All new medical practices are trialed before adoption by health professionals, but just as important is continuing randomised controlled trials based on new evidence and scientific understanding.
This message was highlighted by a new analysis of ‘medical reversals’, where a treatment is found not to work, to cause more harm than good or to provide no benefit over a cheaper alternative treatment.
Conducted by researchers at the Knight Cancer Institute at Oregon Health & Science University (OHSU), in Portland, the study examined over 3,000 randomised controlled trials published in The Journal of the American Medical Association (JAMA), The Lancet, and The New England Journal of Medicine (NEJM) over the past 15 years.
396 medical reversals are listed across all disciplines and types of treatment. The most common field of research was cardiovascular disease at 20%, whereas the most common type of treatment was medication at 33%.
Although the analysis focused on a limited number of journals and the reviewers admit to limited expertise in some fields, it does provide a more comprehensive list of reversals than existing endeavours such as the Cochrane reviews.
The authors are using the results to call for greater initial and ongoing trials of medical practices due to the reputational damage to the medical community caused by reversals, as well as the difficulty of convincing medical professionals to discontinue a practice once adopted.
The full review appears in the journal eLife.
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Source: Medical News Today