Original articleA Decade of Reversal: An Analysis of 146 Contradicted Medical Practices
Section snippets
Methods
We used methods similar to our prior survey of 1 year of publications in a high-impact journal.4 We reviewed all articles under the heading “Original Articles” in the New England Journal of Medicine from 2001 to 2010. These years were the last complete 10 years when we began our investigation. Our choice of journal was made on the basis of the 5-year Hirsch index for medical journals.13 Two reviewers (C.T., A.V., M.C., J.R., S.Q., S.J.C., D.B., V.G., or S.S.) and V.P. independently extracted
Results
From 2001 through 2010, 2044 original articles appeared in one high-impact journal. Most articles (1344 [65.8%]) addressed a medical practice. A total of 981 studies (73.0%) examined a new medical practice, whereas 363 (27.0%) addressed an existing practice. During these 10 years, there were 911 (67.7%) randomized controlled trials, 220 (16.4%) prospective controlled but nonrandomized studies, 117 (8.7%) observational studies, 43 (3.2%) case-control studies, and 53 (3.9%) studies using other
Discussion
Our review of 10 years of publications in a high-impact journal involved examining 2044 articles in duplicate to identify 146 medical reversals. Reversals included medications, procedures, diagnostic tests, screening tests, and even monitoring and treatment guiding devices. We were unable to identify any class of medical practice that did not have some reversal of standard of care (Supplemental Appendix).
The bispectral index monitor (BIS) illustrates many of the principles of medical reversal.
Conclusion
We present 146 medical practices that were reversed in 10 years of publications in a high-profile journal. Our results may be of interest to practitioners and policymakers who seek to identify low-value practices and methodologists and scientists who are interested in the patterns of medical research.
Acknowledgments
The views and opinions of Dr Prasad do not necessarily reflect those of the National Cancer Institute or National Institutes of Health.
References (94)
- et al.
Bacterial urinary tract infections in diabetes
Infect Dis Clin North Am
(1997) - et al.
Allergic rhinitis and its impact on asthma
J Allergy Clin Immunol
(2001) - et al.
ACC/AHA 2002 guideline update for the management of patients with chronic stable angina–summary article: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on the Management of Patients With Chronic Stable Angina)
J Am Coll Cardiol
(2003) - et al.
Over a decade of experience with preimplantation genetic diagnosis: a multicenter report
Fertil Steril
(2004) - et al.
Atherosclerotic renovascular disease in United States patients aged 67 years or older: risk factors, revascularization, and prognosis
Kidney Int
(2005) - et al.
Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial
Lancet
(2004) - et al.
Optimal medical therapy with or without PCI for stable coronary disease
N Engl J Med
(2007) - et al.
Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial
JAMA
(2002) - et al.
A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients
N Engl J Med
(2003) - et al.
The frequency of medical reversal
Arch Intern Med
(2011)
Reversals of established medical practices: evidence to abandon ship
JAMA
Medical reversal: why we must raise the bar before adopting new technologies
Yale J Biol Med
Contradicted and initially stronger effects in highly cited clinical research
JAMA
Choosing wisely: helping physicians and patients make smart decisions about their care
JAMA
Medicine's ethical responsibility for health care reform—the top five list
N Engl J Med
Disinvestment from low value clinical interventions: NICEly done?
BMJ
Over 150 potentially low-value health care practices: an Australian study
Med J Aust
Less is more: how less health care can result in better health
Arch Intern Med
The risk associated with aprotinin in cardiac surgery
N Engl J Med
Aprotinin during coronary-artery bypass grafting and risk of death
N Engl J Med
The effect of aprotinin on outcome after coronary-artery bypass grafting
N Engl J Med
A comparison of aprotinin and lysine analogues in high-risk cardiac surgery
N Engl J Med
Rhythm control versus rate control for atrial fibrillation and heart failure
N Engl J Med
A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation
N Engl J Med
The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation
N Engl J Med
Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention
N Engl J Med
Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery
N Engl J Med
Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial
N Engl J Med
Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years
N Engl J Med
American Academy of Otolaryngology–Head and Neck Surgery 2000 Clinical Indicators Compendium
Developmental outcomes after early or delayed insertion of tympanostomy tubes
N Engl J Med
Tympanostomy tubes and developmental outcomes at 9 to 11 years of age
N Engl J Med
Effects of estrogen plus progestin on health-related quality of life
N Engl J Med
Hormone therapy and the progression of coronary-artery atherosclerosis in postmenopausal women
N Engl J Med
Estrogen plus progestin and the risk of coronary heart disease
N Engl J Med
Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury
N Engl J Med
Effects of intensive glucose lowering in type 2 diabetes
N Engl J Med
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes
N Engl J Med
Coronary intervention for persistent occlusion after myocardial infarction
N Engl J Med
Optimal medical therapy with or without PCI for stable coronary disease
N Engl J Med
Quality of life after late invasive therapy for occluded arteries
N Engl J Med
Simvastatin with or without ezetimibe in familial hypercholesterolemia
N Engl J Med
Extended-release niacin or ezetimibe and carotid intima-media thickness
N Engl J Med
A controlled trial of arthroscopic surgery for osteoarthritis of the knee
N Engl J Med
A randomized trial of arthroscopic surgery for osteoarthritis of the knee
N Engl J Med
A randomized trial of vertebroplasty for osteoporotic spinal fractures
N Engl J Med
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