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

调查医学中“过度诊断”的概念是否以及如何影响：(a)决策过程；(b)拒绝筛查和/或医疗干预的个人经历。重点将放在被邀请参加国民保健制度乳房检查方案后拒绝接受检查、治疗、今后的检查邀请和/或其他建议的医疗干预措施的人的经历上。关键的研究问题将包括：那些拒绝筛查/干预的人如何在医疗保健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、不确定性和责任的话语？过度诊断的概念是否具有临床背景之外的相关性？定性方法将带来关键的关注个人的经验现实，因为他们做出决定和谈判这些，既与医疗保健专业人员和更广泛的社会/家庭网络。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他们对这些决定的解释的话语。访谈将辅以对相关材料的文献分析，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