This new piece in The Conversation by Assistant Professor Ray Moynihan and Professor Paul Glasziou explains how changes in the definition of a disease (such as hypertension or gestational diabetes) cause people who are well to suddenly be labelled as ill.
While early diagnosis of illness can lead to better outcomes, the definitions are often changed without considering the actual benefit to the patient. Many people, who would never become symptomatic, are now monitored or treated for a disease that would not have impacted their lives otherwise.
It is also concerning that there is the possibility that financial incentives affect the expansion of disease definitions. Although most of the people who set the guidelines have the best of intentions, doctors often have financial ties to drug companies with interests in expanding their markets.
To address these problems, Assistant Professor Moynihan and Professor Glasziou, together with an influential group of researchers and family doctors, have published a new paper in BMJ Evidence-Based Medicine. In this paper, they propose new processes and new people for setting disease guidelines.