Podcast: Overdiagnosis & radiology … the arsonist & the firefighter

Professional definition: Radiologists are doctors who specialize in diagnosing and treating diseases and injuries using medical imaging techniques, such as x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET) and ultrasound.

Dr. Saurabh Jha says his profession can be both the arsonist and the firefighter with overdiagnosis.

Jha, a radiologist at the Hospital of the University of Pennsylvania, was guest editor of a special Overdiagnosis Issue of the journal, Academic Radiology, in August. He wrote:

“It is not surprising that radiologists, who are physicians tasked with the diagnosis of disease, find themselves implicated in overdiagnosis. What is surprising is the scarcity of an exposition of overdiagnosis in the radiology literature. Indeed, the issue is not only infrequently discussed but also considered controversial. This is all the more incredulous as radiologists are experts in diagnosis and know the limitations of a diagnostic test. Radiologists do not question the existence of false positives….It is time radiologists thought about overdiagnosis.”

Jha is active on Twitter under the name @RogueRad. Earlier this year, he engaged in a blogging back-and-forth with billionaire Mark Cuban over the latter’s Tweet that “If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health.” Jha wrote: “He has taken the fads of modern healthcare, personalized medicine, big data and early diagnosis, and extrapolated it to nonsensical proportions.”

We met at the Preventing Overdiagnosis 2015 conference at the National Institutes of Health this month.

Click on the arrow below to hear our podcast discussion with him.

Other resources:

• The Overdiagnosis Issue of the journal Academic Radiology. You need a subscription to read everything in it, but at least you can see the index of subjects covered.
• Interview with Dr. Jha on Medscape, “Radiology’s Overdiagnosis Problem.”
• His piece, “A Business Proposal for Mark Cuban.”
• His @RogueRad Twitter page
• His Penn Medicine bio page.

Music excerpts used in this piece:

• “Wrestling” – The Barenaked Ladies

• “Six Days at the Bottom of the Ocean” – Explosions in the Sky

Thanks to Cristeta Boarini for her editing on this podcast.

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