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Elife. 2019 Jun 11;8. pii: e45183. doi: 10.7554/eLife.45183.

A comprehensive review of randomized clinical trials in three medical journals reveals 396 medical reversals.

Author information

1
Knight Cancer Institute, Oregon Health & Science University, Portland, United States.
2
School of Medicine, Oregon Health & Science University, Portland, United States.
3
Division of Internal Medicine, Oregon Health & Science University, Portland, United States.
4
Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, United States.
5
Department of Medicine, University of Chicago, Chigcago, United States.
6
Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, United States.
7
Center for Health Care Ethics, Oregon Health & Science University, Portland, United States.
8
Department of Medicine, Oregon Health & Science University, Portland, United States.
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Contributed equally

Abstract

The ability to identify medical reversals and other low-value medical practices is an essential prerequisite for efforts to reduce spending on such practices. Through an analysis of more than 3000 randomized controlled trials (RCTs) published in three leading medical journals (the Journal of the American Medical Association, the Lancet, and the New England Journal of Medicine), we have identified 396 medical reversals. Most of the studies (92%) were conducted on populations in high-income counties, cardiovascular disease was the most common medical category (20%), and medication was the most common type of intervention (33%).

KEYWORDS:

evidence-based medicine; human; low-value care; medical reversal

Conflict of interest statement

DH, AH, TC, JG, CL, VK, MH, DM No competing interests declared, AC ASC reports that he receives royalties from the book, Ending Medical Reversal. VP VP reports that he receives royalties from his book Ending Medical Reversal; that his work is funded by the Laura and John Arnold Foundation; that he has received honoraria for Grand Rounds/lectures from several universities, medical centers, nonprofit groups and professional societies; that he is a writer for Medscape; and that he hosts the podcast Plenary Session (which has Patreon Backers).

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