Do I really need this test, treatment or procedure? What are the downsides? What happens if I do nothing? And are there simpler, safer options? 

These four questions, promoted by Choosing Wisely Canada, featured prominently at the two 2018 conferences, Too Much Medicine in Helsinki, Finland (figure), and the sixth annual Preventing Overdiagnosis conference in Copenhagen, Denmark. Over 600 of the world’s leading researchers and thinkers in preventing overdiagnosis came together for two weeks in August 2018 to highlight the problems caused by medical excess and to identify evidence-informed practices to wind back the harms of too much medicine.

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