The GIN Board of Trustees established the Overdiagnosis Working Group in August 2014, following a successful meeting organised by Paul Glasziou ahead of the Melbourne conference.

Globally there is increasing concern about the impact of “overdiagnosis” on both the overtreatment of patients and as a major contributor to rising health care costs. Recent activities in this area include the ABIM’s Choosing Wisely campaign (www.choosingwisely.org/), JAMA Internal Medicine’s “Less is More” series, the BMJ’s Too Much Medicine series (www.bmj.com/too-much-medicine) and the controversy over the expanded definitions of psychiatric illness in the recent DSM-5 release (www.psychologytoday.com/blog/dsm5-in-distress).

Currently we have no specific rules or guidance on when and how the definitions of diseases should be modified. A recent study published in PLOS Medicine [Moynihan, 2013]] highlighted the tendency of disease definitions to widen: of 16 guidelines on 14 common conditions, 10 proposed changes widening, 1 narrowing definitions, and 5 were unclear. The widening fell into three categories: creating ‘‘pre-disease’’ (such as pre-hypertension and pre-clinical Alzheimer’s); lowering diagnostic thresholds or boundaries (such as diabetes, and depression); and proposing earlier or different diagnostic methods (such as single scan diagnosis for multiple sclerosis). None of the 16 guidelines included a rigorous assessment of potential harms of proposed definitions changes. There were also considerable conflicts of interest within the committees, including the committee chairs.

 Aims & Objectives

  • To set an internationally acceptable set of rules and guidance on the requirements for modifying the definitions of diseases.
  • Provide guidance to guideline developers who are considering a change to the definition or thresholds for specific diseases or developing new clinical categories.

Chair – Sam White

Board Liaison – Amir Qaseem

How to Join

If you are interested in joining this Working Group please contact our membership manager, Joanne.