a neglect of the fundamental issue that comes before that, which is the definition of disease.”

He explained that the problem with expanding definitions of disease so …

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