Ending Medical Reversal
Improving Outcomes, Saving LivesBook - 2015
Author Prasad (National Cancer Institute) and author Cifu (medicine, University of Chicago) draw on peer-reviewed data as well as their own experiences as physicians and medical educators in this expos of medical reversals, defined here as contemporary medical treatments, diagnostic techniques, medications, and surgeries that don’t work or even make the condition worse, yet are still used by doctors even when evidence shows otherwise. Writing for general readers, they explain how and why medical reversals happen and how readers can avoid becoming victims of medical reversals such as estrogen replacement therapy, stents for stable coronary-artery disease, and vertebroplasty. One chapter is devoted to a primer on evidence-based medicine, and another chapter gives advice on how not to become a victim of medical reversals. The authors seek to consider all sides of the debate and provide references to original sources. The book closes with the authors’ recommendations for reforming medical education, research funding, and the drug approval process in order to prevent medical reversals. A 30-page appendix provides a chart summarizing studies appearing in the New England Journal of Medicine between 2001 and 2010 that revealed medical reversals. Annotation ©2016 Ringgold, Inc., Portland, OR (protoview.com)
Johns Hopkins University Press
We expect medicine to progress in an orderly fashion, with good medical practices being replaced by better ones. But some tests and therapies are discontinued because they are found to be worse, or at least no better, than what they replaced. Medications like Vioxx and procedures such as vertebroplasty for back pain caused by compression fractures are among the medical "advances" that turned out to be dangerous or useless. What Dr. Vinayak K. Prasad and Dr. Adam S. Cifu call medical reversal happens when doctors start using a medication, procedure, or diagnostic tool without a robust evidence base—and then stop using it when it is found not to help, or even to harm, patients.
Drs. Prasad and Cifu narrate fascinating stories from every corner of medicine to explore why medical reversals occur, how they are harmful, and what can be done to avoid them. They explore the difference between medical innovations that improve care and those that only appear to be promising. They also outline a comprehensive plan to reform medical education, research funding and protocols, and the process for approving new drugs that will ensure that more of what gets done in doctors’ offices and hospitals is truly effective.
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If you ever visit a doctor this is a must read. A key stat is the 40% of treatments doctors use don't work. Doctors do their best, but a lot of the time it just doesn't work. They have solid science backing their conclusions. It has practical questions you should ask your doctor before any treatment.
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