The goal of this published study was to identify common medical practices that offer no benefit.
Doctors are often convinced by a drug and/or medical device representative that the latest and greatest drug or medical procedures will make them a better doctor. An analysis of 363 studies finds that not to be true.
A report which will appear in the August Mayo Clinic Proceedings looked at clinical practices found in articles published in the New England Journal of Medicine from 2001 to 2010.
The so-called improvements were found to be no better than what was previously used and in 40 percent of the cases were actually found to be ineffective or harmful. In those cases the practice was reversed. Among the remaining studies 38 percent were beneficial and 22 percent were unknown.
Among the examples of ineffective or harmful procedures is the use of stenting in the case of coronary disease. While it’s a multibillion dollar industry, the outcomes with a stent have not been found to be an improvement over traditional medical management for coronary artery disease. High-dose chemotherapy and stem cell transplant as a treatment for breast cancer was no better than regular chemotherapy; the use of a Swan-Ganz catheter to monitor heart function was found to deliver information that was not useful; and intensive care for type 2 diabetics actually increased mortality.
Hormone replacement therapy was thought to harm cardiovascular health, but has been found to save the lives of women with hysterectomies. Doctors sometimes keep using procedures that make sense to them, but don’t actually improve outcomes – such as opening up cholesterol-clogged arteries.
At the same time doctors appeared to withhold beneficial therapies believing they were harmful, such as failing to give vaccines to patients with multiple sclerosis, withholding birth control from women with lupus, and withholding epidurals in women in labor because some believed that epidurals increased Caesarean sections.
Medicine is business, so doctors are often eager to jump on the latest and greatest therapies that will deliver profits to their practice, even at the cost of their patients. Additionally, when doctors are involved directly in a treatment or medical device they have ownership in, it’s difficult to assess the true value of any therapy. A careful consumer should always view any therapy with a great deal of skepticism.