Book: "Over-diagnosed: Making People Sick in the Pursuit of Health" -- A Review

[HuckleB]

http://www.sciencebasedmedicine.org/?p=10365

"Dr. H. Gilbert Welch has written a new book Over-diagnosed: Making People Sick in the Pursuit of Health, with co-authors Lisa Schwartz and Steven Woloshin. It identifies a serious problem, debunks medical misconceptions and contains words of wisdom.

We are healthier, but we are increasingly being told we are sick. We are labeled with diagnoses that may not mean anything to our health. People used to go to the doctor when they were sick, and diagnoses were based on symptoms. Today diagnoses are increasingly made on the basis of detected abnormalities in people who have no symptoms and might never have developed them. Overdiagnosis constitutes one of the biggest problems in modern medicine. Welch explains why and calls for a new paradigm to correct the problem.

...

We are easily impressed by anecdotes from people who believe their lives were saved by early detection; but we don’t hear anecdotes from people who were harmed by a diagnosis of a condition that would never have hurt them, mainly because we have no way of knowing which ones they were. I am a case in point: I had a suspicious mammogram and an excisional biopsy that removed a lobular carcinoma in situ. That is not really a cancer, but more like a risk factor for cancer. Did my surgery remove a part of my breast that would have eventually developed invasive cancer and killed me, or did it uselessly remove a harmless chunk of tissue? Did it save my life or just mutilate me? I will never know.

What’s the solution? Maintaining a healthy skepticism about early diagnosis. Informed consent for screening tests, based on accurate information. Resisting over-simplified hype about the benefits of screening. Putting our efforts into prevention (exercise, smoking cessation, healthy diet, etc.) rather than pursuing early detection. Pursuing health without paying too much attention to it and without developing anxieties about it. Welch argues for not even mentioning incidentalomas on imaging reports, but I think radiologists and lawyers would object to that strategy.

..."


This seems like a worthy and interesting topic. Hall mentions that the book can be a bit repetitive, but I think I'll give it a go.

[SheilaT]

1. I have it on reserve at my local library.

I love that I can reserve books on-line, renew them on-line, and in the case of books I've reserved, know where I stand in line. For "Overdiagnosed" I'm 1 of 1 reserves.

[HuckleB]

3. It is fantastic, isn't it? That might be best thing about the Internet, IMO.

:toast:

[DURHAM D]

2. I am dealing right now with statin induced muscle myopathy (damage).

Tomorrow I will have a kidney scan to determine how much damage has been done to my kidneys.

I started taking Simvastatin September of 2010 because of elevated cholesterol levels. I am 66 and felt 35 at that time. It is the only medication I have ever taken. I took myself off of statin three weeks ago but muscle issues remain. I have an appointment on Thursday with my doctor to discuss. I let her know about the muscle, joint and abdominal pains in November and again in early January but she blew it off.

Statins aged me. I am pissed.

[SheilaT]

4. I noticed about twenty years ago that

conditions that used to be in the normal range, were suddenly declared in need of medicine. I was very wary then, remain wary now. I am aware that I have high cholesterol. I will not take drugs for it, because everything I read about the ill effects of such medications lead me to conclude that I'm better off without.

I am 62 years old, and despite the silver-gray hair, I must look a lot younger because of the genuinely shocked looks I usually get when I tell someone my actual age. I am essentially never sick. I don't do flu shots. I try to eat well, and have not had any fast food in several years now. Instead, I prefer to do as much of my own from-scratch cooking as possible.

[HuckleB]

5. Sounds like your doc let you down on this one.

I wish you the best.

[HuckleB]

6. kick