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Ending Medical Reversal


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Table of Contents

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

Promotional Information

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

About the Author

Vinayak K. Prasad, MD, MPH, is a practicing hematologist-oncologist and internal medicine physician. He is an associate professor of medicine and public health at Oregon Health & Science University. 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.


Every doctor should read this book.

* JAMA Internal Medicine *

[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.

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

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

* Nursing Times *
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.* Journal of Clinical Research Best Practices *

Dr. Prasad and Dr. Cifu offer a five-step plan, including pointers for determining if a given treatment is really able to do what you want it to do, and advice on finding a like-minded doctor who won't object to a certain amount of back-seat driving.

* The New York Times *

When I describe Ending Medical Reversal as revolutionary, I don't use the term lightly. Go out and read it-right now.

* Common Sense Family Doctor *

Should be considered for undergraduate reading lists. Keep a copy in the pharmacy or your briefcase as a great icebreaker or discussion point with other local healthcare professionals.

* The Pharmaceutical Journal *

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