Intended for healthcare professionals

Letters Crisis in evidence based medicine

The RCGP’s new standing group on overdiagnosis

BMJ 2014; 349 doi: (Published 09 July 2014) Cite this as: BMJ 2014;349:g4454
  1. Margaret McCartney, general practitioner and chair 1,
  2. Julian Treadwell, general practitioner and member1
  1. 1Royal College of General Practitioners’ Standing Group on Overdiagnosis, Glasgow G13 1JE, UK
  1. Margaret{at}

Overdiagnosis and overtreatment are close to the hearts of GPs.1 We are frustrated by the limited resources for applying evidence based guidelines, which are often distant from the local population and the reality of multimorbidity. It is a travesty that so many guidelines and invitations (for example, to NHS Health Checks) have been produced with not enough information for patients to be able to make high quality shared decisions.

A recent council meeting of the Royal College of General Practitioners approved a new standing group on overdiagnosis, to launch later this year. We plan to provide resources for GPs and patients to help avoid unwanted treatment and to raise issues over the structural impediments to getting just the right amount of medicine.

One project already in progress is the development of a 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.

GPs need rapid access to evidence that matters, expressed in a way that is useful for patients (relative risk, number needed to treat), that can be found within 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 will also be an educational tool.

It is hoped that this will be a joint project with the National Institute for Health and Care Excellence, which has provided help in exploring evidence reviews from its existing guidelines.

We would like to hear from anyone in evidence based medicine who might be interested in getting involved in such a project.


Cite this as: BMJ 2014;348:g4454


  • Competing interests: MMcC: Freelance writing and broadcasting for BBC, The 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. I give occasional educational talks to GP groups on overdiagnosis.


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