'Perverse Incentives' Perpetuate Use of Disproven Medical Treatments

Cheryl Clark, August 6, 2013

In what researchers are calling "the largest and most comprehensive study of medical (finding) reversal," they identify 146 medical practices that have been refuted by subsequent studies, but which continue to be used by providers.

Flawed research too often prompts doctors and hospitals to rush in technologies or practices which subsequent studies resoundingly refute. Yet despite solid contradicting evidence, some doctors take years to change their recommended care, and others just don't.

That's the conclusion of researchers who looked at 146 medical practices based on studies published in the New England Journal of Medicine, whose conclusions were reversed by subsequent scientific trials within the next 10 years. The new paper is published in the August issue of the Mayo Clinic Proceedings, and authors wrote that it is "the largest and most comprehensive study of medical (finding) reversal."

See Also: Berwick: Zapping Overtreatment, Costs Takes 'Courage'

"What we found is that when we learn in certain cases that we were wrong, it's much harder to stop doing something that we have been doing, especially when there's money involved, and especially when the finances of the person making the recommendation are tied to the patient going through [with the recommended care]," says Vinay Prasad, MD, an oncologist with the National Cancer Institute and lead author of the report.

"It's a perverse incentive, that's what Don Berwick talks about, and that's what we're identifying."


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