Aryana Libris

Authors : Welch H. Gilbert - Schwartz Lisa M. - Woloshin Steven
Title : Overdiagnosed Making people sick in the pursuit of health
Year : 2011

Link download : Welch_H_Gilbert_-_Overdiagnosed.zip

Introduction : Our Enthusiasm for Diagnosis. My first car was a ’65 Ford Fairlane wagon. It was a fairly simple - albeit large - vehicle. I could even do some of the work on it myself. There was a lot of room under the hood and few electronics. The only engine sensors were a temperature gauge and an oil-pressure gauge. Things are very different with my ’99 Volvo. There’s no extra room under the hood - and there are lots of electronics. And then there are all those little warning lights sensing so many different aspects of my car’s function that they have to be connected to an internal computer to determine what’s wrong. Cars have undoubtedly improved over my lifetime. They are safer, more comfortable, and more reliable. The engineering is better. But I’m not sure these improvements have much to do with all those little warning lights. Check-engine lights - red flags that indicate something may be wrong with the vehicle - are getting pretty sophisticated. These sensors can identify abnormalities long before the vehicle’s performance is affected. They are making early diagnoses. Maybe your check-engine lights have been very useful. Maybe one of them led you to do something important (like add oil) that prevented a much bigger problem later on. Or maybe you have had the opposite experience. Check-engine lights can also create problems. Sometimes they are false alarms (whenever I drive over a big bump, one goes off warning me that something’s wrong with my coolant system). Often the lights are in response to a real abnormality, but not one that is especially important (my favorite is the sensor that lights up when it recognizes that another sensor is not sensing). Recently, my mechanic confided to me that many of the lights should probably be ignored. Maybe you have decided to ignore these sensors yourself. Or maybe you’ve taken your car in for service and the mechanic has simply reset them and told you to wait and see if they come on again. Or maybe you have had the unfortunate experience of paying for an unnecessary repair, or a series of unnecessary repairs. And maybe you have been one of the unfortunate few whose cars were worse off for the efforts. If so, you already have some feel for the problem of overdiagnosis. I don’t know what the net effect of all these lights has been. Maybe they have done more good than harm. Maybe they have done more harm than good. But I do know there’s little doubt about their effect on the automotive repair business: they have led to a lot of extra visits to the shop. And I know that if we doctors look at you hard enough, chances are we’ll find out that one of your check-engine lights is on. ...