OBJECTIVE To analyze the diagnoses, serological test results, and treatment results of the patients evaluated in a Lyme disease clinic, both prior to referral and from current evaluation. DESIGN Retrospective case survey of prescreened patients. SETTING Research and diagnostic Lyme disease clinic in a university hospital. PATIENTS All 788 patients referred to the clinic during a 4.5-year ...

An 18-year-old female student was referred to a mood disorders clinic by her psychiatrist with a diagnosis of bipolar disorder, type II, characterized by prominent “mood swings” for which she had been started on quetiapine (900 mg/day). Her “up” swings consisted of periods lasting up to 2 hours when she felt “happy, positive and more outgoing.” Her friends agreed that she was happy during these...

have always been with us, but the scale and institutionalisation of overdiagnosis and overtreatment have expanded exponentially in the last few decades. Modern concern has been articulated through worldwide movements such as the Preventing Overdiagnosis conferences, campaigns such as the BMJ’s ‘Too Much Medicine’, JAMA’s ‘Less is More’, Italy’s ‘Slow Medicine’ movement, and the US (now internat...

In the first editorial of this series, we described the harms of overscreening, defined as screening patients who are not in the recommended age range or ordering screening tests more often than necessary. Overscreening can exacerbate the problem of overdiagnosis, which is the topic of this editorial. Overdiagnosis occurs when a disease is diagnosed and treated, even though that disease never w...

Objective To analyse stage specific incidence of breast cancer in the Netherlands where women have been invited to biennial mammography screening since 1989 (ages 50-69) and 1997 (ages 70-75), and to assess changes in breast cancer mortality and quantified overdiagnosis.Design Population based study.Setting Mammography screening programme, the Netherlands.Participants Dutch women of all ages, 1...

www.aafp.org/afp Volume 87, Number 6 ◆ March 15, 2013 What does this article say? Jill: This is a prospective historical cohort study looking at the rate of overdiagnosis of invasive breast cancer between 1986 and 2005 in 39,888 Norwegian women 50 to 69 years of age. Norway piloted mammographic screening in four counties that represented 40 percent of the eligible population in 1996 before impl...

OBJECTIVE To estimate the extent of overdiagnosis (the detection of cancers that will not cause death or symptoms) in publicly organised screening programmes. DESIGN Systematic review of published trends in incidence of breast cancer before and after the introduction of mammography screening. DATA SOURCES PubMed (April 2007), reference lists, and authors. Review methods One author extracted...