Technology is changing the definition of disease.

As medical technology improves, doctors will be able to diagnose patients much quicker than before. People who were never treated in the past will find themselves receiving treatment because of the advancement of diagnostic technology and tools. Bjørn Morten Hofmann argues that over-diagnosis and over-treatment have been identified in a wide range of diseases and we need a more reflective and responsible implementation of health technology.

The expansion of diagnostic technology starts with a technical improvement like increased spatial resolution of a diagnostic ultrasound machine. Computed tomography pulmonary angiography increased the detection of pulmonary embolism by 80% from 1998 to 2006. The technological improvement uncovers “under-detected” health problems. This means that people with mild cases are also treated. In many cases, this technological advancement is good because now we can detect papillary cancers much quicker and treat patients sooner for a better outcome. In some cases, people can be over treated and over diagnosed which may become harmful.

If this is the case, what constitutes as a disease now? If we can measure or manipulate something, it tends to become a disease—for example, hypertension and cholesterolaemia would not be relevant to medicine if we could not measure or manipulate blood pressure or cholesterol. With disease categories widening every year, Hofmann argues that people experience increased disease anxiety, pay more for potentially irrelevant diagnostic tests, and lose trust in the healthcare system because of excessive costs and common over-diagnosis.

Hofmann implores that we be more aware of these technological advances and be mindful not to jump into the constant mindset that “more is better than less”, “new is better than old”, and “advanced is more accurate than simple”. He expresses that we should support the stimulation of innovation and advancement but only when the technology has shown real benefit.

This topic interests me because I have noticed that more and more people are anxious about disease and constantly trying to find ways to “be more healthy” by taking many multivitamins and additional supplements. I do think that many people are “over diagnosed” and “over treated” and I personally feel that people will lose trust in the healthcare industry if over-diagnoses continues. What do you think?

https://www-bmj-com.proxy1.lib.uwo.ca/content/350/bmj.h705
https://well.blogs.nytimes.com/2012/08/27/overtreatment-is-taking-a-harmful-toll/