title: Public Opinions about Overdiagnosis: A National Community Survey.
abstract: BACKGROUND
  Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.
  
  
  METHODS
  We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions.
  
  
  RESULTS
  Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity.
  
  
  CONCLUSIONS
  A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.
authors.affiliation: Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.
authors.forename: Ray
authors.initials: R
authors.lastname: Moynihan
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Brooke
authors.initials: B
authors.lastname: Nickel
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jolyn
authors.initials: J
authors.lastname: Hersch
authors.affiliation: Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.
authors.forename: Elaine
authors.initials: E
authors.lastname: Beller
authors.affiliation: Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Doust
authors.affiliation: The Social Research Centre, Melbourne, Victoria, Australia.
authors.forename: Shane
authors.initials: S
authors.lastname: Compton
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Barratt
authors.affiliation: Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bero
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: McCaffery
mesh_terms: D001294:Attitude to Health; D001315:Australia; D016265:Conflict of Interest; D004345:Drug Industry / Q000592:standards; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D000069342:Medical Overuse / Q000706:statistics & numerical data* / Q000639:trends*; D010819:Physician's Role; D011639:Public Opinion; D011795:Surveys and Questionnaires