Navigating perceived overdiagnosis and overtreatment: a sociological analysis of the experiences of people who decline treatment for anomalies identif

一项关于医学中“过度诊断”的概念是否以及如何告知的调查：（a）决策过程;（B）拒绝筛查和/或医疗干预的个人的经历。重点将是那些拒绝筛查，治疗，未来筛查邀请和/或其他建议的医疗干预措施的人在被邀请参加NHS乳房筛查计划后的经历。关键的研究问题将包括：拒绝筛查/干预的人如何在医疗系统内外解释他们的决定？“衰退者”如何利用和平衡风险、义务、不确定性和责任的论述？过度诊断的概念在临床背景之外是否有相关性？定性方法将引起人们对个人经验现实的高度关注，因为他们做出决定并与医疗保健专业人员及其更广泛的社会/家庭网络进行谈判。主要数据将包括与拒绝治疗的个人进行的半结构化访谈。访谈将被分析，特别关注参与者用来构建他们的决定和解释的话语。访谈将辅以相关材料的文件分析，例如患者信息传单、政策文件和临床指南

An investigation into whether and how the concept of 'overdiagnosis' in medicine informs: (a) the decision-making process; and (b) the experiences of individuals who decline screening and/or medical intervention. The focus will be on the experiences of people who decline screening, treatment, future screening invitations and/or other recommended medical interventions after being invited to participate in the NHS breast screening programme. Key research questions will include:How do people who decline screening/intervention account for their decisions, within and beyond the healthcare system?How do 'decliners' draw on and balance discourses of risk, obligation, uncertainty and responsibility?Does the concept of overdiagnosis have relevance beyond a clinical context?Qualitative methodology will bring critical attention to the experiential realities of individuals as they make decisions and negotiate these, both with healthcare professionals and in their wider social/familial networks. The main data will comprise semi-structured interviews with individuals who decline treatment. Interviews will be analysed with a particular focus on the discourses participants draw on to frame both their decisions and their explanations for these. Interviews will be supplemented with a documentary analysis of relevant material, e.g. patient information leaflets, policy documents, and clinical guidelines