Search strategy and selection criteria

We searched four electronic databases: PubMed, Embase, PsycINFO, Global Index Medicus from inception until 24 May 2021, using Cochrane EPOC’s LMIC search filter and MeSH terms and free text about overdiagnosis and overuse of diagnostic and screening tests, with no restrictions on language. Detailed search strategies are available in online supplementary appendix 1. We also emailed at least one corresponding author of included articles from the last 5 years from each country included in the review to identify any relevant and important grey literature, such as government reports.

bmjgh-2022-008696supp001.pdf

We included both primary studies and systematic reviews of quantitative and qualitative studies, from one or more LMICs,²² which investigated the presence or estimates of the extent of overdiagnosis or overuse of tests, drivers of the problems, consequences of the problems such as waste or harm, and potential solutions. Where studies included LMICs and non-LMICs, we included these but only collected and synthesised the data pertaining to LMICs. We excluded non-research opinion pieces such as case reports and series, studies that primarily focused on the overuse of treatments, such as medications and surgical procedures, studies that do not have a major focus on overdiagnosis or overuse of tests, and diagnostic accuracy studies.