Précising definitions as a way to combat overdiagnosis

Wendy A. Rogers*, Mary J. Walker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
9 Downloads (Pure)


Roughly, overdiagnosis (ODx) occurs when people are harmed by receiving diagnoses (often accompanied by interventions) that do not benefit them, usually because the diagnosed conditions do not pose a threat to their health. ODx is a theoretical as well as a practical problem as it relates to definitions of disease. Elsewhere, it has been argued that disease is a vague concept and that this vagueness may contribute to ODx. In response, we develop a stipulative or précising definition of disease, for the specific purpose of decreasing or preventing ODx. We call this diseaseODx, aimed at distinguishing cases where it would be beneficial to identify (and treat the condition) from those where diagnosis is more likely to harm than benefit. A preliminary definition of diseaseODx is that X is a diseaseODx iff there is dysfunction that has a significant risk of causing severe harm. This paper examines the 3 concepts in this definition, using a naturalistic account of function, a Feinbergian account of comparative harm, and a probabilistic understanding of risk. We then test the utility of this approach using examples of clinical conditions that are currently overdiagnosed.

Original languageEnglish
Pages (from-to)1019-1025
Number of pages7
JournalJournal of Evaluation in Clinical Practice
Issue number5
Early online date30 Mar 2018
Publication statusPublished - Oct 2018

Bibliographical note

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  • diagnosis
  • philosophy of medicine
  • overdiagnosis

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