Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
St. George's University School of Medicine, St. George's, WI, Grenada.
Intern Emerg Med. 2022 Apr;17(3):629-633. doi: 10.1007/s11739-022-02952-8. Epub 2022 Mar 5.
Overdiagnosis occurs when a person's symptoms or life experiences are given a diagnostic label that ultimately causes them more harm than good. We describe the complex drivers of overdiagnosis spanning five interconnected domains, which can lead to numerous negative impacts on patients. Emergency physicians are often tasked with making timely clinical assessments, decisions, and diagnoses that can unintentionally result in overdiagnosis. Three pertinent areas related to overdiagnosis in Emergency Medicine: anaphylaxis, subsegmental pulmonary embolism, and low-risk chest pain are discussed. For a broader perspective, insight on overdiagnosis from medical students and a patient advisor are presented. The perspectives illustrated are meant to spark reflection on: the ethics of labeling a person with a diagnosis, current clinical practices, the limitations of medical education, and patient care and communication in the context of overdiagnosis in the Emergency Department.
过度诊断是指当一个人的症状或生活经历被贴上诊断标签，最终给他们带来的伤害大于好处。我们描述了五个相互关联的领域中过度诊断的复杂驱动因素，这些因素可能对患者造成许多负面影响。急诊医生通常负责进行及时的临床评估、决策和诊断，这可能会无意中导致过度诊断。本文讨论了与急诊医学中过度诊断相关的三个领域：过敏反应、亚段肺栓塞和低危胸痛。为了更广泛的视角，本文还介绍了医学生和患者顾问对过度诊断的看法。所说明的观点旨在引发对以下方面的思考：给一个人贴上诊断标签的伦理道德、当前的临床实践、医学教育的局限性以及在急诊室过度诊断背景下的患者护理和沟通。
