walkitout (walkitout) wrote,

_Overdiagnosed_, H. Gilbert Welch, Lisa Schwartz, Steven Woloshin

Subtitled: Making People Sick in the Pursuit of Health
Published by Beacon Press

First, a word about Beacon Press:


I got Welch's _Should I Be Tested for Cancer?_ years ago (probably shortly after it was published, but I think I got it at the library) when I stumbled across the public health guys in White River Junction. The researcher I initially found (name escapes me at the moment) had not written a book, but he pointed me at Welch's work. The trio listed as the authors on this are the same as a book I bought in 2008, _Know Your Numbers_, which I also really liked.

If you read _Overdiagnosed_, you probably don't need to go back and read the earlier works; it is more or less an updated superset of the ideas and evidence of the earlier ones.

The nature of this topic is inherently repetitive. It isn't the fault of the authors but rather an important component of their thesis. Many, many aspects of medicine share a very similar pattern: a treatment (surgical, medical, radiological or other) is devised for a previously unrecognized or untreatable problem. It works great -- people live way longer, maybe die of something totally unrelated decades later, instead of dying in a shorter number of years from the problem. So then people start thinking, hey, let's catch this earlier. But as you get earlier and earlier, you get more and more people who have the "problem" or the health number proxy for it or are at risk for it, etc. Some -- maybe many or even most -- of these people weren't going to get sick from that much less die of it for a long time, and the treatments are, alas, not risk free.

Obviously, mammograms and PSA are discussed, as are hypertension, high cholesterol, a bunch of "cancers", "incidentalomas" and the problems they present, etc. They touch on some of the many problems associated with turning pregnancy and childbirth into a disease process.

This group is really scrupulous. They don't reason in advance of the data (sometimes I wish they would, because there are some pretty obvious places they could go but they decline). I never worry about recommending them. Should you read this? Oh yeah. Buy a copy and loan it around when you're done. It's like Consumer Reports; it pays for itself almost immediately by helping you make better decisions. You save money AND the results are better.

If you're wondering why I didn't review this back in January when it came out, that's because I didn't know about it until T., the midwife who did my well woman visit, mentioned it to me. Had I known then who it was by, I could have told her right off what I would think about it even without reading it.
Tags: book review, health, non-fiction
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