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Editorial
Aug 13/27, 2012

Overdiagnosis of DiseaseA Modern Epidemic

Author Affiliations

Author Affiliations: Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles (Dr Hoffman); and Department of Medicine/Emergency Medicine, University of California, Los Angeles (UCLA), School of Medicine (Drs Hoffman and Cooper).

Arch Intern Med. 2012;172(15):1123-1124. doi:10.1001/archinternmed.2012.3319

Most of us learned that brain herniation is about as close to death as a living patient can get. But a clinically important proportion of patients with head computed tomography (CT)-defined herniation are awake and alert (personal communication, Kelli O’Laughlin, MD, MPH, December 1, 2011).1,2 Is herniation far less grave than we have always thought? Does this mean that we need to order even more CT scans so as not to miss “occult” herniation in normal-appearing patients?

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