MARC Record from harvard_bibliographic_metadata

LEADER: 05854cam a22005894a 4500
001 014144269-7
005 20140821225007.0
008 100827s2011 maua b 001 0 eng
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020 $a9780807022009 (hardcover : alk. paper)
020 $a0807022004 (hardcover : alk. paper)
020 $a9780807021996 (pbk.)
020 $a0807021997 (pbk.)
035 $a(PromptCat)99959372515
035 0 $aocn610837006
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050 00 $aRC71.3$b.W45 2011
060 10 $aWB 60$bW439o 2011
060 00 $a2011 C-100
082 00 $a616.07/54$222
100 1 $aWelch, H. Gilbert.
245 10 $aOverdiagnosed :$bmaking people sick in the pursuit of health /$cH. Gilbert Welch, Lisa Schwartz, Steven Woloshin.
260 $aBoston, Mass. :$bBeacon Press,$cc2011.
300 $axvii, 228 p. :$bill. ;$c24 cm
504 $aIncludes bibliographical references and index.
505 0 $aOur enthusiasm for diagnosis -- Genesis: people become patients with high blood pressure -- We change the rules: how numbers get changed to give you diabetes, high cholesterol, and osteoporosis -- We are able to see more: how scans give you gallstones, damaged knee cartilage, bulging discs, abdominal aortic aneurysms, and blood clots -- We look harder for prostate cancer: how screening made it clear that overdiagnosis exists in cancer -- We look harder for other cancers -- We look harder for breast cancer -- We stumble onto incidentalomas that might be cancer -- We look harder for everything else: how screening gives you (and your baby) another set of problems -- We confuse DNA with disease: how genetic testing will give you almost anything -- Get the facts -- Get the system -- Get the big picture -- Pursuing health with less diagnosis.
520 $aExamining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, the author makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs. After the criteria used to define osteoporosis were altered, seven million American women were turned into patients literally overnight. The proliferation of fetal monitoring in the 1970s was associated with a 66 percent increase in the number of women told they needed emergency C-sections, but it did not affect how often babies needed intensive care, or the frequency of infant death. The introduction of prostate cancer screening resulted in over a million additional American men being told they have prostate cancer, and while studies disagree on the question of whether a few have been helped, there is no disagreement that most have been treated for a disease that was never going to bother them.
520 $aAs a society consumed by technological advances and scientific breakthroughs, we have narrowed the definition of normal and increasingly are turning more and more people into patients. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades, while the number of deaths from those diseases has been largely unaffected. Drawing on twenty-five years of medical practice and research, the author and his colleagues have studied the effects of screenings and presumed preventative measures for disease and "pre-disease." Heh argues that while many Americans believe that more diagnosis is always better, the medical, social, and economic ramifications of unnecessary diagnoses are in fact seriously detrimental. Unnecessary surgeries, medication side effects, debilitating anxiety, and the overwhelming price tag on health care are only a few of the potential harms of overdiagnosis.
520 $a Through the stories of his patients and colleagues, and drawing from popular media, he illustrates how overdiagnosis occurs and the pitfalls of routine tests in healthy individuals. We are introduced to patients such as Michael, who had a slight pain in his back. Despite soon feeling fine, a questionable abnormal chest X-ray led to a sophisticated scan that detected a tiny clot in his lung. Because it could not be explained, his doctors suggested that it could be a sign of cancer. Michael did not have cancer, but he now sees a psychiatrist to deal with his anxiety about cancer. According to the author, a complex web of factors has created the phenomenon of overdiagnosis: the popular media promotes fear of disease and perpetuates the myth that early, aggressive treatment is always best.
520 $aIn an attempt to avoid lawsuits, doctors have begun to leave no test undone, no abnormality (no matter how incidental) overlooked; and, inevitably, profits are being made from screenings, a wide array of medical procedures, and, of course, pharmaceuticals.
650 0 $aDiagnostic errors.
650 0 $aMedical misconceptions.
650 0 $aMedical screening.
650 12 $aDiagnostic Techniques and Procedures$xethics.
650 12 $aEarly Diagnosis.
650 22 $aDiagnostic Techniques and Procedures$xutilization.
650 22 $aEarly Detection of Cancer$xethics.
650 22 $aEarly Detection of Cancer$xutilization.
650 22 $aHealth Policy.
650 7 $aDiagnostic errors.$2fast$0(OCoLC)fst00892353
650 7 $aMedical misconceptions.$2fast$0(OCoLC)fst01432063
650 7 $aMedical screening.$2fast$0(OCoLC)fst01014632
700 1 $aSchwartz, Lisa.
700 1 $aWoloshin, Steve.
849 $bLAM$cGEN$hRC71.3$i.W45 2011
988 $a20140821
049 $b32044126852268$aPCAT162012
906 $0OCLC