In the medical world, new is not necessarily better says the NY Times; avoiding new methods that can be useless or worse.

In the medical world, new is not necessarily better says the NY Times; avoiding new methods that can be useless or worse.

There is constant innovation of new medicines, new procedures and even new devices from medical suppliers, drug companies and even from doctors who have marketed new procedures. From the point of view of the health consumer, especially since we find ourselves paying more of the bill ourselves, being able to figure out which one of these new developments is truly better and safer than methods that have been around for years. A couple of drugs that come to mind which fit that description are Coumadin, the widely used blood thinner and Prednisone, the steroid which has side effects but is inexpensive to use, doctors are comfortable and familiar with it and it works with a high safety level. Newer drugs on the other hand have not fared so well that were supposed to replace these because they were more expensive (because they were not available as generics) and were often not any more effective or were less effective than Prednisone or Coumadin. There are many devices that are relatively inexpensive such as tens machines for pain control which do a good job of controlling pain, at a lower cost than many of the newer devices. Recently, intuitive Surgical’s Da Vinci robot has come under fire for surgeries that seemingly were not as good as those done by hand, with many facilities that use the machine charging a premium for surgeries done with the robot.

The point being made is that often tried and true in the medical world offers us the best value because of the proven track record that was earned by the product or drug. That is not to say innovations cannot be better and many often are, however, we are constantly being sold on the next greatest thing which often is not as good as what it tries to replace. The NY Times looks at this dilemma.

Medical Procedures May Be Useless, or Worse

We usually assume that new medical procedures and drugs are adopted because they are better. But a new analysis has found that many new techniques and medicines are either no more effective than the old ones, or worse. Moreover, many doctors persist in using practices that have been shown to be useless or harmful.

Scientists reviewed each issue of The New England Journal of Medicine from 2001 through 2010 and found 363 studies examining an established clinical practice. In 146 of them, the currently used drug or procedure was found to be either no better, or even worse, than the one previously used. The report appears in the August issue of Mayo Clinic Proceedings.

More than 40 percent of established practices studied were found to be ineffective or harmful, 38 percent beneficial, and the remaining 22 percent unknown. Among the practices found to be ineffective or harmful were the routine use of hormone therapy in postmenopausal women; high-dose chemotherapy and stem cell transplant, a complex and expensive treatment for breast cancer that was found to be no better than conventional chemotherapy; and intensive glucose lowering in Type 2 diabetes patients in intensive care, which not only failed to reduce cardiovascular events but actually increased mortality.

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