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Medical studies often overturn standards of care

NEWS IN BRIEF — Posted Aug. 5, 2013

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Established medical practices are frequently contradicted by new research, said a study posted online July 12 in Mayo Clinic Proceedings (link).

Researchers examined all the original articles published from 2001 to 2010 in The New England Journal of Medicine and found 363 studies that tested a medical practice constituting the standard of care at the time. Forty percent of the time, the published article contradicted the established medical practice, adding up to 146 cases in which new evidence questioned the care physicians were advised to provide.

“They weren’t just practices that once worked, and have now been improved upon. Rather, they never worked,” said Vinay Prasad, MD, lead author of the Mayo Clinic Proceedings study and a medical oncology researcher at the National Cancer Institute in Bethesda, Md. “They were instituted in error, never helped patients and have eroded trust in medicine.”

While research disproved the standard of care 40% of the time, a subsequent study reaffirmed the established practice 38% of the time. Meanwhile, 22% of the articles were inconclusive, the Mayo Clinic Proceedings study said. Examples of care standards that were found to be unsupportable by NEJM studies during this period included adding percutaneous coronary intervention to optimal medical therapy for patients with stable coronary artery disease and targeting a hemoglobin A1c of 7% or less for most patients with diabetes.

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