title: Survey of public definitions of the term 'overdiagnosis' in the UK.
abstract: OBJECTIVE
  To determine how 'overdiagnosis' is currently conceptualised among adults in the UK in light of previous research, which has found that the term is difficult for the public to understand and awareness is low. This study aimed to add to current debates on healthcare in which overdiagnosis is a prominent issue.
  
  
  METHODS
  An observational, web-based survey was administered by a survey company.
  
  
  METHODS
  Participants completed the survey at a time and location of their choosing.
  
  
  METHODS
  390 consenting UK adults aged 50-70 years. Quota sampling was used to achieve approximately equal numbers in three categories of education and equal numbers of men and women.
  
  
  METHODS
  Participants were asked whether they had seen or heard the term 'overdiagnosis'. If they had, they were then invited to explain in a free-text field what they understood it to mean. If they had not previously encountered it, they were invited to say what they thought it meant. Responses were coded and interpreted using content analysis and descriptive statistics.
  
  
  RESULTS
  Data from 390 participants were analysed. Almost a third (30.0%) of participants reported having previously encountered the term. However, their responses often indicated that they had no knowledge of its meaning. The most prevalent theme consisted of responses related to the diagnosis itself. Subthemes indicated common misconceptions, including an 'overly negative or complicated diagnosis', 'false-positive diagnosis' or 'misdiagnosis'. Other recurring themes consisted of responses related to testing (ie, 'too many tests'), treatment (eg, 'overtreatment') and patient psychology (eg, 'overthinking'). Responses categorised as consistent with 'overdiagnosis' (defined as detection of a disease that would not cause symptoms or death) were notably rare (n=10; 2.6%).
  
  
  CONCLUSIONS
  Consistent with previous research, public awareness of 'overdiagnosis' in the UK is low and its meaning is often misunderstood or misinterpreted.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Ghanouni
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Susanne F
authors.initials: SF
authors.lastname: Meisel
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Cristina
authors.initials: C
authors.lastname: Renzi
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
mesh_terms: D000368:Aged; D001364:Awareness; D001943:Breast Neoplasms / Q000175:diagnosis; D032882:Comprehension; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D000069342:Medical Overuse; D008875:Middle Aged; D011639:Public Opinion; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D006113:United Kingdom
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH