Diagnostic uncertainty in sepsis contributes to both undertreatment (delayed antibiotics) and overtreatment (unnecessary early antibiotics in nonsepsis patients). We hypothesized hospitals with strong sepsis undertreatment and overtreatment performance have better outcomes.MethodsWe conducted a retrospective cohort study of hospitalized adults at 20 hospitals (Advocate Health, Michigan Medicine) between 2022 and 2024. Patients met ≥2 systemic inflammatory response syndrome criteria within 6 hours of presentation. Hospital performance was characterized using risk-standardized rates (RSRs) for undertreatment and overtreatment. “Diagnostic excellence” (DxEx) was prespecified as top-tertile performance in 1 measure without bottom-tertile performance in the other. The primary outcome was hospital mortality or hospice discharge. Secondary outcomes were hospital-free days alive at 28 days (HFD), length of stay (LOS), and total antibiotic days.ResultsAmong 152 779 patients, 49 109 (32.1%) received antibiotics within 3 hours and 16 361 (10.7%) ultimately met sepsis criteria. Undertreatment RSRs ranged from 29.3% to 46.8%. Overtreatment RSRs ranged from 21.5% to 37.2%. There was negative correlation between performance ranks (τ = −0.51; P = .01). Four hospitals met DxEx criteria. Receiving treatment at DxEx hospitals was associated with lower hospital mortality or hospice discharge (adjusted OR = 0.61; 95% CI = .41–.90; P = .01), greater HFD (adjusted difference = 0.59; 95% CI = .04–1.14; P = .04), reduced LOS (adjusted difference = −1.20; 95% CI = −2.23 to −.17; P = .02), and fewer antibiotic days (adjusted difference = −0.62; 95% CI = −1.28–.05; P = .07), versus non-DxEx hospitals.ConclusionsHospital performance that jointly minimizes sepsis undertreatment and overtreatment was associated with improved patient outcomes, adjusting for patient and hospital factors. Findings highlight the importance of reducing diagnostic error in efforts to improve sepsis outcomes.

An analysis of United States data reveals a broad shift away from overtreatment of low-risk prostate cancer. The analysis published in CANCER indicates a shift toward surveillance in response to concerns of overdiagnosis and overtreatment that have hindered screening in the recent past.

PDF | Agency problems are a defining characteristic of health care markets. We present the results from a field experiment in the market for dental... | Find, read and cite all the research you need o...

UCL trial of 6,000 prostate cancer patients found the Decipher genetic test indicates which tumours are going to spread amid ongoing debate around overtreatment

By MD, PhD Frederik Schaltz-Buchholzer, Assistant Professor in Vaccine Epidemiology, University of Southern Denmark

Medical experts explicitly recommend against blanket screenings.

Is the field of dentistry rife with overtreatment?

The rapid expansion of private testosterone prescribing risks extending treatment beyond men with clearly defined need to people with nonspecific symptoms and borderline test results, for whom the balance of benefit and long-term risk is less certain, warn experts in The BMJ.

A cancer diagnosis carries with it fear and upheaval. For many patients the cellular changes do not warrant the label

Fraud, waste, and abuse (FWA) continue to challenge dental plans as overtreatment, miscoding and inappropriate billing practices drive unnecessary costs and weaken payment integrity. For dental payers, the stakes extend beyond financial losses: these issues can also expose members to unnecessary procedures and consume benefits that should be preserved for appropriate care.

Urologic oncologists who treat prostate cancer are split over the benefits of focal therapy compared to traditional surgery or radiation.

to RePEc:ehl:lserod:115383

European Radiology -

Papillary thyroid cancer (PTC), the most prevalent form of thyroid malignancy, is generally indolent but poses a recurrence risk of 10%-15%, leading to a clinical paradox: the need to mitigate recurre...

This narrative review discusses chemotherapy decision-making support tools and updated evidence guiding therapeutic decision-making among older adults with early-stage breast cancer.

Pentagon temporarily rescinds guidance on testosterone screening for US troops Doctors say broad testosterone testing lacks evidence to improve combat readiness, could risk overtreatment https://t.co...

The Pentagon ​is temporarily rescinding recently published clinical guidance for a new, mandatory testosterone deficiency screening policy for service members aged 30 and ‌older, a U.S. official told ...