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Ending medical reversal : improving outcomes, saving lives / Vinayak K. Prasad and Adam S. Cifu.

by Prasad, Vinayak K., 1982-

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Johns Hopkins University Press, [2015]

Clinical trials.

9781421417721 (hc.)

1421417723 (hc.)

viii, 264 p. ; 24 cm.

"Why medicine adopts ineffective or harmful medical practices only to abandon them -- sometimes too late"--Cover.

Includes bibliographical references and index.

What is medical reversal? -- Subjective outcomes : why feeling better is often misleading -- Surrogate outcomes -- Screening tests -- System failure -- Finding flawed therapies on our own -- The frequency of medical reversal -- The harms of medical reversal : today's patients, tomorrow's patients and the healthcare field -- A primer in evidence based medicine : what is evidence in medicine? -- What really got you better : when evidence gets complicated -- Scientific progress, revolution, and medical reversal -- Sources of flawed data -- Why are we so attracted to flawed therapies? -- Medical education : a very good place to start -- Academic medicine -- Reforming the system : the burden of proof and nudging our way past reversal -- How not to become a victim of reversal -- Beyond dogma : when randomized trials are unnecessary.

"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. 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. Fascinating stories from every corner of medicine exploring why medical reversals occur, how they are harmful, and what can be done to avoid them. The difference between medical innovations that improve care and those that only appear to be promising. 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"--Provided by publisher.

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