Thoughts & Notes: “Overdiagnosed” by Dr. Gilbert Welch

This time I will focus on the notes! Here we go:

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📝 Overdiagnosis occur when people get diagnosed with conditions that might never cause symptoms or death.

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📝 A overdiagnosed patient can’t be treated, only harmed.

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📝 Overdiagnosis started with the diagnosis and treatment of high blood pressure. Which have helped a lot of people.

“It marked the beginning of treatment for people without syntoms”.

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📝 As we expand treatment to people with to milder abnormalities, their potential benefit from treatment becomes progressively smaller. Severity matters!

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📝 Better equipment find more abnormalities. Famous study found that 10 percent of healthy participants have had strokes without knowing about it.

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📝 “The realities are, with this level of information, I have yet to see a normal patient.” – radiologist who scanned over ten thousand people.

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📝 Overdiagnosis also leads to impressive numbers. 1000 women are diagnosed with progressive breast cancer and 700 survive. That’s 70% survival rate. Add 500 overdignosed patients (diagnoses that never would lead to any syntoms or death). That would make the survival rate go up to 80%!

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📝 Doctors fear lawyers, Love good grades from patients and are punished for not diagnosing = overdiagnosis.

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📝 “Mammography reduce breast cancer deaths AND lead to over-diagnosis.”

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⭐️ TAKEAWAY: If you are a healthy individual with no symptoms, the responsible answer to testing might be “no”. Or you might run the risk of getting treated for an abnormality that would never cause any symptoms. Ever! An options many never consider.

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A very good book, but if your not in the medical practitioner, reading half of it will suffice to get the big picture. I love the nuanced arguments and leave this book with even more admiration for the med. profession.

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3/5

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