Don't Do This

15 More Medical Procedures To Avoid

The Mayo Clinic's review of ten year's worth of medical reversals published by a leading journal turned up a host of medical procedures that were once thought to be the standard of care.  The latest evidence says that they are not worth the risk or the cost.

1) Anticonvulsant drugs during pregnancy
In 2001 a large observational study confirmed suspicions that anticonvulsants taken in pregnancy increase the risk of fetal abnormality.

2) Chelation therapy to prevent cognitive impairment in children with moderately elevated lead levels
Using chelation therapy with succimer did reduce neuropsychological delays in a randomized, placebo-controlled trial of children with moderately high blood lead levels.

3) Treatment of asymptomatic Trichomonas vaginalis during pregnancy
A randomized trial found that using metronidazole did not prevent preterm delivery in women with asymptomatic Trichomonas vaginalis.

4) Estrogen plus progestin hormone therapy to reduce heart disease or coronary artery disease
Postmenopausal women were randomized and given either estrogen/progesterone or a placebo.  After 5 years the hormone replacement therapy had provided no protection against cardiac disease.  In a second study postmenopausal hormone therapy did not provide protection against coronary-artery artherosclerosis either.

5) Nebulized epinephrine for infants with acute bronchiolitis
Even though epinephrine tratmentfor infants provides short-term improvement in bronchiolitis symptoms, a randomized, double blind study found that it did not shorten the overall time spent in the hospital.

6) Corticosteroids for bronchiolitis in children
Oral dexamethasone, given as a single dose in the emergency room, did not improve outcomes or reduce hospitalizations for children in a randomized and controlled study.

7) Lung transplant for cystic fibrosis
A large retrospective study found that lung transplants cannot be expected to extend life or improve quality of life for end-stage cystic fibrosis patients.

8) Corticosteroids for preschool children with wheezing due to upper respiratory infections
Virus-induced wheezing was not reduced in children who were treated with prednisolone in a large, randomized and double-blind trial.

9) Acyclovir for Bell's Palsy
A randomized, controlled study found that acyclovir, either alone or as an adjunct therapy, did not benefit patients.

10) Saw Palmetto for prostate enlargement
A year-long double-blind trial of 225 middle-aged men found they had no improvement after using saw palmetto (160 mg twice per day) for the treatment of benign prostatic hyperplasia.

11) Antidepressants as an adjunct in bipolar disorder
Adding standard antidepressants to a patient's regimen neither was not found to increase mood polarity but it didn't decrease it either.

12) Irradiation for breast cancer in women over 70
For women over 70 who have a lumpectomy with Tamoxifen for the treatment of estrogen receptor positive breast cancer the addition of irradiation was not better than lumpectomy with Tamoxifen alone in a randomized study.


13) Stents instead of artery bypass for multivessel coronary bypass disease
A large observational study in New York State found that stenting did not work better than traditional coronary-artery bypass for patients with disease in mulitiple vessels.

14) Vertebroplasty for fractured spinal bone
Despite being paid for by Medicare and performed on over 27,000 patients in 2004, vertebroplasty (the injection of cement into the bone) produced no better results than a sham procedure.

15) Delay of epidural anesthesia for women in labor
A 2005 study found that using systemic opioids in early labor gave did not reduce C-section rates compared to epidurals.