Sculpture in Denver.
Vinayak K. Prasad, M.D., and Adam S. Cifu, M.D., make a plea for the evidence-based cleaning up of medicine in their new book, Ending Medical Reversal: Improving Outcomes, Saving Lives (Johns Hopkins University Press, 2015). They heavily discuss “medical reversals” — established clinical practices overturned by new or better evidence that reveals harm or at least least no improvement over the previous standard of care.
MedPage Today reports that “The doctors passionately argue that medical reversal is the most important problem in medicine today, illustrating the impact reversals have had on patient care and the entire healthcare system through clinical practices that have been ‘adopted without a robust evidence base’– the breeding ground for medical reversals.”
“The book ends with a clear and thorough proposal for a recalibration throughout healthcare, from medical education and academic medicine career tracks, to clinical trial oversight and retesting of established therapies.”
They duo, reports MedPage,”argue for changes in most corners of the healthcare system, from the way the next generations of docs could be trained and how academic medical centers should encourage replication research, to placing more of the burden of proof for new therapies on drug makers and eschewing ‘give it a shot’ practices in medicine.”
And, they say, “As clinicians, we are aware that there needs to be wiggle room — we will continue to make some decisions without a solid evidence base.”
But they hope that “the house of medicine” can be cleaned with the help of a much bigger evidence base.