Overdiagnosis across medical disciplines: a scoping review | BMJ Open

Curious about which areas of medicine have more problems with overdiagnosis than others? Wondering in which fields the problem has been studied extensively? A group from the Netherlands has looked into this extensively in their paper: Overdiagnosis across medical disciplines: a scoping review for BMJ Open.

One of the biggest challenges in exploring this area is that the problem of 'too much medicine' goes by many different terms, these vary from place to place, and even where the same term is used there is disagreement about definitions. 

Jenniskens, a PhD student at Utrecht University, et al looked at almost 5000 studies and included 1581 for review. Unsurprisingly, the majority of papers pertained to the field of oncology, perhaps because wide-spread screening programs and attempts for early diagnosis are much more common for cancer than for chronic disease and other conditions. Though they did not publish the information, they also took a moment to determine from where in the world the papers were being written.

For years, I have been fascinated with the geographically diverse response to the problem of overdiagnosis and the idea that overdiagnosis can happen in resource-rich and -poor countries alike. I worked with Alan Cassels to facilitate a group discussion at the Preventing Overdiagnosis conference in Barcelona in 2016. We identified movements that attempt to combat overuse of tests, treatments, and procedures around the world (presentation slides are available here) and discussed what factors in each region might be playing a role.

Seeing that presentation and recognizing my interest, Mr Jenniskens has since kindly provided me with a breakdown of the country of origin of the authors for the papers analyzed in his group's review. While most of the papers were tied to the United States, first authors from 65 different countries were among the 1581 papers.

Grey - no authors; Light Green - few authors; Orange - many authors.

Grey - no authors; Light Green - few authors; Orange - many authors.

Please click through to interactive map to view the % proportion of authors of the 1581 assessed papers, originating from each country. From Albania to Zimbabwe, it is clear that overdiagnosis is a global concern, and is being researched everywhere.

Read more about the papers considered in the scoping review.

Source: http://bmjopen.bmj.com/content/7/12/e01844...