INDUSTRY & RESEARCH
campusreview.com.au
Better not to know
P
The rise of
‘incidentalomas’
is evidence that
our medical
tests may be
too good – and
used too often.
Paul Glasziou
interviewed by
Patrick Avenell
14
rofessor Paul Glasziou from Bond University
heads up a team of Australian researchers –
including professors Rachelle Buchbinder from
Monash, and Chris Maher and Kirsten McCaffery from
the University of Sydney – who have just received
a $9,578,895 grant to investigate unnecessary
testing and treatment of so-called ‘incidentalomas’,
particularly in the areas of musculoskeletal diseases,
cardiovascular disease and cancer.
In this interview with Campus Review, Glasziou
explains what an incidentaloma is and how too much
testing can lead to trauma and illness, rather than
preventing it.
CR: Tell me a bit about yourself and the team that
you’ve put together to spend the $9.5 million grant
PG: I’m a general practice researcher who’s been
working in what’s called evidence-based medicine,
which is about using the best research to guide
clinical practice, for about 20 years. Recently, there’s
been a concern about what’s called over-diagnosis
leading to over-treatment. We’ve put together a team
of chief investigators: myself; Rachelle Buchbinder
from Monash University, she’s a rheumatologist
who works in this area; Chris Maher, who is a
physiotherapist at the University of Sydney; and
Kirsten McCaffery, who is a health psychologist, also
at USYD. The four of us have a common interest
in dealing with this problem of over-testing and
over-diagnosis.
Can you give our readers an idea about what
over-testing and over-diagnosis are?
You can think of it as a case of our tests getting better
and better. In some ways, the tests are too good.
We’re detecting things that probably wouldn’t harm
anybody in their lifetime. Just to give you a specific
example of that, I’m 61 years old and pretty healthy
and well, but if you did an ultrasound of my shoulder,
there’s a 13 per cent chance that you’d find what’s
called a rotator cuff tear.
If you did magnetic resonance imaging (an MRI) of