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Overdiagnosis

Overdiagnosis is one of the challenges following medical uncertainty. Detecting conditions, processes, or states that can develop to disease without knowing whether they do so, poses some basic problems for modern medicine.

About the project

Overdiagnosis is one of the challenges following medical uncertainty. Detecting conditions, processes, or states that can develop to disease without knowing whether they do so, poses some basic problems for modern medicine: 

  • What are such states? (This represents ontological challenges)
  • How can we gain knowledge about such states? (This represents epistemological challenges)
  • What should we do with such states? (Should we diagnose, inform about, and treat them?) (This represents ethical challenges)

Objectives

To investigate conceptual, ontological, epistemological, and ethical aspects of overdiagnosis. 

Methods

Conceptual, epistemological, and ethical analysis of overdiagnosis. 

Financing

Part of the project has been financed by the Norwegian Research Council, of the Harkness Fellowship, part of the project has been financed by the Commonwealth Fund, and a small part of the research has been financed by the Brocher Foundation (as a research stay in Hermance April 2018). 

Cooperation

Dartmouth College, NH, USA.

Outcomes (publications)

  • Hofmann B, Lea M. On the Ethics of Withholding and Withdrawing Unwarranted Diagnoses. Cambridge Quarterly of Healthcare Ethics, 2023, 32.3: 425-433.
  • Hofmann B. Addressing the paradox: Health expansion threatening sustainable healthcare. European Journal of Internal Medicine, 2023, 117: 3-7.
  • Hofmann B, Lea M. On the Ethics of Withholding and Withdrawing Unwarranted Diagnoses. Cambridge Quarterly of Healthcare Ethics, 2023, 32.3: 425-433.
  • Hofmann B. Temporal uncertainty in disease diagnosis. Medicine, Health Care and Philosophy, 2023, 1-11.
  • Hofmann B. M., Reid L., Carter S., Rogers W. Overdiagnosis: one concept, three perspectives, and a model. European Journal of Epidemiology (EJE). 2021;36:361-6.
  • Hofmann B. How to Draw the Line Between Health and Disease? Start with Suffering. Health Care Analysis. 2021;29(2):127-43.
  • Rogers W., Carter S., Hofmann B. M., Reid L. Why are the harms of overdiagnosis treated less seriously than other iatrogenic harms? BMJ Evidence-Based Medicine. 2019:A16-A7.
  • Hofmann B. M. Overdiagnosis: epistemic uncertainty and ethical challenges. BMJ Evidence-Based Medicine. 2019:A11.
  • Hofmann B. M. Responce to “Defining Overdiagnosis”. American Journal of Epidemiology. 2019:1821-2.
  • Hofmann B. M. Benefits beyond basics. Hofmann responds to Harris' commentary "Defining Overdiagnosis". American Journal of Epidemiology. 2019:1821-2.
  • Hofmann B. M. Overdiagnosis: epistemic uncertainty and ethical challenges.  Preventing Overdiagnosis 2019; 2019-12-05 - 2019-12-07; Sydney2019.
  • Hofmann B. M. Back to Basics: Overdiagnosis Is About Unwarranted Diagnosis. American Journal of Epidemiology. 2019;188(10):1812-7.
  • Hofmann B. 9 Overdiagnosis: epistemic uncertainty and ethical challenges. BMJ Evidence-Based Medicine. 2019;24(Suppl 2):A11-A.
  • Hofmann B. 3 Overdiagnosis is like platypus: difficult to classify and difficult to address. BMJ Evidence-Based Medicine. 2019;24(Suppl 2):A53-A4.
  • Hofmann B. Expanding disease and undermining the ethos of medicine. Eur J Epidemiol. 2019;34(7):613-9.
  • Hofmann B. Getting personal on overdiagnosis: on defining overdiagnosis from the perspective of the individual person. Journal of evaluation in clinical practice. 2018 Accepted.
  • Hofmann B. Getting personal on overdiagnosis: On defining overdiagnosis from the perspective of the individual person. Journal of evaluation in clinical practice. 2018;24(5):983-7.
  • Hofmann B. Fake facts and alternative truths in medical research. BMC medical ethics. 2018;19(1):4.
  • Hofmann B. Looking for trouble? Diagnostics expanding disease and producing patients. Journal of evaluation in clinical practice. 2018;24(5):978-82.
  • Hofmann B. Getting personal on overdiagnosis: On defining overdiagnosis from the perspective of the individual person. Journal of evaluation in clinical practice. 2018;24(5):983-7.
  • Hofmann B. M. Conceptual overdiagnosis. A comment on Wendy Rogers and Yishai Mintzker's article “Getting clearer on overdiagnosis”. Journal of evaluation in clinical practice. 2017;23(5):1118-9.
  • Hofmann B. The overdiagnosis of what? On the relationship between the concepts of overdiagnosis, disease, and diagnosis. Medicine, health care, and philosophy. 2017;20(4):453-64.
  • Hofmann B. On the Social Construction of Overdiagnosis Comment on "Medicalisation and Overdiagnosis: What Society Does to Medicine". Int J Health Policy Manag. 2017;6(10):609-10.
  • Hofmann B. M. Conceptual overdiagnosis. A comment on Wendy Rogers and Yishai Mintzker's article "Getting clearer on overdiagnosis". Journal of evaluation in clinical practice. 2016(Epub ahead of print).
  • Hofmann B. Ethical issues with colorectal cancer screening-a systematic review. Journal of evaluation in clinical practice. 2016.
  • Hofmann B. The overdiagnosis of what? Barring the expansive conception of disease.  4th international conference on Preventing Overdiagnosis; 2016-09-20 - 2017-09-22; Barcelona2016.
  • Hofmann B. Medicalization and overdiagnosis: different but alike. Medicine, Health care and Philosophy. 2016;19(2):253-64.
  • Hofmann B. Defining and evaluating overdiagnosis. Journal of medical ethics. 2016;42(11):715-6.
  • Hofmann B. Diagnosing overdiagnosis: conceptual challenges and suggested solutions. European Journal of Epidemiology. 2014;29(9):599-604.

Project start and finish

2014 – 2023

Published Sep. 5, 2022 10:55 AM - Last modified Jan. 9, 2024 5:22 PM

Contact

Project leader

Bjørn Hofmann 
 

Participants

  • Bjørn Morten Hofmann University of Oslo
  • H.Gilbert Welch (Dartmouth College)
  • Wendy Rogers (MQ.edu.au)
  • Stacy Carter (UOW.edu.au)
  • Lynette Reid (DAL.ca)
Detailed list of participants