Tuesday, November 10, 2015

Book on "medical reversals"

Know what a medical reversal is? You do--but not by that term. Medical reversals are when long-accepted medical practices are abandoned because they are proved to be ineffective.

Vinayak K. Prasad of the National Center Center and Adam S. Cifu of the University of Chicago, who wrote Ending Medical Reversal, say these reversals are distressingly common. They looked at the New England Journal of Medicine from 2001-2010 and 40% of the articles were about new or recently adopted practices that were "reversed."

This is not--they emphasize--because a drug or procedure worked and then stopped working--this is when it never worked in the first place.

In short, doctors prescribe or do procedures without robust research behind it. This results in higher health costs and no change in health.

Why does this happen in the age of "precision medicine"? The nature of clinical trials, medical education, funding, and drug approval.

Take osteoporosis--bone weakening. Trials may focus on bone density--while they should focus on how many people get fractures...The fractures, not the density--are the issue.

The book zeroes in on screening tests--because these are given to healthy people. The evidence that these prevent cancer death are pretty weak.

Individuals are also guilty of self-medicating--say with vitamins and supplements--without evidence of effectiveness.

Want to learn more about what means what and the ins and outs of various types of trials--this is your book.

No comments: