To the Editor We would like to thank Stunkel et al for their study1 aiming to identify the incidence and causes of overdiagnosing optic neuritis at a tertiary center. To interpret the findings of the study, it is important to note that the term overdiagnosis covers a broad spectrum of definitions; for example, Bulliard et al define it as “the diagnosis of a condition that would have remained indolent in the patient’s lifetime if left undetected.”2(p1) In this study, the assessment of overdiagnosis is that of overreferrals in which time and resources are invested in investigating a diagnosis of optic neuritis in patients with a very low likelihood of having it; this is unlike the definition suggested by Bulliard et al, which implies the consequence of overdiagnosis lies in treating trivial conditions.
Abdulhussein D, Seth I, Badat N. Incidence and Causes of Overdiagnosis of Optic Neuritis: Physician Insecurity. JAMA Ophthalmol. 2018;136(11):1312. doi:10.1001/jamaophthalmol.2018.3482
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