Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2022 |
| Outros Autores: | , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10451/51854 |
Resumo: | © 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative reviewChanging risk factorDisease definitionLow-value careOverdiagnosisOvertreatmentResource overuse© 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Medical overuse—defined as the provision of health services for which potential harms exceed potential benefits—constitutes a paradigm of low-value care and is seen as a threat to the quality of care. Value in healthcare implies a precise definition of disease. However, defining a disease may not be straightforward since clinical data do not show discrete boundaries, calling for some clinical judgment. And, if in time a redefinition of disease is needed, it is important to recognize that it can induce overdiagnosis, the identification of medical conditions that would, otherwise, never cause any significant symptoms or lead to clinical harm. A classic example is the impact of recommendations from professional societies in the late 1990s, lowering the threshold for abnormal total cholesterol from 240 mg/dl to 200 mg/dl. Due to these changes in risk factor definition, literally overnight there were 42 million new cases eligible for treatment in the United States. The same happened with hypertension—using either the 2019 NICE guidelines or the 2018 ESC/ECC guidelines criteria for arterial hypertension, the proportion of people overdiagnosed with hypertension was calculated to be between 14% and 33%. In this review, we will start by discussing resource overuse. We then present the basis for disease definition and its conceptual problems. Finally, we will discuss the impact of changing risk factor/disease definitions in the prevalence of disease and its consequences in overdiagnosis and overtreatment (a problem particularly relevant when definitions are widened to include earlier or milder disease).Repositório da Universidade de LisboaBandovas, João PedroLeal, BeatrizReis-de-Carvalho, CatarinaSousa, David CordeiroAraújo, João CruzPeixoto, PedroHenriques, Susana OliveiraCarneiro, António VazChoosing Wisely Working Group of the European Federation of Internal Medicine2022-03-21T12:12:17Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/51854engJournal of Internal Medicine, 2022, 291; 426–4370954-682010.1111/joim.134651365-2796info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T16:56:51Zoai:repositorio.ul.pt:10451/51854Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:03:05.181673Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| title |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| spellingShingle |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review Bandovas, João Pedro Changing risk factor Disease definition Low-value care Overdiagnosis Overtreatment Resource overuse |
| title_short |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| title_full |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| title_fullStr |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| title_full_unstemmed |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| title_sort |
Broadening risk factor or disease definition as a driver for overdiagnosis: a narrative review |
| author |
Bandovas, João Pedro |
| author_facet |
Bandovas, João Pedro Leal, Beatriz Reis-de-Carvalho, Catarina Sousa, David Cordeiro Araújo, João Cruz Peixoto, Pedro Henriques, Susana Oliveira Carneiro, António Vaz Choosing Wisely Working Group of the European Federation of Internal Medicine |
| author_role |
author |
| author2 |
Leal, Beatriz Reis-de-Carvalho, Catarina Sousa, David Cordeiro Araújo, João Cruz Peixoto, Pedro Henriques, Susana Oliveira Carneiro, António Vaz Choosing Wisely Working Group of the European Federation of Internal Medicine |
| author2_role |
author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
| dc.contributor.author.fl_str_mv |
Bandovas, João Pedro Leal, Beatriz Reis-de-Carvalho, Catarina Sousa, David Cordeiro Araújo, João Cruz Peixoto, Pedro Henriques, Susana Oliveira Carneiro, António Vaz Choosing Wisely Working Group of the European Federation of Internal Medicine |
| dc.subject.por.fl_str_mv |
Changing risk factor Disease definition Low-value care Overdiagnosis Overtreatment Resource overuse |
| topic |
Changing risk factor Disease definition Low-value care Overdiagnosis Overtreatment Resource overuse |
| description |
© 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| publishDate |
2022 |
| dc.date.none.fl_str_mv |
2022-03-21T12:12:17Z 2022 2022-01-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10451/51854 |
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http://hdl.handle.net/10451/51854 |
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eng |
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eng |
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Journal of Internal Medicine, 2022, 291; 426–437 0954-6820 10.1111/joim.13465 1365-2796 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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