Abstract:
OBJECTIVE:To identify medical practices that offer no net benefits. METHODS:We reviewed all original articles published in 10 years (2001-2010) in one high-impact journal. Articles were classified on the basis of whether they addressed a medical practice, whether they tested a new or existing therapy, and whether results were positive or negative. Articles were then classified as 1 of 4 types: replacement, when a new practice surpasses standard of care; back to the drawing board, when a new practice is no better than current practice; reaffirmation, when an existing practice is found to be better than a lesser standard; and reversal, when an existing practice is found to be no better than a lesser therapy. This study was conducted from August 1, 2011, through October 31, 2012. RESULTS:We reviewed 2044 original articles, 1344 of which concerned a medical practice. Of these, 981 articles (73.0%) examined a new medical practice, whereas 363 (27.0%) tested an established practice. A total of 947 studies (70.5%) had positive findings, whereas 397 (29.5%) reached a negative conclusion. A total of 756 articles addressing a medical practice constituted replacement, 165 were back to the drawing board, 146 were medical reversals, 138 were reaffirmations, and 139 were inconclusive. Of the 363 articles testing standard of care, 146 (40.2%) reversed that practice, whereas 138 (38.0%) reaffirmed it. CONCLUSION:The reversal of established medical practice is common and occurs across all classes of medical practice. This investigation sheds light on low-value practices and patterns of medical research.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Prasad V,Vandross A,Toomey C,Cheung M,Rho J,Quinn S,Chacko SJ,Borkar D,Gall V,Selvaraj S,Ho N,Cifu Adoi
10.1016/j.mayocp.2013.05.012subject
Has Abstractpub_date
2013-08-01 00:00:00pages
790-8issue
8eissn
0025-6196issn
1942-5546pii
S0025-6196(13)00405-9journal_volume
88pub_type
杂志文章,评审abstract::Recognizing the adverse metabolic effects of predominantly visceral body fat distribution associated with low testosterone levels, researchers have investigated the effects of androgen treatment on body fat distribution in men. This presentation reviews the results of research on acute and longer-term effects of treat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To ascertain the incidence and timing of fever in patients at risk for temperature modulation of brain injury resulting from ischemia or trauma. DESIGN:We retrospectively reviewed the medical records of patients admitted between January 1991 and December 1994. MATERIAL AND METHODS:We investigated three grou...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)64885-4
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abstract::During the past decade, major advances have been made in vitamin D research that transcend the simple concept that vitamin D is Important for the prevention of rickets in children and has little physiologic relevance for adults. Inadequate vitamin D, in addition to causing rickets, prevents children from attaining the...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/81.3.353
更新日期:2006-03-01 00:00:00
abstract::Of the 355 patients with tuberous sclerosis complex (TSC) examined at the Mayo Clinic, 49 had died (9 of causes other than TSC). We attempted to determine what pattern of organ involvement occurred most often in the 40 patients who died of TSC. One baby died of cardiac failure due to cardiac rhabdomyomas, and one chil...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61196-3
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abstract::Skin cancer has become the most common neoplasm in the United States. With early diagnosis and appropriate management, most skin cancers have an overall 5-year survival rate of 95%. Cutaneous malignant melanoma (CMM), however, has a significantly higher morbidity and mortality, resulting in 65% of all skin cancer deat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/81.4.500
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To determine the association between cardiorespiratory fitness and sedentary behavior, independent of exercise activity. PATIENTS AND METHODS:We included 2223 participants (aged 12-49 years; 1053 females [47%]) without known heart disease who had both cardiovascular fitness testing and at least 1 day of acce...
journal_title:Mayo Clinic proceedings
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doi:10.1016/j.mayocp.2014.04.019
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abstract::The old paradigm states that the greater the stenosis, the greater the risk of cardiac events. Revascularization procedures are the only effective approach to improving prognosis associated with coronary artery disease. In contrast, on the basis of the new paradigm, the nature of the plaque determines the risk of acut...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract::Thalamic deep brain stimulation is becoming increasingly popular for the control of drug-refractory tremor. Implantable cardiac pacemakers and defibrillators are commonly used therapeutic modalities. Concerns exist about the potential interactions between these 2 devices in the same patient, but no experience has been...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.1.87
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To review the association of coronary artery calcification with coronary atherosclerosis and its potential clinical application as detected on electron beam computed tomography (EBCT). DESIGN:A literature review of coronary artery calcification, coronary artery disease, and EBCT is presented, and clinical ap...
journal_title:Mayo Clinic proceedings
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journal_title:Mayo Clinic proceedings
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1980-12-01 00:00:00
abstract::The assessment of a patient with binocular vertical diplopia begins with a thorough history and neuro-ophthalmologic examination. The neuro-ophthalmologic examination includes observation for a compensatory head, face, or chin position; ocular ductions and versions in the nine cardinal positions of gaze; the three-ste...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63620-3
更新日期:1998-01-01 00:00:00
abstract::Many misconceptions continue to persist in both the lay and the professional literature regarding the proper approach to the diagnosis and treatment of hypoglycemia. Often, patients with a symptom complex suggestive of hypoglycemia have normal levels of plasma glucose in association with these symptoms. The major diag...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)64790-9
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.10.987
更新日期:2001-10-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)64787-9
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/79.2.169
更新日期:2004-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.04.023
更新日期:2016-07-01 00:00:00
abstract::Understanding the sequence of events responsible for pressure-related natriuresis and their pathophysiologic alterations may be useful in distinguishing various types of essential hypertension of renal origin. The perturbation of a distal step in the sequence is likely to be reflected in a simple physiologic defect. F...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65384-1
更新日期:1989-11-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2018.04.031
更新日期:2019-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65623-7
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/S0025-6196(11)61140-3
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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doi:10.1016/j.mayocp.2019.05.025
更新日期:2019-11-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/71.2.161
更新日期:1996-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
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doi:10.1016/j.mayocp.2013.09.001
更新日期:2013-11-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62663-9
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1976-02-01 00:00:00