Too much or too little medicine? Overdiagnosis, underdiagnosis, overtreatment and undertreatment in respiratory diseases

Abstract

At a time when technical possibilities for medical investigations are plentiful and ever expanding, there is growing awareness that more is not always better and that “too much medicine” may be harmful. In recent years, the global Choosing Wisely educational campaign has aimed to bring attention to unnecessary healthcare. Unnecessary healthcare includes overtesting, overdiagnosis and overtreatment [1]. The March issue of Breathe aims to challenge us to rethink our clinical practice, to reflect on the evidence, and to identify potential cognitive biases that might influence us to provide “too much” or “too little” medicine [2].

Long-Term Mechanical Insufflation-Exsufflation Cough Assistance in Neuromuscular Disease: Patterns of Use and Lessons for Application

“…Pragmatically, MI-E use when required is more sensible because we should avoid overburdening individuals with unnecessary medical interventions. 39 However, it is important to have the right equipment available to individuals to prevent prolonged ineffective secretion-clearance sessions and respiratory tract infections. Requirements should be reassessed regularly, especially in those with progressive disorders.…”