Acad Radiol. 2015 Aug;22(8):947-8. doi: 10.1016/j.acra.2015.06.002. Epub 2015 Jun 19.
Jha S1.
There are several factors which increase our propensity to overdiagnose, whereas the root cause of overdiagnosis is imperfect information and the trade-offs as a result of that imperfection. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.
Overdiagnosis is the finding of mild disease for which the harms in diagnosing and treating exceed the benefits (1). Overdiagnosis is a problem of modernism and affluence. It is not a significant issue in developing countries, where people still die from infectious diseases. Overdiagnosis, however, affects even the poorer citizens in developed countries because health care has little granularity or ability to discern shades of importance.
Many etiologies are offered for overdiagnosis including a payment structure which rewards expansion of disease definition, influence of pharmaceutical companies and disease advocacy groups, and defensive medicine. However, these factors, though contributory, do not explain the root of overdiagnosis. Broadly, overdiagnosis occurs because of a convergence of two factors, imperfect information (the information problem), and the push for anticipatory medicine. Overdiagnosis is fundamentally an epistemologic problem.