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Overdiagnosed: Making People Sick in the Pursuit of Health
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Overdiagnosed: Making People Sick in the Pursuit of Health

4.19 of 5 stars 4.19  ·  rating details  ·  488 ratings  ·  99 reviews
From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

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 excesse
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Kindle Edition, 248 pages
Published (first published January 1st 2011)
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Meredith
Overdiagnosed: Making People Sick in the Pursuit of Health challenges the current mindset that it's always desirable and beneficial to obsessively screen healthy people for potential illnesses. Dr. Welch describes how actively pursuing illness in healthy people can actually be harmful to the patient.

Why is it bad to discover that people have diseases they don't know about and that have yet to create any symptoms? A few reasons are:
1) The medical-industrial complex continually lowers the numbers
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Jafar
First-World problems.

If you’ve been led to believe that it’s a good idea to get an annual physical checkup even though there’s nothing wrong with you, you need to read this book. The idea that it’s beneficial that we subject ourselves to tests and screenings, which are judged based on sometimes arbitrarily-set numerical criteria, only to look for problems that do not yet exist or have not shown up yet as symptoms is a pseudo-scientific hoax that is promulgated by those who want to sell you tests
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Sally
A very clear, well-reasoned, reader friendly, evidence-based argument for the view that preemptively hunting for health problems in asymptomatic people through routine screenings and tests, and lowering diagnostic thresholds (as has been done with high blood pressure, cholesterol, and diabetes), is not in the best interests of the vast majority of people. Many such early-intervention strategies do not lower the number of deaths from those diseases, result in false positives and overtreatment, an ...more
A.
Apr 24, 2011 A. rated it 5 of 5 stars
Recommended to A. by: no one
This book is a lot better and more accurate than you would think. I happened upon it at the library. After looking at it for a week I was super bored and read it. Could not put it down! It explains how diagnostic tests have shifted (high cholesterol is now 200 and over where before it was 240 and over) after studies (paid for by drug companies-often) determined a lower threshold was needed. It also discusses how if you get enough tests you are bound to find something and that sometimes the treat ...more
Carl Kessler
Everyone should read this book, but I fear that few will. Partly because it is perceived as a difficult topic. No worries there: Dr. Welch and his co-authors make this as easy and straightforward a read as possible. Even if you barely passed high school biology or math, you'll have no problems here: the science is simple, the statistics are very clearly explained.

Another reason folks might not read this is that they are comfortable delegating their personal health decisions to physicians. The fa
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Jennifer
The biggest fault of this book is probably the tendency of the author to repeat himself rather a lot, both in explaining what he means and what he does not mean to say. But you can understand that because of the severe risks to his readers of misinterpretation of his message, or to himself if others looking to sue him were to misconstrue what he is saying.
Welch has an important point to make - I won't bore you with a restating of what that point is, as you will have read about it already to get
...more
Joan
Jan 01, 2014 Joan rated it 4 of 5 stars  ·  review of another edition
Recommends it for: Every adult
Recommended to Joan by: ??
I found myself feeling dubious about some of the claims. I also found myself wishing for more detail. Basically, the concept is that doing hunting expeditions for diseases isn't a good idea. He is all for what he calls diagnostic screening: if the patient goes to the doctor with a lump or something. He is very opposed to screening being done routinely and explains why in convincing detail. I'm just not completely convinced. My father in law was diagnosed with colon cancer after getting a toilet ...more
Sam
Dr. Welch was involved in an experiment in which a group of men who had had heart attacks were split into two groups, one of which was equipped with devices to measure irregularities & the other which was given the usual regular checkups. The experiment was discontinued when the researchers found that the device-equipped group received more treatment & died in greater numbers. This got the author looking for similar medical treatment phenomena.

