RT Journal
A1 Wiener R, Schwartz LM, Woloshin S
T1 CAution on interpreting the time trends in pulmonary embolism as “overdiagnosis”—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD November 28
VO 171
IS 21
SP 1963
OP 1964
DO 10.1001/archinternmed.2011.550
UL http://dx.doi.org/10.1001/archinternmed.2011.550
AB 
We thank Ashrani and Heit for their interest in our study.1 Because direct evidence of overdiagnosis can only be obtained if individuals diagnosed as having a PE are observed without treating the PE until they die from other causes, using indirect evidence from population data is an established method of identifying overdiagnosis.2- 4 The pattern of rising incidence, stable mortality, and decreasing case fatality in the setting of the introduction of a highly sensitive test is strongly suggestive of overdiagnosis.5 While we agree with Ashrani and Heit about the general limitations inherent in administrative data (and noted many of these limitations in our article), we are not convinced by their specific comments about competing explanations for our findings.