Public opinions about overdiagnosis: A national community survey

Ray Moynihan, Brooke Nickel, Jolyn Hersch, Elaine Beller, Jenny Doust, Shane Compton, Alexandra Barratt, Lisa Bero, Kirsten McCaffery

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33 Citations (Scopus)
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Abstract

Background: Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions. Methods: We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions. Findings: Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity. Conclusions: A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.

Original languageEnglish
Article numbere0125165
JournalPLoS One
Volume10
Issue number5
DOIs
Publication statusPublished - 20 May 2015

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public opinion
Public Opinion
prostatic neoplasms
physicians
Screening
questionnaires
screening
drugs
Industry
Prostatic Neoplasms
Mammography
Telephone
sampling
Pharmaceutical Preparations
breast neoplasms
Surveys and Questionnaires
Medical Overuse
interviews
Early Detection of Cancer
Research

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Moynihan, Ray ; Nickel, Brooke ; Hersch, Jolyn ; Beller, Elaine ; Doust, Jenny ; Compton, Shane ; Barratt, Alexandra ; Bero, Lisa ; McCaffery, Kirsten. / Public opinions about overdiagnosis : A national community survey. In: PLoS One. 2015 ; Vol. 10, No. 5.
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title = "Public opinions about overdiagnosis: A national community survey",
abstract = "Background: Despite evidence about the {"}modern epidemic{"} of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions. Methods: We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions. Findings: Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20{\%} and cooperation rate was 44{\%}. Only 10{\%} (95{\%} CI 8{\%}-13{\%}) of people reported ever being told about overdiagnosis by a doctor. 18{\%} (95{\%} CI 11{\%}-28{\%}) of men who reported having prostate cancer screening, and 10{\%} (95{\%} CI 6{\%}-15{\%}) of women who reported having mammography said they were told about overdiagnosis. 93{\%} (95{\%} CI 90{\%}-95{\%}) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78{\%} (95{\%} CI 74{\%}-82{\%}) felt ties to pharmaceutical companies inappropriate, and 91{\%} (95{\%} CI 82{\%}-100{\%}) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity. Conclusions: A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.",
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Moynihan, R, Nickel, B, Hersch, J, Beller, E, Doust, J, Compton, S, Barratt, A, Bero, L & McCaffery, K 2015, 'Public opinions about overdiagnosis: A national community survey' PLoS One, vol. 10, no. 5, e0125165. https://doi.org/10.1371/journal.pone.0125165

Public opinions about overdiagnosis : A national community survey. / Moynihan, Ray; Nickel, Brooke; Hersch, Jolyn; Beller, Elaine; Doust, Jenny; Compton, Shane; Barratt, Alexandra; Bero, Lisa; McCaffery, Kirsten.

In: PLoS One, Vol. 10, No. 5, e0125165, 20.05.2015.

Research output: Contribution to journalArticleResearchpeer-review

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AB - Background: Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions. Methods: We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions. Findings: Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity. Conclusions: A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.

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