Bloodletting was a common medical practice for over two millennia until modern medicine gave us other, far more efficacious, treatments for headaches, back pain and pneumonia. But while there’s no questioning the advances of medical treatment today, just because a procedure or a drug is “the latest thing” does not mean that these are better.
Yet doctors, according to a recent study from Mayo Clinic Proceedings (pdf), continue to carry out some procedures despite a lack of evidence that they actually help a patient. In some cases, some procedures and protocols are still used even though they have been shown to make a patient more ill.
The researchers evaluated every issue from 2001 through 2010 of one of the most well-regarded medical journals in the U.S. if not the world, the New England Journal of Medicine. They found a total of 363 studies that investigated established practices among doctors treating patients. In 146 cases, the drug or procedure in use was “found to be either no better, or even worse, than the one previously used.” In fact, more than 40 percent of established practices were found to be ineffective or harmful while 38 percent were shown to be beneficial; the remaining 22 percent were of unknown effectiveness.
As lead author Dr. Vinay Prasad, a chief fellow in medical oncology at the National Cancer Institute, comments, “there’s an inertia, a 10-year period of time when the contradicted procedure continues to be practiced.” He also noted that doctors often continue to follow a procedure in the face of evidence about it being effective because doing so seems “to make sense.”
Some examples of such procedures and protocols that are referenced in the Mayo Clinic study:
1. Doctors have delayed giving women in labor epidurals until their cervix has dilated to a certain point, out of the unsubstantiated belief that this procedure would increase the risks of a woman having a C-section.
2. Vaccines have not been given to those with multiple sclerosis on the theory that these could cause MS symptoms to flare up; studies have “undermined” these concerns.
3. Women with lupus have been denied oral contraceptives out of concern that these would increase the severity of their disease, but such has not been proven and may have led to an increase in elective abortions among women with lupus.
4. Type 2 diabetes patients in intensive care have had a procedure called intensive glucose lowering administered to them, on the theory that it would reduce cardiovascular events. It was found not to do so and, in some cases, increased mortality rates.
5. Administering high-dose chemotherapy and stem cell transplant — an extensive, and expensive, treatment — to treat women with breast cancer has been found to be no better than conventional chemotherapy.
6. Millions of dollars are spent every year on impermeable mattress covers to help alleviate symptoms in those with asthma and allergies, but these have been found to be clinically ineffective in adults with asthma.
7. Pre-implantation genetic screening has been recommended for women of advanced maternal age who undergo in vitro fertilization (IVF) as pregnancy rates among them are low. But the screening actually “significantly reduced the rates of ongoing pregnancies and live births after IVF.”
Thanks to the Internet, consumers can make their own investigations about about medical procedures, other people’s experiences with doctors and hospitals, drugs and their side effects and now more than ever. Of course, not everything you read about health and medicine on the web is accurate. But it is a good thing that consumers today can inform themselves with medical knowledge prior to a doctor’s visit or before undergoing a surgical procedure.
Further research could show that the medical procedures cited in the study may have benefits. The new Mayo Clinic study is a reminder that, when it comes to our health, “accepted medical practices” (bloodletting was considered such for over 2,500 years!) may not necessarily be the best for our health.
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