If a form of cancer has become much more co
...more
Jodi
If you are interested in America's health care system, you should read this book. The authors are practicing physicians and bring both real world experience and an MD level understanding of clinical trials. We are moving from treating sick people that have definite symptoms to looking at healthy people with no symptoms in the hope that "early detection" will prevent sickness. With the advent of MRIs and CT scans, we are able to see much more than ever before. The cut offs for diagnosing high blo ...more
Azure
After hearing Dr. Welch give this presentation I immediately went out and got the book. He does a convincing way of presenting data to support his premise without putting one to sleep. I feel his conclusions are well reasoned and logical and appreciate his suggestions regarding 'what now'. You can see his presentation on You Tube https://www.youtube.com/watch?v=C-Dnz.... If this message resonates with you then I'd suggest you read The End of Illness and Our Daily Meds. Both books lend themselves ...more
Laloofah
I'd seen a few of Dr. Welch's interviews online (and enjoyed them) before reading this, and as a patient of Dr. John McDougall I was already well versed in the insidious risks of overdiagnosis - and have been an unwitting victim of it myself several times. Dr. Welch's book is an important read - because truly informed consent is so often lacking, while aggressive marketing of highly questionable "early detection" testing and other procedures is pervasive. I liked Dr. Welch's eloquent summary on ...more
Amie
This book was really interesting considering the direction American healthcare is taking, namely spending more and more money but doing nothing to actually improve quality of life. I mainly picked it up because there was a chapter about ultrasound and fetal monitoring...turned out this was the shortest chapter but worth reading. The author had a degree in economics before going to med school so his perspective was unique. My main complaint is how frequently the author repeated catch phrases...we ...more
Murray
The book is worth reading. Dr. Welch does a good job making his points. He and others who share his zeal have contributed to public awareness of a problem that has bothered medical professionals for sometime. The use of many cancer-screening tests can lead to the diagnosis of tumors that may never have been harmful had they remained undetected. In this situation we say the cancer is overdiagnosed and the patients overtreated. Welch has many excellent good points to make. Unfortunately, he, and t ...more
Melissa Mulvihill
I cannot imagine who would not find this book relevant. We have had a child over diagnosed and I have been misdiagnosied. Living with a chronic condition that's extremely difficult to manage, having left the care of doctors who minimize surgical interventions, and being aware that the thresholds for diagnosing many common conditions have been significantly lowered over the last 20 years I am always interested in understanding how I can lower the odds that I will be over diagnosed. Full of easy t ...more
Jen
This book presents some interesting ideas, and it certainly made me feel like a Monday-morning quarterback about some of my recent health decisions. Some of the writing feels a bit redundant, but dividing the chapters by conditions helps to keep things moving. A solid 3 1/2 stars.
Linda
Excellent and fair-handed review of the overuse of diagnostic tests in America. The author does a very good job of showing both the benefits and risks of common procedures that most people wouldn't even think to question and yet should. In our current atmosphere of "more testing must be better," it was refreshing to read a sane voice, and Welch is scrupulous about backing up every point he makes with data. People who have blind faith in the medical industrial complex will walk away disappointed ...more
Nathan
This book supports a notion that I have had for many years, so perhaps I am biased towards the conclusion it draws.

Basically this book suggests that America has decided, nearly unilaterally, that it is better to treat everything that MAY cause health issues in the future, rather than to wait and see what actually does.

The statistics are heavy and the anecdotes few, but the problem exists for everything from high blood pressure or cholesterol to a multitude of cancer treatments.

