- Title Pages
- List of contributors
- List of abbreviations
- Chapter 1 Shared decision making
- Chapter 2 Broad versus narrow shared decision making
- Chapter 3 Embracing patient and family engagement to advance shared decision making
- Chapter 4 Overcoming implementation challenges to advance shared decision making in routine practice
- Chapter 5 Implementing shared decision making
- Chapter 6 The role of shared decision making in achieving allocative efficiency in health systems
- Chapter 7 Emerging legal issues for providers in the USA
- Chapter 8 Preparing patients ahead of time to share decisions about their health care
- Chapter 9 Demystifying decision aids
- Chapter 10 Tools to engage patients in clinical encounters
- Chapter 11 Engaging clinical teams in an interprofessional approach to shared decision making
- Chapter 12 The science and art of partnering with patients in research
- Chapter 13 The three talk model of shared decision making
- Chapter 14 Models for teaching shared decision making
- Chapter 15 Standardized patients as educational interventions
- Chapter 16 Avatars and virtual worlds
- Chapter 17 Dispelling myths about the implementation of shared decision making
- Chapter 18 What you need to know as a clinician about risk communication
- Chapter 19 Making sense of numbers about health risks—The Facts Box
- Chapter 20 Overdiagnosis and overtreatment
- Chapter 21 GRADE
- Chapter 22 The effects of patient decision aids
- Chapter 23 Implementing shared decision making
- Chapter 24 Personalized care planning
- Chapter 25 Using interventions with patients before clinical encounters to encourage their participation
- Chapter 26 Patient-reported measures of shared decision making
- Chapter 27 Observer measures of shared decision making
- Chapter 28 Implementing shared decision making
- Chapter 29 Case study
- Chapter 30 Case study
- Chapter 31 Case study
- Chapter 32 Case study
- Chapter 33 Case study
- Chapter 34 Case study
- Chapter 35 Shared decision making interventions and health inequalities
- Chapter 36 Shared decision making, health literacy, and patient empowerment
- Chapter 37 Shared decision making and motivational interviewing
- Chapter 38 Quality improvement and shared decision making
- Chapter 39 Bringing shared decision making and evidence-based practice together
- Chapter 40 Encounter tools
- Chapter 41 How can journalists do a better job reporting on the principles of shared decision making?
- Chapter 42 What can patients and patient groups do to promote shared decision making?
- Chapter 43 What can junior physicians do to help promote shared decision making?
- Chapter 44 What can experienced physicians do to help promote shared decision making?
- Chapter 45 What can medical educators do to help promote shared decision making?
Overdiagnosis and overtreatment
Overdiagnosis and overtreatment
Beware of guidelines with expanded disease definitions
- (p.129) Chapter 20 Overdiagnosis and overtreatment
- Shared Decision Making in Health Care
- Oxford University Press
Along with other aspirations, shared decision making (SDM) has the laudable aim of bringing more scrutiny of evidence into our health care choices, including assessing the risks and benefits of all treatment options. But as evidence about the problem of ‘overdiagnosis’ grows, we may need to bring more attention to the risks and benefits of a diagnostic label, even before any scrutiny of the pros and cons of possible treatments. This chapter explores how heavily conflicted guideline panels are expanding disease definitions, labelling those with milder symptoms or at lower risks, for whom a diagnosis and treatment may do more harm than good. It explores several examples where there is controversy over recently widened definitions. The chapter concludes that if we’re to better inform people about the risks of overdiagnosis and related overtreatment, and ultimately assist in reducing them, genuine SDM will include information about controversies over disease definitions.
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