Abstract
“Overdiagnosis” - when people are labelled with or treated for a disease that would never cause them harm - is increasingly highlighted as a significant issue within contemporary healthcare, yet one which to date, has received little attention outside of the medical context. As a society, our collective enthusiasm to diagnose and treat disease has paradoxically been shown to potentially do more harm than good, impacting individuals whilst simultaneously increasing financial costs to the health system. As health systems across the world continue to face unprecedented pressures, tackling this phenomenon represents an important step in reducing the proliferation of low-value care inherent within the practice of modern medicine, and contributing towards the development of sustainable health systems. This research represents the first interdisciplinary analysis of the factors contributing towards overdiagnosis within modern healthcare systems. The analysis finds that individual disciplines of a medical and non-medical origin elude to important insights in relation to the drivers of overdiagnosis which are not necessarily reflected across multiple disciplines. Drivers identified within literature which lies beyond the medical context likely represent new knowledge in relation to the causes of overdiagnosis, and collectively provide a starting point from which to consider the role of patients and clinicians in influencing overdiagnosis, the nature of the interaction between the drivers of overdiagnosis, and the role of the different models of health in providing a unique perspective of the wider phenomenon. These findings highlight the importance of interdisciplinarity within health research and contribute towards efforts to reduce the rise of low value care within modern healthcare, fostering the development of sustainable health systems.
Highlights
It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities
Health inequalities occur by Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital plus factors such as age and sexual orientation (PROGRESS-Plus). [1]
Previous systematic reviews have focused on mean weight loss [5] and have not considered whether uptake, adherence or effectiveness differs by PROGRESS-Plus criteria
Summary
The HIV-1 envelope glycoprotein (Env) is the target of antigen design for antibodybased vaccination. In 2019, four trimeric Env vaccines entered an experimental trial: ConM, ConS, and their cross-linked counterparts. The trimers were formulated with MPLA adjuvant. Studies have demonstrated that adjuvants trigger neutrophil infiltration. Neutrophils activate and degranulate releasing proteases, namely elastase and cathepsinG. Aims: To assess the stability and immunogenicity of these vaccines in the presence of adjuvantrecruited neutrophils and their proteolytic enzymes
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