Is more truly better. As patients demand more tests to try to get to the bottom of their ailments and as physicians acquiesce and even push it on them who gains and who suffers? It is in this context that we should truly ask ourselves this very important question. While on the surface it does appear to be better because it assumes that a new test or an expensive one will find what is wrong. Alas if it were so.
In a recent analysis in Mayo Clinic Proceedings that reviewed 10 years of articles published in the New England Journal of Medicine about 40% of current medical practices may be ineffective and should be reconsidered, according to a new analysis. These included assessments of screening or diagnostic tests, medications, and procedures. Lead author Vinay Prasad reported that of 363 articles that tested a current medical practice, 40% concluded that the methods were ineffective (medical reversals) and 22% were inconclusive. The study identified 146 medical practices that should be or have been reversed. these include:
- Administering hormone therapy for postmenopausal women
Stenting for stable coronary artery disease;
Routinely installing a pulmonary artery catheter for patients in shock;
Using the drug aprotonin during heart surgery; and
Applying stringent glycemic targets for diabetic patients.