Department for the Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.
The Centre for Medical Ethics, University of Oslo, Oslo, Norway.
Int J Health Policy Manag. 2017 Oct 1;6(10):609-610. doi: 10.15171/ijhpm.2017.21.
In an interesting article Wieteke van Dijk and colleagues argue that societal developments and values influence the practice of medicine, and thus can result in both medicalisation and overdiagnosis. They provide a convincing argument that overdiagnosis emerges in a social context and that it has socially constructed implications. However, they fail to show that overdiagnosis per se is socially constructed and how this construction occurs. Moreover, the authors discuss overdiagnosis on a micro level without acknowledging that overdiagnosis cannot be observed in individuals "in the doctor's office." We cannot tell whether a diagnosed person is overdiagnosed or not. This is the core of the problem. Despite these shortcomings, Wieteke van Dijk and her colleagues are certainly on to something important, and they should be encouraged to elaborate their perspective. We certainly need to deepen our understanding of the social construction of overdiagnosis.
在一篇有趣的文章中，Wieteke van Dijk 和同事们认为，社会发展和价值观会影响医学实践，从而导致医学化和过度诊断。他们提供了一个令人信服的论点，即过度诊断出现在社会背景下，并且具有社会构建的含义。然而，他们未能表明过度诊断本身就是社会构建的，以及这种构建是如何发生的。此外，作者在微观层面上讨论了过度诊断，而没有认识到过度诊断不能在“医生办公室里的个体”中观察到。我们无法判断一个被诊断的人是否被过度诊断。这是问题的核心。尽管存在这些缺点，但 Wieteke van Dijk 和她的同事们肯定是在研究一些重要的问题，应该鼓励他们详细阐述自己的观点。我们当然需要加深对过度诊断的社会构建的理解。
