Nearly 400 established medical practices have been found to be ineffective in clinical studies published in JAMA, the Lancet and the New England Journal of Medicine.
Researchers conducted a search of randomised controlled trials published over 15 years in the three journals. From 3,000 articles, there was evidence to support 396 medical reversals (when newer and superior clinical trial data contradict existing clinical practice).
Cardiovascular disease was the most commonly represented medical category among the reversals (20%), followed by public health/preventive medicine (12%) and critical care (11%). Medication was the most common intervention (33%) involved, followed by a procedure (20%) and vitamins and/or supplements (13%).
Writing in the open-access journal eLife, the researchers hope their findings will encourage the “de-adoption” of these practices.
Commenting on the findings, senior author, Vinay Prasad said: "There are a number of lessons that we can take away from our set of results, including the importance of conducting RCTs for both novel and established practices."
“Once an ineffective practice is established, it may be difficult to convince practitioners to abandon its use. By aiming to test novel treatments rigorously before they become widespread, we can reduce the number of reversals in practice and prevent unnecessary harm to patients,” he said.