RESUMO
This paper presents some concepts about overdiagnosis and its consequences: overtreatment and the medicalization of the society. It recalls the origin of the term, that comes from the screening and diagnosis of cancer, and it reviews the strategies to overdiagnose. Furthermore, it analyses the conversion of illnesses diagnostic thresholds as well as the transformation of normal and vital processes and risk factors in illnesses. It shows some strategies to confront overdiagnosis at the time of medical consultation, including the management of uncertainty and the shared decision making through the right interpretation of the diagnosis results and treatment estimators. Finally, it shows the minimally disruptive medicine as the best strategy to face the disease burden induced by the overtreatment in patients suffering from multimorbidity.
Assuntos
Uso Excessivo dos Serviços de Saúde/prevenção & controle , Medicalização , Humanos , Neoplasias/diagnóstico , Fatores de Risco , Terminologia como AssuntoRESUMO
En este artículo se presentan algunos conceptos acerca del sobrediagnóstico y sus consecuencias: sobretratamiento y medicalización de la sociedad. Se recuerda el origen del término a partir del cribado y diagnóstico del cáncer y se revisan las estrategias para "sobrediagnosticar", como la modificación de los umbrales diagnósticos de las enfermedades y la conversión de procesos vitales normales, así como los factores de riesgo, en enfermedad. Se exponen algunas estrategias para afrontar el sobrediagnóstico "desde la consulta", como son el manejo de la incertidumbre y la toma compartida de decisiones a través de la correcta interpretación de los estimadores de resultado de diagnóstico y de tratamiento. Finalmente, se presenta la medicina mínimamente disruptiva como la mejor estrategia para afrontar la carga de enfermedad a la que conduce el sobretratamiento en los pacientes con multimorbilidad
This paper presents some concepts about overdiagnosis and its consequences: overtreatment and the medicalization of the society. It recalls the origin of the term, that comes from the screening and diagnosis of cancer, and it reviews the strategies to overdiagnose. Furthermore, it analyses the conversion of illnesses diagnostic thresholds as well as the transformation of normal and vital processes and risk factors in illnesses. It shows some strategies to confront overdiagnosis at the time of medical consultation, including the management of uncertainty and the shared decision making through the right interpretation of the diagnosis results and treatment estimators. Finally, it shows the minimally disruptive medicine as the best strategy to face the disease burden induced by the overtreatment in patients suffering from multimorbidity
Assuntos
Humanos , Uso Excessivo dos Serviços de Saúde , Prestação Integrada de Cuidados de Saúde , Medicina Baseada em Evidências , Padrões de Prática Médica , Medição de RiscoRESUMO
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