How Rad is this? Academic Radiology dedicated "Overdiagnosis Issue" Aug 2015

The Preventing Overdiagnosis conference in Bethesda, MD this year was amazing for many reasons.

One of my favourite parts? Meeting all the people who are doing excellent work in the area of preventing harm to patients from unnecessary tests and treatments! I've been lucky to "know" quite a few motivated people on Twitter, but putting faces to names to twitter handles was really something.

Imaging my delight to meet @RogueRad, aka Dr Saurabh Jha, the developer of Value of Imaging and Assistant Professor of Radiology at the Hospital of the University of Pennsylvania, with a background (and Master's) in Health Policy Research. He is really interested in uncertainty as a driver of diagnostic imaging utilization and how we decide which tests have value.

It should not be surprising then that he handed me a copy of Academic Radiology; why? The August journal, with Jha's editorial hand, was dedicated entirely to Overdiagnosis! 

You can view the contents here. It is an impressive edition, with a Guest Editorial from H. Gilbert Welch and articles ranging from breast cancer screening to PET scanning in dementia to the role of Precision Medicine in confronting overdiagnosis. While I'm less optimistic about that last point, the August edition of Academic Radiology on the whole strikes a nice combination of hope and caution, balancing under- and over- diagnosis, even explicitly in the case of and article about this in the context of Mild Traumatic Brain Injury (MTBI).

Hopefully in the coming year we'll see more medical journals dedicating themselves to this issue with the help of keen leadership like that of Dr Jha.


Incidentalomas: What they are and why we should be concerned | Jill Wruble | TEDxPenn - YouTube

At the Preventing Overdiagnosis conference, I met a wide variety of people all dedicated to the same cause: the pursuit of better care for patients by way of helping them to avoid unnecessary and harmful tests and treatments.

By chance I met Dr Jill Wruble, a radiologist at Veterans Medical Center in West Haven, Connecticut and Clinical Assistant Professor with Yale and the University of Connecticut.

We talked about incidentalomas and what could be done to help improve our handling of them. When Jill told me about her TedX talk, I knew it would be worth checking out. She models appropriate care in her practice, teaches colleagues and residents, and has been making efforts to inspire others to make sure they are using diagnostic imaging meaningfully and judiciously. And she's a pretty amazing woman - did you see that bio!?


Not sure what an incidentaloma is? Or what to do if you find one (or are told you have one)? See her 15 minute talk on the subject:



It's #PODC2015 time: Preventing Overdiagnosis 2015 is here

After an incredible General Council (the annual meeting of the Canadian Medical Association), it is now time for me to zip off to Bethesda, MD for Preventing Overdiagnosis.

Although I attended last year in Oxford, this will be my first time speaking at the conference; I have the fortune of working with Dr James Rickert (who challenges conflict of interest in orthopedics and puts the patient first) in order to present a workshop around some of the criticisms (and related solutions) for the Choosing Wisely campaign (at 11:30, Weds Sept 2nd).

I would say that I am Choosing Wisely's biggest fan, and biggest critic. I am looking forward to the opportunity to hear more thought from my peers about the campaign and what the next steps might entail. There is so much hope and opportunity with this initiative and it's a great time to strengthen it and to reach higher!

This conference will also be a great opportunity to reflect on the past couple of years and the progress that so many people have made, and to meet up with colleagues to hear about their planned work going forward. There will be quite a few curious and critical-thinking Canadians in attendance, including (I hear):

-   Dr. Laurent Marcoux (former head of the Quebec Medical Association, one of the key developers of their Action Plan for Overdiagnosis

-    Dr. Roland Grad (researcher in family practice currently looking at harnessing infoPOEMs to identify low-value tests and treatments)

-    Dr. Rita McCracken (finishing her PhD, an expert on polypharmacy/deprescribing in the elderly)

-    Dr. Tracy Monk (humble yet highly effective champion and practicer of patient centered, evidence-based, and relationship-based care)

-    Dr Alan Cassels (co-author of Selling Sickness and highly sensible drug policy researcher)

-    Joanna Trimble (family member and advocate for confronting polypharmacy and sedative overuse in the elderly, at Is Your Mom On Drugs?)

-    Dr. Danielle Martin (head of Canadian Doctors for Medicare and outspoken advocate for doing more with less)

-    Dr Sacha Bhatia (chair of evaluation and can-do pioneer for Choosing Wisely Canada)

-    Dr Jennifer Young (leader of the Don’t Just Do Something, Stand There workshop with the Ontario College of Family Practitioners)

Go Canada!

And that is just the tip of the iceberg. The entire conference will be comprised of like-minded peers from around the world. I can't wait to get started tomorrow; see you there!!!