Literature DB >> 35249191

Overdiagnosis in the emergency department: a sharper focus.

Marisa Vigna1, Carina Vigna2, Eddy S Lang3.   

Abstract

Overdiagnosis occurs when a person's symptoms or life experiences are given a diagnostic label that ultimately causes them more harm than good. We describe the complex drivers of overdiagnosis spanning five interconnected domains, which can lead to numerous negative impacts on patients. Emergency physicians are often tasked with making timely clinical assessments, decisions, and diagnoses that can unintentionally result in overdiagnosis. Three pertinent areas related to overdiagnosis in Emergency Medicine: anaphylaxis, subsegmental pulmonary embolism, and low-risk chest pain are discussed. For a broader perspective, insight on overdiagnosis from medical students and a patient advisor are presented. The perspectives illustrated are meant to spark reflection on: the ethics of labeling a person with a diagnosis, current clinical practices, the limitations of medical education, and patient care and communication in the context of overdiagnosis in the Emergency Department.
© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

Entities:  

Keywords:  Ethics; Low-value care; Overdiagnosis; Overtreatment; Overuse; Shared decision-making

Mesh:

Year:  2022        PMID: 35249191     DOI: 10.1007/s11739-022-02952-8

Source DB:  PubMed          Journal:  Intern Emerg Med        ISSN: 1828-0447            Impact factor:   3.397


  14 in total

1.  The road to overdiagnosis: the case of subsegmental pulmonary embolism.

Authors:  Saurabh Jha
Journal:  Acad Radiol       Date:  2015-06-19       Impact factor: 3.173

2.  The challenge of overdiagnosis begins with its definition.

Authors:  S M Carter; W Rogers; I Heath; C Degeling; J Doust; A Barratt
Journal:  BMJ       Date:  2015-03-04

3.  Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients.

Authors:  Ronna L Campbell; John B Hagan; Veena Manivannan; Wyatt W Decker; Abhijit R Kanthala; Maria Fernanda Bellolio; Vernon D Smith; James T C Li
Journal:  J Allergy Clin Immunol       Date:  2011-11-01       Impact factor: 10.793

4.  Mapping the drivers of overdiagnosis to potential solutions.

Authors:  Thanya Pathirana; Justin Clark; Ray Moynihan
Journal:  BMJ       Date:  2017-08-16

Review 5.  Epidemiology of anaphylaxis.

Authors:  M A Tejedor Alonso; M Moro Moro; M V Múgica García
Journal:  Clin Exp Allergy       Date:  2015-06       Impact factor: 5.018

6.  Real-world peanut OIT in infants may be safer than non-infant preschool OIT and equally effective.

Authors:  Lianne Soller; Stuart Carr; Sandeep Kapur; Gregory A Rex; Mary McHenry; Victoria E Cook; Sara Leo; Tiffany Wong; Timothy K Vander Leek; Thomas V Gerstner; Joanne Yeung; Elissa M Abrams; Raymond Mak; Kyla J Hildebrand; Stephanie C Erdle; Scott B Cameron; Edmond S Chan
Journal:  J Allergy Clin Immunol Pract       Date:  2021-12-23

7.  The ethical dilemma of emergency department patients with low-risk chest pain.

Authors:  Nella W Hendley; John Moskop; Nicklaus P Ashburn; S A Mahler; Jason P Stopyra
Journal:  Emerg Med J       Date:  2021-03-09       Impact factor: 3.814

Review 8.  Overdiagnosis across medical disciplines: a scoping review.

Authors:  Kevin Jenniskens; Joris A H de Groot; Johannes B Reitsma; Karel G M Moons; Lotty Hooft; Christiana A Naaktgeboren
Journal:  BMJ Open       Date:  2017-12-27       Impact factor: 2.692

9.  Trends in Imaging for Suspected Pulmonary Embolism Across US Health Care Systems, 2004 to 2016.

Authors:  Ralph C Wang; Diana L Miglioretti; Emily C Marlow; Marilyn L Kwan; May K Theis; Erin J A Bowles; Robert T Greenlee; Alanna K Rahm; Natasha K Stout; Sheila Weinmann; Rebecca Smith-Bindman
Journal:  JAMA Netw Open       Date:  2020-11-02
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