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Medical treatments to reconsider

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This piece in JAMA looks at non-evidence-based medical treatments that  the authors believe should be often reconsidered. They conclude:

“Findings included lack of benefit for screening pelvic examinations (positive predictive value <5%), carotid artery screening (no reduction in stroke), and thyroid ultrasonography (15-fold increase in thyroid cancer). The harms of cancer screening included unnecessary surgery and complications. Head computed tomography was an overused diagnostic test (clinically significant findings in 4% [7 of 172] of head computed tomographic scans). Overtreatment included acetaminophen for low back pain, perioperative aspirin use, medications to increase high-density lipoprotein cholesterol level, stenting for renal artery stenosis, and prolonged opioid use after surgery (use >90 days in 3% [1229 of 39 140] of patients).

“Conclusions and Relevance  Many common medical practices should be reconsidered. It is anticipated that our review will promote reflection … and lead to questioning of other non-evidence-based practices.”

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