1 APRIL 2016
CAUTION! DIAGNOSIS CREEP
An editorial in the latest edition of Australian Prescriber suggests that some guidelines prepared by expert panels are broadening definitions of disease.
This means more and more healthy people are being labelled as ‘sick’.
In the article published online today, Dr Ray Moynihan, senior research fellow at Bond University in Queensland, suggests that expansion of disease definitions risks more children and adults being wrongfully diagnosed.
“Diagnosis creep often results from experts expanding the definitions of common conditions, such as high blood pressure or depression, meaning more people can become labelled with the condition,” says Dr Moynihan.
The editorial also examines how many panelists in the USA had multiple financial ties to drug companies that may benefit from expanded patient populations. Dr Moynihan explains that, while for some newly labelled patients there will no doubt be benefits, for others with mild problems, or at very low risk of illness, a diagnosis can bring more harm than good. This could lead to unnecessary treatment and use of resources that could be better directed to those in genuine need.
“The decisions made by guideline panels ultimately influence whether or not an individual is labelled as ‘diseased’, changing their life’s narrative forever,” says Dr Moynihan.
“Health professionals and the public should be more informed about how we are reaching contemporary definitions of disease. Although diagnostic criteria are regularly changed with the best intentions, there are also challenges because of the potential for unintended harms.”
The author puts forward Choosing Wisely Australia ® as an example of an initiative led by health professionals that challenges the notion that ‘more is always better’. Choosing Wisely Australia provides evidence-based recommendations on tests and treatments that are unnecessary, or of proven low value.
This is the penultimate print edition of Australian Prescriber before it moves fully online later in 2016. Other articles in the April issue include:
* Bone mineral density: testing for osteoporosis
* Osteoporosis treatment and medication-related osteonecrosis of the jaws
* Prescribing and borderline personality disorder
* Menstrual issues for women with intellectual disability
* New drugs: asunaprevir for hepatitis C; idelalisib for chronic lymphocytic leukaemia, follicular lymphoma; nintedanib for idiopathic pulmonary fibrosis, non-small cell lung cancer; ramucirumab for gastric cancer; secukinumab for psoriasis.
To read the full issue, or to subscribe for free to our digital edition, go to nps.org.au/australianprescriber.