A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices

Very interesting, I would love to see what medical practices are used by stroke doctors and the science behind them. But that would be suggesting that our doctors don't know what they are doing.
Our stroke associations should be doing this analysis if they were any good.

One of the reversals here from Table 2.
Mild intraoperative hypothermia during surgery for intracranial aneurysm (Todd et al,⁶⁰ 2005)Hypothermia was found to be helpful as a neurosurgical adjunct in 1955, especially for ischemic and traumatic insults.
At the time of this publication, the practice was used in nearly 50% of aneurysm surgeries.⁶¹ This large randomized study, the Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST), found no improvement in neurologic outcomes with hypothermia, while noting an increase in bacterial infections with the intervention .

This probably means we need more studies before we setup all ambulances with hypothermia tools.
I guess I'll quit pushing them.
Do you really think the reversals and inconclusive results are read and understood by all your stroke doctors? I think not.
http://www.mayoclinicproceedings.org/article/S0025-6196%2813%2900405-9/fulltext

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.