Überdiagnose als medizinisches Problem

Viele medizinische Tests sorgen dafür, dass Diagnosen schnell gestellt werden und zu medizinischem Handeln motivieren. Doch dies kann dann zum Problem werden, wenn eine Überdiagnose vorliegt. Es werden bei einer Überdiagnose Krankheiten erkannt, die nie zu einem echten Problem für den Betroffenen werden würden.

Überdiagnose als medizinisches Problem
Überdiagnose als medizinisches Problem

Früher ging man zum Arzt, wenn man sich erkrankt fühlte oder nachweisbare Handlungseinschränkungen hatte. Heute geht man bereits zum Arzt, wenn man noch gesund ist und sich entsprechend fühlt, aber Vorsorge-Untersuchungen gegen mögliche spätere Erkrankungen vornehmen lassen möchte. So misst dann der Arzt einen erhöhten Cholesterinspiegel oder stellt eine andere Anomalie im Blutbild fest, woraus sich dann weitere medizinische Untersuchungen und eine riskante medizinische Therapie ergeben können.

Man spricht dann von einer Überdiagnose, wenn eine Krankheit erkannt wird, die jedoch nie vom Patienten als gesundheitliche Einschränkung erlebt werden würde. Objektiv liegt zwar ein Gesundheitsproblem vor, doch tatsächlich hat der Betroffene keine Einschränkung und wird auch in seinem Leben nie eine Einschränkung erleben. Überdiagnose kann zu einer Übertherapie führen, wenn nun allzu schnell agiert wird. Beispielhaft wird für die Überdiagnose und Übertherapie häufig die Prostatavorsorge genannt. Man hat festgestellt, dass viele Männer im höheren Alter hier auffällig werden. Auch hier ist es wichtig, dass nach einer Diagnose sehr genau überlegt wird, ob angesichts des Lebensalters oder sonstiger Umstände eine schnelle Therapie mit starken Eingriffen notwendig ist, denn in diesen wie in anderen Fällen kann eine Therapie auch zu unerwünschten Effekten führen, die die Lebensgestaltung unnötig einschränken.

Jede medizinische Diagnose ist mit Unsicherheit verknüpft; die Patienten stehen anschließend vor der schwierigen Frage, ob und wie sie mit der Diagnose zu einer angemessenen Therapie kommen können. Denn es ist keineswegs immer ein Automatismus von der Diagnose zur zeitangemessenen Therapie gegeben. Insbesondere dann, wenn Blutwerte kurzfristig und knapp von den vorgegebenen Grenzwerten abweichen, stellt sich die Frage, ob hier nur ein einmaliger Ausrutscher vorliegt oder ob dies auf ein grundlegendes Problem hinweist. Es ist daher kein Fehler, bei einer sehr grundlegenden Diagnose eine zweite medizinische Meinung einzufordern. Überdiagnosen und Übertherapien können so vermieden werden.

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