Harkness Project Title: Avoiding Over-Diagnosis as a Strategy for a High Performing Health Care System
Mentor: Glyn Elwyn, M.D., M.Sc., FRCGP, Ph.D. (Dartmouth Center for Health Care Delivery Science and Dartmouth Institute for Health Policy and Clinical Practice)
Co-Mentor: H. Gilbert Welch, M.D., M.P.H. (Dartmouth Institute for Health Policy and Clinical Practice)
Placement: Dartmouth Institute for Health Policy and Clinical Practice
Biography at time of Harkness Fellowship: Bjorn Hofmann, Ph.D., M.Sc., a 2014–15 Norwegian Harkness Fellow in Health Care Policy and Practice, is a professor in the Department of Health, Technology, and Society at the University College of Gjøvik and an adjunct professor at the Center for Medical Ethics at the University of Oslo. Prior to this, Hofmann served as professor and, for a period, as the head of the Centre for Medical Ethics, as a researcher and senior advisor in ethical issues in health technology assessments at the Norwegian Knowledge Centre for the Health Services, and as an advisor at the Directorate of Health on various committees. He is partner and collaborator in many EU funded projects on topics such as integrated health technology assessment for complex technologies, cancer research, bioethics, donation of biological material, and genetic data and bio-banking. He was appointed by the Ministry of Health and Care Service as a member of the committee on reactions and responsibility with negligence amongst health professionals in the Norwegian Health Services from 2013 to 2015, and as a member of the committee on criminalizing risk for and transmission of contagious disease from 2010 to 2012. Hofmann has published 121 peer-reviewed journal articles in journals such as the International Journal of Technology Assessment in Health Care and the American Journal of Bioethics (two of which have received awards), as well four books, and numerous book chapters and research reports. He received his Ph.D. from the University of Oslo.
Project: Overdiagnosis leads to unnecessary suffering and significant costs in the U.S. and Norway. The objective of Dr. Hofmann’s research is to review the estimates of overdiagnosis associated with mammography screening, to assess the information provided to individuals, professionals, and decision-makers, and to evaluate the micro and macro decision-making processes, and where feasible to suggest improvements. Bjorn will use literature and document review to investigate how patients, professional and health policy makers are informed about overdiagnosis. He will use a shared decision-making tool (CollaboRATE or other) and in-depth interviews with health policy makers to assess the decision-making on overdiagnosis in breast cancer screening.
Career Activity since Fellowship:
Current Positions: Professor, Norwegian University of Science, and Technology at Gjøvik, 2016
Adjunct Professor, University of Oslo Center for Medical Ethics (updated 04/2017)
Email: [email protected]
Harkness Related Publications:
B. Hofmann, H.G. Welch. “New diagnostic tests: more harm than good,” BMJ. 2017.
J. Wale, A. Scott, B. Hofmann, S. Garner, E. Low, L. Sansom. “Why patients should be involved in health technology assessment,” International Journal of Technology Assessment in Health Care. 2017.
B. Hofmann. “The overdiagnosis of what? On the relationship between the concepts of overdiagnosis, disease, and diagnosis,” Medicine, Health Care and Philosophy. 2017.
B. Hofmann. “Defining and evaluating overdiagnosis,” J Med Ethics. 2016.
K.B. Lysdahl, W. Oortwijn, G. Jan van der Wilt, P. Refolo, D. Sacchini, K. Mozygemba, A. Gerhardus, L. Brereton, B. Hofmann. “Ethical analysis in HTA of complex health interventions,” BMC Medical Ethics. 2016.
B. Hofmann. “Too much technology,” BMJ. 2015.
B. Hofmann, W. Oortwijn, K.B. Lysdahl, P. Refolo, D. Sacchini, G. Jan van der Wilt, A. Gerhardus. “Integrating ethics in health technology assessment: many ways to Rome,” International Journal of Technology Assessment in Health Care. 2015.