Overdiagnosis and overtreatment as a quality problem: insights from healthcare improvement research

Abstract

(Opening paragraph) Overdiagnosis and overtreatment are increasingly highlighted as a significant problem in contemporary healthcare. While not necessarily straightforward to define, overdiagnosis and any subsequent overtreatment are terms generally used about instances in which a diagnosis is ‘correct’ according to current standards but the diagnosis or associated treatment has a low probability of benefitting the patient, and may instead be harmful. While initially used largely in the context of cancer screening, more recently concerns about overdiagnosis and overtreatment have spread to a wide range of clinical activities. The potential consequences of overdiagnosis and overtreatment may be significant and include such harms as the psychological and behavioural effects of disease labelling, physical harms and side effects of unnecessary tests or treatments, unnecessary treatment negatively affecting quality of life, increased financial costs to individuals and wasted resources and opportunity costs to the health system.