Too much medicine

The BMJ’s Too Much Medicine initiative aims to highlight the threat to human health posed by overdiagnosis and the waste of resources on unnecessary care. We are part of a movement of doctors, researchers, patients, and policymakers who want to describe, raise awareness of, and find solutions to the problem of too much medicine.

Causes of too much medicine include expanded disease definitions, uncritical adoption of population screening, disease mongering and medicalisation, commercial vested interest, strongly held clinical beliefs, increased patient expectations, litigation, and fear of uncertainty and new technology. Winding back the harms of too much medicine invites clinicians to focus on those who are sick, and only intervene with those who are well when there is a strong case to do so.

How to decide how much is too much?

How to spot too much medicine

Why is it difficult?

 

Projects at The BMJ

Overdiagnosis series

The BMJ publishes a popular series highlighting medical conditions which may be overdiagnosed.

COPD • Bone fragility • Aortic aneurysm • Mammography • Mild hypertension • Pre-diabetes • Gestational diabetes • Low mood • ADHD • Predementia • Thyroid cancer • Chronic kidney disease • Pulmonary embolism • PCOS

Theme issues

2015 - Digital theme issue on overdiagnosis

2002 - Too much medicine

2017 - The European Journal of Hospital Pharmacy theme issues on deprescribing

2017 - Digital theme issue to coincide with The Preventing Overdiagnosis conference 2017

2018 - Renaming low risk conditions labelled as cancer

2018 - Overdiagnosis in primary care: framing the problem and finding solutions

Partnering

The BMJ is the media partner for the international scientific conference, Preventing Overdiagnosis. The last conference took place on 20-22 August 2018 in Copenhagen.
Listen to the podcast round up

In July 2016 the journal joined forces with the overdiagnosis standing group of the UK’s Royal College of General Practitioners, whose campaign Better medicine: shared decisions, best evidence is also hosted on bmj.com.

 

Interactive timelines of relevant articles from The BMJ

AD and BP

Blood Pressure Reduction and Alzheimer's Disease

-Study examines nilvadipine and cerebral blood flow, showing increased, safe flow to hippocampus

by Vicki Brower , CME Writer, MedPage Today June 23, 2019

CME Author: Vicki Brower

Study Authors: Daan L. K. de Jong, Rianne A. A. de Heus, et al.

Target Audience and Goal Statement:

Neurologists, geriatricians, cardiologists, internists, family medicine specialists

The goal of this study was to determine whether blood pressure reduction with antihypertensive medication could affect cerebral blood flow, in particular, to the hippocampus and posterior cingulate cortex, in patients with Alzheimer clinical syndrome in a mild-to-moderate stage of dementia.

Questions Addressed:

• Can the calcium channel blocker nilvadipine increase cerebral blood flow (CBF) in patients with mild-to-moderate Alzheimer's disease (AD)?
• What parts of the brain are affected by lowering of blood pressure?
• What effect does this have on cerebral autoregulation?

Action Points

Expanding Universe?

Ask Ethan: What Could Solve The Cosmic Controversy Over The Expanding Universe? Two independent techniques give precise but incompatible answers. Here’s how to resolve it. Ethan Siegel in Starts With A Bang!9 min read

collective unconscious

How Jung’s collective unconscious inspired Alcoholics Anonymous

Por

 

Charles Fox

aeon.co

5 min

Exibir original

psychology

Alcoholics Anonymous (AA) is an international mutual-aid fellowship with more than 2 million members worldwide. It strives to help members ‘stay sober and other alcoholics achieve sobriety’. Despite the fact that studies of its efficacy have been inconsistent, AA has had a significant and long-term effect on the culture of the United States and one of its founders was among Time magazine’s most important people of the 20th century.

Mosquitoes

Why Do Some People Always Get Bitten by Mosquitoes, While Others Don't?

By Grant Currin, Live Science Contributor | June 22, 2019 07:42am ET

Some people can sit outside all summer long and not suffer from mosquito bites. Others turn into an itchy mess despite bathing in DEETand never leaving the purple glow of the bug zapper. What gives?

It's mostly about the invisible chemical landscape of the air around us. Mosquitoes take advantage of this landscape by using specialized behaviors and sensory organs to find victims by following the subtle chemical traces their bodies leave behind.

"Mosquitoes start orienting themselves to those pulses of carbon dioxide and keep flying upwind as they sense higher concentrations than the normal ambient air contains," said Joop van Loon, an entomologist at Wageningen University in the Netherlands. Using carbon dioxide, mosquitoes can lock onto targets from up to 164 feet (50 meters) away.

Things start getting personal when mosquitoes get about 3 feet (1 m) away from a group of potential targets. In close quarters, mosquitoes take into account a lot of factors that vary from person to person, including skin temperature, the presence of water vapor and color.

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