In Reply We thank Dr Yang and colleagues for raising important points regarding our Special Communication1 on modifying disease definitions, many of which we alluded to in our article but that we agree need further discussion.
We agree with Dr Yang and colleagues that when modifying a disease definition, it is essential to consider whether the additional patients classified with the expanded definition warrant clinical intervention, as well as whether this net benefit should be paid for. Such decisions should include consideration of the regional variations in the values of the population concerned and their available resources. In our checklist, we recommended that the definition should reflect the values and preferences of patients and the wider community and include the impact on resource usage.1
Doust J, Qaseem A, Glasziou P. Considerations Concerning Disease Redefinition—Reply. JAMA Intern Med. 2017;177(12):1873. doi:10.1001/jamainternmed.2017.6155
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