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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, October 27, 2015


Resultado de imagen de Emergency Physicians monthly
"EP Monthly has highlighted the issue of practice heterogeneity over the last four years, but the universe of emergency medicine has largerly resisted efforts to admit and address this problem. Why? Do we not believe it to be true? Do we assume that it is unavoidable?
What is Overdiagnosis?
...Overdiagnosis occurs when patients without symptoms are diagnosed with a “disease or condition” that, if left untreated, would not cause them to experience significant untoward effects or early death. For example, a patient might have a clinically insignificant PE. Everybody probably has PE’s at some point. The million dollar question is “if the PE does not cause significant symptoms do we need a screening test to make the diagnosis?” Undoubtedly, some would argue that this does not apply to EM since we do not do screening tests. We perform diagnostic tests, since all of our patients have symptoms. I would argue that overdiagnosis still applies to us for two reasons:
  • Just having a diagnosis doesn’t always explain the cause of the symptoms for which the patient came to the ED, let alone predict a prognosis (i.e. what to tell the patient to expect in the future).
  • Diagnostic accuracy for clinical intuition, physical exam, lab tests, and imaging is often overestimated and misunderstood."