Citizens’ juries can bring public voices on overdiagnosis into policy making

Unnecessary and harmful interventions from overdiagnosis challenge the social and ethical contract that underpins healthcare.12 Strategies to tackle overdiagnosis from population screening should engage with the public and consider its values and concerns.3 Most high income countries develop evidence based policies to guide population screening using stringent criteria that are applied by expert panels to review the available technical evidence. Similarly, if perhaps not so systematically, expert panels collect and analyse pathophysiological and clinical evidence to determine disease thresholds and definitions.4 But in both cases the final judgments on the acceptability and legitimacy of different screening policies and disease definitions are informed by the values of the decision makers, because the relative balance of harms and benefits of making changes are also subjectively weighed and valued.567 For the deliberation sponsors (researchers, government, or other agencies), putting matters to the public can promote greater social and political engagement, public accountability, and confidence in the decision ultimately made.

Public engagement …