TY - JOUR
T1 - Medical Reversals in Family Practice
T2 - A Review
AU - Haslam, Alyson
AU - Livingston, Catherine
AU - Prasad, Vinay
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020
Y1 - 2020
N2 - Background: Primary care physicians are challenged by the need to stay abreast of current research on a wide variety of topics in an environment of time constraints, evolving literature, and misinformation on health topics that are sometimes promulgated to the public. Objective: We sought to identify and discuss common clinical situations encountered in primary care for which medical reversals have occurred. Methods: We recently identified almost 400 medical practices that were used in clinical care before they were tested in well-done randomized controlled trials and subsequently were found to be ineffective or harmful. Results: We review several of these practices commonly used in family medicine, which include arthroscopy for osteoarthritis of the knee, opioids for common causes of pain, and aspirin and continuous positive airway pressure for the prevention of cardiovascular disease. Conclusions: Although these practices were implemented because of sound biologic plausibility or encouraging observational data, well done randomized controlled trials have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high-quality evidence demonstrating efficacy.
AB - Background: Primary care physicians are challenged by the need to stay abreast of current research on a wide variety of topics in an environment of time constraints, evolving literature, and misinformation on health topics that are sometimes promulgated to the public. Objective: We sought to identify and discuss common clinical situations encountered in primary care for which medical reversals have occurred. Methods: We recently identified almost 400 medical practices that were used in clinical care before they were tested in well-done randomized controlled trials and subsequently were found to be ineffective or harmful. Results: We review several of these practices commonly used in family medicine, which include arthroscopy for osteoarthritis of the knee, opioids for common causes of pain, and aspirin and continuous positive airway pressure for the prevention of cardiovascular disease. Conclusions: Although these practices were implemented because of sound biologic plausibility or encouraging observational data, well done randomized controlled trials have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high-quality evidence demonstrating efficacy.
KW - arthroscopic surgery
KW - cardiovascular disease
KW - medical reversal
KW - opioid use
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85081005822&partnerID=8YFLogxK
U2 - 10.1016/j.curtheres.2020.100579
DO - 10.1016/j.curtheres.2020.100579
M3 - Article
AN - SCOPUS:85081005822
SN - 0011-393X
VL - 92
JO - Current Therapeutic Research - Clinical and Experimental
JF - Current Therapeutic Research - Clinical and Experimental
M1 - 100579
ER -