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Ending Medical Reversal

Improving Outcomes, Saving Lives

Vinayak K. Prasad, MD, MPH, and Adam S. Cifu, MD

Publication Date
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Why medicine adopts ineffective or harmful medical practices only to abandon them—sometimes too late.

Medications such as Vioxx and procedures such as vertebroplasty for back pain are among the medical "advances" that turned out to be dangerous or useless. What Dr. Vinayak K. Prasad and Dr. Adam S. Cifu call medical reversal happens when doctors start using a medication, procedure, or diagnostic tool without a robust evidence base—and then stop using it when it is found not to help, or even to harm, patients.

In Ending Medical Reversal, Drs. Prasad and Cifu narrate fascinating stories from every...

Why medicine adopts ineffective or harmful medical practices only to abandon them—sometimes too late.

Medications such as Vioxx and procedures such as vertebroplasty for back pain are among the medical "advances" that turned out to be dangerous or useless. What Dr. Vinayak K. Prasad and Dr. Adam S. Cifu call medical reversal happens when doctors start using a medication, procedure, or diagnostic tool without a robust evidence base—and then stop using it when it is found not to help, or even to harm, patients.

In Ending Medical Reversal, Drs. Prasad and Cifu narrate fascinating stories from every corner of medicine to explore why medical reversals occur, how they are harmful, and what can be done to avoid them. They explore the difference between medical innovations that improve care and those that only appear to be promising. They also outline a comprehensive plan to reform medical education, research funding and protocols, and the process for approving new drugs that will ensure that more of what gets done in doctors' offices and hospitals is truly effective.

Reviews

Reviews

Every doctor should read this book.

[A]n excellent and realistic discussion of some of the horror stories that occur in medical practice... The examples are quite interesting and certainly educational for all readers. Highly recommended.

Ending Medical Reversal goes far in teaching medical students and practicing physicians alike how to learn on our own.

This has to be on the reading list for medical and nursing students.

Ending Medical Reversal presents persuasive evidence that many current standard-of-care treatments are probably ineffective or harmful, thoroughly explains how such treatments came to be accepted, and proposes a number of ways to address the general problem (only some of which involve avaricious companies and mercenary physicians) and minimize its impact on a specific patient.

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About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
280
ISBN
9781421429045
Illustration Description
9 line drawings
Table of Contents

Introduction
Part I
Examples, Frequency, and Consequences
1. What Is Medical Reversal?
2. Subjective Outcomes
Why Feeling Better Is Often Misleading
3. Surrogate Outcomes
4. Screening Tests
5. Systems Failure

Introduction
Part I
Examples, Frequency, and Consequences
1. What Is Medical Reversal?
2. Subjective Outcomes
Why Feeling Better Is Often Misleading
3. Surrogate Outcomes
4. Screening Tests
5. Systems Failure
6. Finding Flawed Therapies on Our Own
7. The Frequency of Medical Reversal
8. The Harms of Medical Reversal
Today's Patients, Tomorrow's Patients, and the Health-Care Field
Part II
9. A Primer on Evidence-Based Medicine
What Is Evidence in Medicine?
10. What Really Made You Better
When Evidence Gets Complicated
Part III
11. Scientific Progress, Revolution, and Medical Reversal
12. Sources of Flawed Data
13. Why Are We So Attracted to Flawed Therapies?
Part IV
14. Medical Education
A Very Good Place to Start
15. Academic Medicine
16. Reforming the System
The Burden of Proof and Nudging Our Way Past Reversal
17. How Not to Become a Victim of Reversal
18. Beyond Dogma
When Randomized Trials Are Unnecessary
Acknowledgments
Appendix
References
Index

Author Bios
Vinayak K. Prasad, MD, MPH
Featured Contributor

Vinayak K. Prasad, MD, MPH

Vinayak K. Prasad, MD, MPH is a practicing hematologist-oncologist and internal medicine physician. An associate professor of medicine and public health at Oregon Health & Science University, he is the coauthor of Ending Medical Reversal: Improving Outcomes, Saving Lives.
Adam S. Cifu, MD
Featured Contributor

Adam S. Cifu, MD

Adam S. Cifu, MD, is a professor of medicine at the University of Chicago. He is a practicing general internist, medical educator, and the coauthor of Symptom to Diagnosis: An Evidence-Based Guide.