Welch, H. Gilbert, M.D., M.P.H., Lisa Schwartz, Steve Woloshin

Overdiagnosed

Making People Sick in the Pursuit of Health

• Broschiertes Buch

Produktbeschreibung

A nationally recognized expert offers a searing exposé of Big Pharma and the American healthcare system s zeal for excessive medical testing.

More screening doesn t lead to better health but can turn healthy people into patients.

Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening.

Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with abnormal test results have been drastically lowered just when technological advances have allowed us to see more and more abnormalities, many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers.

With genetic and prenatal screening now common, patients are being diagnosed not with disease but with pre-disease or for being at high risk of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.

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Produktdetails

• Verlag: Beacon Press
• Seitenzahl: 248
• Erscheinungstermin: 3. Januar 2012
• Englisch
• Abmessung: 232mm x 154mm x 23mm
• Gewicht: 366g
• ISBN-13: 9780807021996
• ISBN-10: 0807021997
• Artikelnr.: 33396193

Autorenporträt

H. Gilbert Welch

Inhaltsangabe

Table of Contents...

Introduction: Our Enthusiasm for Diagnosis

Chapter 1) Genesis: People Become Patients with High Blood Pressure
Chapter 2) We Change the Rules: How Numbers Get Changed to Give You Diabetes, High Cholesterol, and Osteoporosis
Chapter 3) We Are Able to See More: How Scans Give You Gallstones, Damaged Knee Cartilage, Bulging Discs, Abdominal Aortic Aneurysms, and Blood Clots
Chapter 4) We Look Harder for Prostate Cancer: How Screening Made It Clear That Overdiagnosis Exists in Cancer
Chapter 5) We Look Harder for Other Cancers
Chapter 6) We Look Harder for Breast Cancer
Chapter 7) We Stumble onto Incidentalomas That Might Be Cancer
Chapter 8) We Look Harder for Everything Else: How Screening Gives You (and Your Baby) Another Set of Problems
Chapter 9) We Confuse DNA with Disease: How Genetic Testing Will Give You Almost Anything
Chapter 10) Get the Facts
Chapter 11) Get the System
Chapter 12) Get the Big Picture

Conclusion: Pursuing Health with Less Diagnosis

Acknowledgments
Notes
Index

Rezensionen

Very insightful and engaging. Dennis Rosen, The Boston Globe

One of the most important books about health care in the last several years. Cato Institute

"One of the big strengths of this relatively small book is that if you are inclined to ponder medicine's larger questions, you get to tour them all. What is health, really?... In the finite endeavor that is life, when is it permissible to stop preventing things? And if the big questions just make you itchy, you can concentrate on the numbers instead: The authors explain most of the important statistical concepts behind evidence-based medicine in about as friendly a way as you are likely to find." Abigail Zuger, MD, The New York Times

"Overdiagnosed albeit controversial is a provocative, intellectually stimulating work. As such, all who are involved in health care, including physicians, allied health professionals, and all current or future patients, will be well served by reading and giving serious thought to the material presented." JAMA

Everyone should read this book before going to the doctor! Welcome evidence that more testing and treatment is not always better. Susan Love, MD, author of Dr. Susan Love s Breast Book

This book makes a compelling case against excessive medical screening and diagnostic testing in asymptomatic people. Its important but underappreciated message is delivered in a highly readable style. I recommend it enthusiastically for everyone. Arnold S. Relman, MD, editor-in-chief emeritus, New England Journal of Medicine, and author of A Second Opinion: Rescuing America s Health Care

This stunning book will help you and your loved ones avoid the hazards of too much health care. Within just a few pages, you ll be recommending it to family and friends, and, hopefully, your local physician. If every medical student read Overdiagnosed, there is little doubt that a safer, healthier world would be the result. Ray Moynihan, conjoint lecturer at the University of Newcastle, visiting editor of the British Medical Journal, and author of Selling Sickness

An overdiagnosis is a label no one wants: it is worrisome, it augurs overtreatment, and it has no potential for personal benefit. This elegant book forewarns you. It also teaches you how and why to ask, Do I really need to know this? before agreeing to any diagnostic or screening test. A close read is good for your health. Nortin M. Hadler, MD, professor of medicine and microbiology/immunology at University of North Carolina at Chapel Hill and author of Worried Sick and The Last Well Person

We ve all been made to believe that it is always in people s best interest to try to detect health problems as early as possible. Dr. Welch explains, with gripping examples and ample evidence, how those who have been overdiagnosed cannot benefit from treatment; they can only be harmed. I hope this book will trigger a paradigm shift in the medical establishment s thinking. Sidney Wolfe, MD, author of Worst Pills, Best Pills and editor of WorstPills.org