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Preventing Overdiagnosis: How To Stop Harming The Healthy, Ray Moynihan, Jenny Doust, David Henry
Preventing Overdiagnosis: How To Stop Harming The Healthy, Ray Moynihan, Jenny Doust, David Henry
Jenny Doust
Medicine’s much hailed ability to help the sick is fast being challenged by its propensity to harm the healthy. A burgeoning scientific literature is fuelling public concerns that too many people are being overdosed, overtreated, and overdiagnosed. Screening programmes are detecting early cancers that will never cause symptoms or death, sensitive diagnostic technologies identify “abnormalities” so tiny they will remain benign, while widening disease definitions mean people at ever lower risks receive permanent medical labels and lifelong treatments that will fail to benefit many of them. With estimates that more than $200bn (£128bn; €160bn) may be wasted on unnecessary treatment …
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Jenny Doust
Aims: Diagnosis of heart failure in primary care is often inaccurate, and access to and use of echocardiography is suboptimal. This study aimed to develop and provisionally validate a clinical prediction rule to optimize referral for echocardiography of people identified in primary care with suspected heart failure. Methods and results: A systematic review identified studies of diagnosis of heart failure set in primary care. The individual patient data for five of these studies were obtained. Logistic regression models to predict heart failure were developed on one of the data sets and validated on the others using area under the receiver …