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Medical Reversals in Family Practice: A Review

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 identif...

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Detalles Bibliográficos
Autores principales: Haslam, Alyson, Livingston, Catherine, Prasad, Vinay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063107/
https://www.ncbi.nlm.nih.gov/pubmed/32180846
http://dx.doi.org/10.1016/j.curtheres.2020.100579
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author Haslam, Alyson
Livingston, Catherine
Prasad, Vinay
author_facet Haslam, Alyson
Livingston, Catherine
Prasad, Vinay
author_sort Haslam, Alyson
collection PubMed
description 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.
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spelling pubmed-70631072020-03-16 Medical Reversals in Family Practice: A Review Haslam, Alyson Livingston, Catherine Prasad, Vinay Curr Ther Res Clin Exp Original Research 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. Elsevier 2020-02-22 /pmc/articles/PMC7063107/ /pubmed/32180846 http://dx.doi.org/10.1016/j.curtheres.2020.100579 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Haslam, Alyson
Livingston, Catherine
Prasad, Vinay
Medical Reversals in Family Practice: A Review
title Medical Reversals in Family Practice: A Review
title_full Medical Reversals in Family Practice: A Review
title_fullStr Medical Reversals in Family Practice: A Review
title_full_unstemmed Medical Reversals in Family Practice: A Review
title_short Medical Reversals in Family Practice: A Review
title_sort medical reversals in family practice: a review
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063107/
https://www.ncbi.nlm.nih.gov/pubmed/32180846
http://dx.doi.org/10.1016/j.curtheres.2020.100579
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