Title Media fails to cover harms of early diagnostic testing: Study Degree of recognition National Media name/outlet News GP Media type Web Country Australia Date 7/04/21 Description Researchers fear a lack of risk–benefit analysis may be contributing to overdiagnosis...
Professor Mark Morgan, Chair of the RACGP Expert Committee – Quality Care (REC–QC), told newsGP there are a host of harms that can arise from over-testing and that overdiagnosis is the most important downside, but the least understood.
‘One of the great examples might be the early detection of a slow-growing thyroid cancer,’ he said.
‘On first thought you’d think “Oh yeah, pick it up early, that’s going to be a good idea”. But actually, if it leads to further invasive confirmatory tests, unnecessary treatments, lots of additional anxiety, increased insurance premiums or inability to get insurance – and that diagnosis was never going to cause any trouble for the rest of your life, then that’s an overdiagnosis.’
Despite the potential risks and harms of overdiagnosis, the study found only 5% of news stories mentioned it.
Beyond that, Professor Morgan says the potential for false-positives and -negatives also have downsides.
‘Where a test falsely reassures somebody, that could lead to a delayed diagnosis and symptoms that are dangerous being ignored, or a change towards more risky behaviour because of a false-negative test,’ he said...
One example cited is coverage of the Apple watch’s ability to detect atrial fibrillation. Out of 22 authors for a key trial examining the watch’s ability, 19 disclosed taking grants or personal fees from the company, yet the information was rarely reported.
‘If people have a conflict and if something’s an infomercial, it needs to be clearly labelled as such,’ Professor Morgan said.
‘I get frustrated to see people with a product to sell having things published that look like they’re reporting a news story, when in fact it’s a sales pitch. That’s a fundamental issue of honesty and making sure that media reporting is delivering what it says it’s delivering.’
Professor Morgan says the misrepresentation in the media has significant implications for GPs and the health system as a whole.
‘If we start doing lots of ad hoc screening … we don’t have the infrastructure to back that up with appropriate follow up,’ he said.
‘And if those tests are not very good tests, and they have a lot of false-negatives and false-positives, then a lot of resources are diverted towards inappropriate screening programs, when it’d be much better to concentrate on the screening programs, such as bowel cancer screening, that have good evidence and really do save lives.’
Producer/Author Anastasia Tsirtsakis Persons Mark Morgan