[The drawbacks of diagnostic diligence].
More, earlier and better diagnostic work is being done nowadays, leasing to detection of abnormalities and preliminary stages that used to remain undetected; a large reservoir of subclinical disorders is found to exist. More intensive and sensitive diagnostic methods as a rule lead to higher disease prevalence figures, with the consequences of a seeming increase of disease risk, unnecessary further examinations, treatment and follow-up of individuals and overestimation of the effects of treatment. This may even start a vicious circle. More attention should be given to using diagnostic methods in such a way that the earlier and more frequent detection of disease actually profits the patient. The proof of this should be found in scientific (population) studies of the magnitude and severity of the burden of disease, the determinants of progression, the severity of abnormalities and diseases and the favourable effect of (early) treatment.
Giard
R W
RW
Afd. Klinische Pathologie, St. Clara Ziekenhuis, Rotterdam.
Coebergh
J W
JW
D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D004813:Epidemiology / Q000191:economics / Q000639:trends; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D009426:Netherlands; D011315:Preventive Medicine / Q000191:economics / Q000639:trends*; D012680:Sensitivity and Specificity; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
De keerzijde van diagnostische ijver.