Overdiagnosis and overtreatment as a quality problem: insights from healthcare improvement research
نویسندگان
چکیده
منابع مشابه
Overdiagnosis and overtreatment
claim that our critique of the randomized screening trials has little merit; that there is no reason to believe that the Canadian study was of better quality than the New York Health Insurance Plan (HIP) study or the Two-County study; and that the prior consensus on mammography was correct. However, their review suffers from erroneous assumptions and biased statistical analyses, and their quota...
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Over thepast 30 years, awareness and screening have led to an emphasis on early diagnosis of cancer. Althoughthegoalsof theseeffortswere to reduce the rate of late-stagediseaseanddecreasecancermortality, secular trendsandclinical trials suggest that thesegoalshave notbeenmet; national datademonstrate significant increases inearly-stagedisease,withoutaproportionaldecline in later-stagedisease.Wh...
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Expert’s summary: One of the major goals of improving the survival rate for many common cancers has been seeking an earlier diagnosis. The concept has been that ifwe candiagnose cancers earlier,we can treat them before metastasis occurs, and the survival rates will increase. Unfortunately, despite the rapid introduction and use of prostate-specific antigen (PSA) testing, chest and abdominal ima...
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Overdiagnosis and overtreatment are often thought of as relatively recent phenomena, influenced by a contemporary combination of technology, specialization, payment models, marketing, and supply-related demand. Yet a quick glance at the historical record reveals that physicians and medical manufacturers have been accused of iatrogenic excess for centuries, if not millennia. Medicine has long ha...
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Improvement of health care requires making changes in processes of care and service delivery. Although process performance is measured to determine if these changes are having the desired beneficial effects, this analysis is complicated by the existence of natural variation—that is, repeated measurements naturally yield different values and, even if nothing was done, a subsequent measurement mi...
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ژورنال
عنوان ژورنال: BMJ Quality & Safety
سال: 2018
ISSN: 2044-5415,2044-5423
DOI: 10.1136/bmjqs-2017-007571