过度诊断是什么意思？

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近年来，医生和学者对问题越来越感兴趣称为“过度诊断”。可以定义多种方式过度诊断。

一个特别有用的方法是把它当the diagnosis of a disease that would never have caused a person symptoms or led to their death, whether or not it had been found through a medical test. In other words, even if a person had not had the test, the disease would never have caused them any harm.

Catching it early

这可能是如何发生的。例如，想象一个女性要进行乳房筛查，该妇女在开始引起症状之前试图在早期发现癌症。

The thinking behind this type of test is that if the disease is found early, it will be easier to treat and there is a higher chance of curing it. Most people are familiar with this idea that ‘catching it early’ is a good thing.

The cancer is real but the diagnosis does not benefit the woman at all; it results in treatment that she did not need (‘overtreatment’).

因此，假设一个没有症状的妇女进行筛查，测试发现癌症：她通常会继续接受治疗（例如手术）。

然而，尽管她无法确定自己知道，但癌症可能会慢慢增长，以至于她会活到老年，死于无关的事物，而没有知道癌症，如果她没有去筛查。

The cancer is real but the diagnosis does not benefit the woman at all; it results in treatment that she did not need (‘overtreatment’). In fact, if she had not had the screening test, she would have avoided all the problems that come with a cancer diagnosis and treatment.

研究发现了什么

如果您发现过度诊断违反直觉的想法，那么您并不孤单。几项研究试图在这个问题上衡量公众舆论，发现这是一个相当典型的观点，部分是因为某些疾病（例如癌症）可能永远不会引起症状或死亡的观念，这种观点不会受到很多关注，并且经常是与我们的个人经历不符。

结果Australian studyin 2015 found that awareness of ‘overdiagnosis’ is low – in a study of 500 adults who were asked what they thought it meant, only four out of ten people gave a description of the term that was considered approximately correct and these descriptions were often inaccurate to varying degrees.

For example, people often thought in terms of a ‘false positive’ diagnosis (diagnosing someone with one illness when really they do not have that illness at all), or giving a person ‘too many’ diagnoses.

这在英国是一样的吗？

我们问一组390名成年人，他们之前是否遇到过“过度诊断”一词，并要求他们描述他们认为这是什么意思

我们也想知道是否这是真实的我n the UK. We asked a group of 390 adults whether they had come across the term ‘overdiagnosis’ before and asked them to describe what they thought it meant in their own words, as part of an online survey.

We found that only a minority (three out of ten people) had encountered the term and almost no-one (10 people out of all 390) described it in a way that we thought closely resembled the concept described above.

并不总是很清楚如何最好地总结人们的描述，但是we found thatpeople often stated that they had no knowledge or had similar conceptions to the Australian survey such as ‘false positives’ and ‘too many’ diagnoses.

Some descriptions were somewhat closer to the concept of overdiagnosis such as an ‘overly negative or complicated’ diagnosis (e.g. where the severity of an illness is overstated) but there were also some descriptions that we found more surprising such as being overly health-conscious (e.g. worrying too much about health issues).

改进的空间

Many people who work in public health and healthcare believe that people should be aware of the possibility of overdiagnosis, particularly since they will eventually be offered screening tests in which there is this risk.

我们的发现表明，我们如何将过度诊断的方式告知公众有很大的改进空间。

In this respect, our findings show that there is substantial room for improvement in how we inform the public about overdiagnosis. In part, this may be due to the term itself not having an intuitive meaning, in which case other terms might be more helpful (for example the term ‘unnecessary detection’).

This could be tested in future studies. Our findings also motivated us to find out the extent to which trusted information sources (such as websites run by the NHS and leading health charities) are already providing information on overdiagnosis.

我们想在后续博客文章中分享这项研究的发现。我们将在UCL Health Behaviour Research Centre website很快