89 Overdiagnosis and overuse of healthcare in limited-resource settings: a workshop

Background

Overdiagnosis and overuse of healthcare is broadly defined as care likely to cause more harm than benefit, and it diverts resources from addressing underuse, and threaten the sustainability of health systems. While much of the evidence for overdiagnosis and overuse arises from high resource settings, the problem may be even more serious in limited-resource settings such as low- and middle-income countries (LMICs). We recently conducted a series of scoping reviews to identify and summarise the evidence around these problems in LMICs. We found growing evidence suggesting that overdiagnosis and overuse is widespread within LMICs and limited robust evidence around potential solutions – highlighting the importance of building collaborations to rigorously investigate these problems and evaluate potential solutions to reduce overdiagnosis and overuse of healthcare in limited-resource settings.

Objectives

We aim to (i) build a global network of clinicians, researchers, patients and the public, and policymakers who are interested in advancing the agenda related to overdiagnosis and overuse in healthcare services in their local settings; (ii) identify the ten most important research questions related to these problems in light of the evidence emerging from the series of the scoping reviews; and (iii) organise a set of activities to share data and learn from each other’s experience, across both high-income countries and LMICs.

Summary

Part I: An online workshop before or during PODC (90 min) This accessible on-line workshop would be open to people from all over the world, and the timing would be arranged to optimise maximum attendance from LMIC participants. It will have three segments. Overview of the problem of overdiagnosis and overuse of healthcare services in resource-limited settings (30 min) We will provide an overview of the problem of overdiagnosis and overuse of healthcare services in resource-limited settings with different examples from LMICs. We will also invite participants to reflect on their own real-life examples of the problem. Discussion on the ten most important research questions related to these problems (30 min) In small groups, participants will list the ten most important research questions related to the problem of overdiagnosis and overuse of healthcare services in resource-limited settings that need to be addressed. Then, in the whole group, we will ask participants to rank the list of research questions to achieve the ten most important research questions Feedback on the proposal of a global survey of the extent of overdiagnosis and overuse of healthcare services in LMICs (30 min) We will present the proposal of a global survey of the extent of overdiagnosis and overuse of healthcare services in LMICs and invite feedback on the proposal. We will also invite collaborators for this research proposals. Part II: A face-to-face meeting during PODC (60 min) This meeting will be primarily face-to-face but will also potentially be open for remote participants to join. In this meeting, we will present a summary of part I and discuss the next steps to take the suggested recommendations forward, including activities to share and learn from each other’s experiences in addressing these problems.