A recent study conducted by Dr. Vinay Prasad of the National Institutes of Health reveals that many accepted medical practices don't actually help patients. Dr. Prasad came to this conclusion after studying ten years of published articles in the New England Journal of Medicine had shown many accepted practices of medicine simply don't work.
"They weren't just practices that once worked, and have now beenupon; rather, they never worked," said Prasad. "They were instituted in error, never helped patients, and have eroded trust in medicine."
Prasad intended to identify the broad trends in medicine and prove that a large number of accepted medical practices just don't work. "Identifying medical practices that don't work is necessary because the continued use of such practices wastes resources, jeopardizes patient health, and undermines trust in medicine," said Prasad.
According to Medical Daily, "He and his team highlighted three examples of medical reversals in particular:
- Stenting for stable coronary artery disease was a multibillion-dollar-a-year industry when it was found to be no better than medical for most patients with stable coronary artery disease.
- Hormone therapy for postmenopausal women intended to improve cardiovascular outcomes was found to be worse than no intervention.
- The routine use of the pulmonary artery catheter in patients in shock was found to be inferior to less invasive management strategies.
Other instances of medical error include use of the drug aprotinin in cardiac surgery, use of a primary rhythm control strategy for patients with atrial fibrillation, and application of recommended glycemic targets for patients with diabetes. Prasad's team found that in some cases where weak evidence for a practice exists, it may nevertheless gain acceptance "largely through vocal support from prominent advocates" and blind faith that the underlying mechanism of action is sound. Later, even after trials prove the therapy to be ineffective (or even harmful), removing the contradicted practice can prove challenging. Another surprise finding was how often a potentially beneficial therapy would be withheld because of unfounded concerns about the potential to cause harm."
This study is another blow to patient confidence but it is always better to be aware of the state of medicine than remain ignorant of shortcomings and deficits.
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