Loses one star d
...more
Shela Sundawa
I should applaud the autors willingness to acknowledge such unpopular issue of today's healthcare. Problem of overdiagnose is problematic that it present with two edges sword, in which doctor leave in a ambiguous field of medicine.
This book provides a lot of evidence to back up the argument of overdiagnose especially in US, either with convincing studies or patients story. Yet, it can do better if the authors provide meticulous explanation of the studies as a curious reader ( like me) worry the
...more
Jim Duncan
The want to know versus the need to know. Nicely balances the concerns about over testing with the benefits of early detection. Always a two edged sword
Barb
A timely look at how the medical profession is over diagnosing patients. It is time to start questioning why some tests are really necessary.
Deborah
I very much appreciate the message of this book and believe wholeheartedly that the author is right. For me there is a bit too much statistical evidence to support his premise. I prefer anecdotal to statistical. And, as other reviewers mentioned, there was a lot of repetition. It took me a while to finish the book even though I scanned some parts, especially those with graphs. I almost returned the book to the library without finishing, but I convinced myself to read the wrap-up and am glad I di ...more
Daniel Roth
It seems intuitive: detecting health abnormalities earlier is better. And in some cases it is. However, Dr. Gilbert Welch argues, as we look harder for abnormalities, with ever more powerful diagnostic capabilities, the vast majority of what we are finding are "abnormalities" that will never cause harm--a small indolent cancer that is destined never to spread, as is the case with most thyroid cancers. That is over diagnosis. And we are suffering an epidemic of over diagnosis causing real harm to ...more
Peter Pecksen
One of the most thought provoking books I have read in a long time. If you are comfortable or at least curious about questioning the reasons for the seemingly non-stop barrage of medical tests and screenings that are recommended these days, this is a must read. It is NOT about seeing your Doctor when you are sick or have a symptom of some abnormality. The book is all about questioning why anyone would want to submit to testing and screening when you feel good and have no symptoms of abnormalitie ...more
Arminzerella
Dr. Welch makes the unusual suggestion that current methods of screening for disease as a means of prevention often results in over-diagnosis. Expensive tests are ordered, abnormalities are discovered, patients are unnecessarily traumatized in the name of disease discovery. He suggests that not all tests and screenings are necessary, and that there is evidence to show that they can do more harm than good. Convincing examples of data and patient histories are shared. Unfortunately, the predominan ...more
Asha Tenbroeke
'Overdiagnosed' is, without a doubt, an important book. It convincingly shows that if we look harder for a disease, we find more "abnormalities" but we're not preventing any deaths. Instead, the more people are subjected to unneccesary medical procedures, which can be just scary, expersive and annoying but also debilitating or even lethal.
The authors explains how this happens with great clarity. Let's say, as an example, that each year a hundred women find a lump in their breast. They go and se
...more
Jim
This book is a very good corrective to some of the over-simplified public health (not to mention individual doctor) messages we get about screening and early detection. Many of us know about the risk of false positives. This book goes through all the risks of over-diagnosis--those cases where there was an abnormality that has been identified, but where that abnormality never would have progressed to cause symptoms or threaten the person's life. In those cases, the person overdiagnosed becomes me ...more
Gloria
In some ways this is a very important book with a vital message but he repeats himself so much. Maybe he does this to get his message across; unfortunately the people who'd choose to read the book don't need this constant review and repitition. The basic message is that too much screening is performed on people who are free of symptoms. The screening invariably picks up some abnormalities that thus need to be "followed up". These abnormalities would often neither cause symptoms nor illness nor d ...more
AGC
Dr. Welch sheds light upon a controversial, lesser-known corner of medicine -- over-diagnoses. Although it is a term rarely used in today's medical world, he (and others) are bringing up issues in the U.S. healthcare system of how not everything that we pursue in medicine may be beneficial to the patients, physicians, and the system as a whole. Today's medicine is all about catching diseases early, even before it starts. and testing and treating more. This can bring more income, prevent malpract ...more
Greg
Would explain a lot about why we spend so much on medical care yet do not have the best health in the world. The author reviews several diseases (mainly cancers) and asks whether they are being overdiagnosed. The principal hypotheses the author makes behind his analysis are:

- Doctors have never really operated in a scientific manner. Since they often do not have the luxury of denying patients treatment and seeing whether they get better anyway, they never really know whether treatment was effect
...more
Jeffrey
We know too much! The author, a physician and researcher, discusses the problems of overdiagnosis, including the controversial mammogram overdiagnosis issue and others. He suggests that much of the testing we do is unnecessary and even counter-productive in terms of patient health. He explores with depth and compassion, the issues with the literally millions of folks who suffer under 'false positive' diagnoses, from blood pressure, to cancer to childbirth, which he finds has been medicalized to ...more
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“Given the number of small cancers they did find and the number that they reasoned they had missed...the researchers concluded that virtually everybody would have some evidence of thyroid cancer if examined carefully enough.” 1 likes
“The only way to know if the screening is saving lives is by doing a randomized trial. It's easy to forget this and assume that if technology can find more cancer, it will save more lives. Marketers exploit this assumption. Don't fall for it.” 1 likes
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