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When a medical treatment, device or procedure is no better than previous or lesser alternatives, it's deemed a 'medical reversal'. These discredited practices are a major barrier to better and cheaper healthcare, but actually identifying them is surprisingly difficult and rarely done.
A recent study, designed to create a more comprehensive list, has unearthed nearly 400 established treatments, devices and procedures that fit this bill.
"We hope our broad results may serve as a starting point for researchers, policy makers and payers who wish to have a list of practices that likely offer no net benefit to use in future work," says hematologist-oncologist Vinay Prasad from Oregon Health & Science University (OHSU), who helped coin the term 'medical reversal'.
The findings are based on more than 15 years of randomised controlled trials, a type of research that aims to reduce bias when testing new treatments. Across 3,000 articles in three leading medical journals from the UK and the US, the authors found 396 reversals.
"GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients," the analyst wrote. "In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise."