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Are incorrect treatments widespread?
An extensive analysis of various studies in highly reputed journals has now shown that many current medical practices are ineffective. The researchers found that there are almost 400 so-called medical reversals in the cases examined alone.
The current joint study by the University of Maryland, the University of Chicago and the Oregon Health & Science University found that there are currently almost 400 medical practices that are actually ineffective or faulty. The results of the study were published in the English language journal "eLife".
What is medical reversal?
Medical Reversal is a term that defines cases in which new and improved clinical studies prove that current medical practices are ineffective or faulty. Medical reversals occur when new clinical studies show that a particular medical practice does not work or does more harm than it does. These new studies are superior to previous studies due to better controls, better study design, or larger samples. So-called medical reversals often affect medication, but can also include surgery. The new meta-analysis of approximately 3,000 studies has now identified 396 cases of medical reversals.
3,000 studies were evaluated
The researchers wanted to provide a more comprehensive list of medical reversals to enable more effective and economical treatment. To this end, they analyzed over 3,000 controlled studies that have been published in three renowned medical journals over the past 15 years: Journal of the American Medical Association (JAMA), The Lancet and The New England Journal of Medicine (NEJM). The analysis identified 396 studies that represented a medical U-turn: 154 of them in JAMA, 129 in NEJM and 113 in The Lancet. Most of these studies (92 percent) were conducted in high-income countries, eight percent in low- and middle-income countries - including China, India, Malaysia, Ghana, Tanzania and Ethiopia.
In which areas were medical reversals identified?
The medical reversals occurred in the areas of cardiovascular diseases (20 percent), public health and preventive medicine (twelve percent) and intensive care medicine (eleven percent). The most common medical reversals identified were medication (33 percent), medical interventions (20 percent), vitamins and supplements (13 percent), medical devices (9 percent) and system interventions (8 percent).
Ineffective treatments must be avoided
Once an ineffective practice is established, it can be difficult to convince users to give up the application they are using. Attempts to rigorously test novel treatments before they spread to practice could reduce the number of medical reversals and prevent unnecessary harm to patients, the study authors explain. The current study also provides a starting point for a list of practices that are unlikely to be of real use for further research.
Were there any restrictions in the study?
However, the authors also warn that their review has some limitations, such as the small number of journals it contains and the limited expertise of the reviewers on some topics. Experts from various areas should take a close look at the medical reversals in the analysis and evaluate them critically. Hopefully, the results of the current study will lead physicians to evaluate their own practices more critically and to demand high-quality research before adopting new applications in practice, according to the researchers. (as)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Meta-Research: A comprehensive review of randomized clinical trials in three medical journals reveals 396 medical reversals