Overdiagnosis group

The overdiagnosis group was set in 2014 to explore and develop thinking around overdiagnosis. This group is an informal Google group which communicates through email. Membership is mainly GPs but also students and trainees, specialists, health care professionals and members of the public. Although mainly UK based, the group also has world-wide members. The group is now over 300 strong and hope you will join us to improve thinking around overdiagnosis. This group encourages cognition and we have all taken up increased critical thinking and ethical skills from the interactions.

Comments and contributions are welcome from anyone, as are ideas and offers of input to make things happen. You are free to read, delete or contribute as you wish. At times there can be a lot of emails so be selective, open-minded and we hope you enjoy the intellectual exchanges. It can help on emails if you briefly put who you are/role under your name. Please join us.

Please note that all members must make a public declaration of their interests. Having a declaration of interest(s) or conflict(s) of interest is not an issue but not declaring it is! Non-doctors can also email Who Pays This Doctor to declare interests and possible conflicts.

There are no 'rules' but we respect confidentiality of posting. The chair or vice chair may intervene if the topic is clearly not related to overdiagnosis or is advertising. Overdiagnosis topics may include optimal diagnosis or under-diagnosis. 

New and forthcoming work

In January 2019 the group had a subgroup on optimal testing and a subgroup exploring usual practice in diagnosis and management of insect bites. We will add the work from these groups as it becomes available.

In 2018 Margaret McCartney and Sam Finnikin were appointed as RCGP Fellows for Values and Evidence. These titles reflect the discussions within the Overdiagnosis Group: over diagnosis and over treatment are inherently entangled with risk, shared decision making, evidence and information quality, drivers to testing and treatment, quality of life issues, medicalisation of normality, and conflicts of interest. Below you will find some resources that many professionals and patients may find useful when considering these issues.

International Annual Preventing Overdiagnosis Conference

There is an annual conference around the world which some of us attend and is thoroughly recommended. The next one is in Denmark.

Find out more about the conference.

UK conference

Preventing Overdiagnosis through the Shared Understanding of Medicine (POSSUM) was held in Birmingham, run by Sam Finnikin, in June 2018. We hope to repeat that success with a day talking about the legal ramifications of guidelines, shared decision making (SDM) and evidence based medicine (EBM).

RCGP standing group on overdiagnosis – report to council

This paper examines policy making in relation to overdiagnosis and overtreatment in general practice, and makes recommendations for the future examination of policy, either presented to or created within the RCGP, in order to prevent avoidable harm, via the use of 'tests' to be applied to new policies being considered.

Download a copy of the report:

RCGP standing group on overdiagnosis for shared decisions in healthcare (PDF file, 53 KB)

Join us

Fill in the form to join us: RCGP standing group on overdiagnosis.

Specific contacts

Group governance

  • The list of members is available on membership in the Google group.
  • The group is an informal discussion group by email and so does not have funding or a constitution/terms of reference.
  • The chair and two vice chairs moderate the group.
  • Last meeting of the chair and vice chairs: 1st Nov 22. There are no regular face to face committee meetings.

Resources

The group has developed some resources that many professionals and patients may find useful when considering overdiagnosis, values and evidence.

Harding Centre for Risk Communication

Fact boxes which provide quick graphical description of relative risks and benefits for some interventions - includes statins for primary prevention, screening, antibiotics for bronchitis.

Aimed at professionals

Aimed at everyone

  • James Lind Library: extensive online library documenting the history of fair tests of interventions in health care.
  • Risk of deception tool: online resource from the University of British Columbia to help people identify the likelihood of internet scams.
  • Know your chances: free online book by Dartmouth University academics aimed at a wide readership which teaches basic statistical literacy.

Aimed at children

  • Informed health choice: This international initiative aims to teach children to spot fake healthcare claims. Includes an evidence based medicine song!
  • Facts for Life: Course developed for children in schools teaching about ‘normal’ health and illness. Available on a paid-for basis in the UK.

Other resources - campaigns and conferences

  • RCGP policy on overdiagnosis: paper approved by the RCGP council which contains 5 tests which are to be applied to any new RCGP policy.
  • Choosing Wisely - UK campaign: part of a global initiative website; contains resources such as posters asking patients to ask doctors the BRAN questions (Benefits/Risks/Alternative/What would happen if I do nothing?)
  • AllTrials campaign: many clinical trials go unreported leading to bias - this campaign aims to change that
  • Compare-trials campaign: Outcome switching may be legitimate in clinical trials but may increase the risk of bias. Campaign to compare registered and published trial outcomes

Conferences

  • Preventing Overdiagnosis 2018 - Denmark
  • Preventing Overdiagnosis 2019 - Australia, December 2019
  • EBMLive 2019 - making Evidence Relevant and Replicable for Policy, Patients and Professionals in Healthcare. Oxford, July 2019

While the content of this page is reviewed and updated on a regular basis, we do not control or accept any responsibility for any linked resources on third-party websites or for any liability arising from their use. Any inclusion in this page does not necessarily imply RCGP endorsement. Access to and use of content including clinical guidelines on any third-party website is carried out solely at your own risk.