Advances in Diagnostic Imaging and Overestimations of Disease Prevalence and the Benefits of Therapy

• Published in: The New England journal of medicine Vol. 328; no. 17; pp. 1237 - 1243
• Main Authors: Black, William C, Welch, H. Gilbert
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 29.04.1993
• Subjects: Abdomen; Aged; Aneurysms; Aortic Aneurysm, Abdominal - diagnosis; Aortic Aneurysm, Abdominal - epidemiology; Aortic Aneurysm, Abdominal - therapy; Bias; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - epidemiology; Cancer screening; Cardiovascular disease; Decision Making; Diagnostic Imaging - trends; Disease; Female; General aspects; Humans; Male; Medical diagnosis; Medical imaging; Medical research; Medical sciences; Medical technology; Middle Aged; Neoplasms - diagnosis; Neoplasms - epidemiology; NMR; Nuclear magnetic resonance; Planification. Prevention (methods). Intervention. Evaluation; Population; Prevalence; Prostate cancer; Public health. Hygiene; Public health. Hygiene-occupational medicine; Therapy; Thyroid gland; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - epidemiology; Tumors; Human; Medicine; Prevalence; Disease; Diagnosis; Technique; Public health
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199304293281706

Over the past two decades a vast new armamentarium of diagnostic techniques has revolutionized the practice of medicine. The entire human body can now be imaged in exquisite anatomical detail. Computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography routinely “section” patients into slices less than a centimeter thick. Abnormalities can be detected well before they produce any clinical signs or symptoms. Undoubtedly, these technological advances have enhanced the physician's potential for understanding disease and treating patients. Unfortunately, these technological advances also create confusion that may ultimately be harmful to patients. Consider the case of prostate cancer. Although the prevalence . . .