Evidence-based Medicine

Promoting Evidence-Based Medicine

Less is More

Medical treatments, each with their own set of side effects, often continue to be used even after data has shown that they do not improve outcomes in certain situations. The reasons are many and include systematic profit structures, lack of awareness, or simply the understandable desire to “do something” for the patient. How to address this?

Parsemus Foundation has helped make possible a year-long series called “Less is More,” running 2010-2011 in the Archives of Internal Medicine (now called the Journal of the American Medical Association Internal Medicine), a journal that goes to primary care physicians all over the country. This series highlighted cases where unnecessary medical procedures are actually damaging to patient health and clarifying the conditions under which procedures and drugs are best used. Angioplasty and stenting were covered in the original series, as well as data on colonoscopy frequency, proton pump inhibitors, and more. Due to the popularity of the series, it has continued to this day.

List of the series publications: Less is More

Some early press coverage

Series introduction in USA Today: link

Proton pump inhibitors
Are too many people taking heartburn drugs? 5/2010, CNN Health

Stents
Stents: How new technology drives health costs. 4/2011, Reuters

Angioplasty and lack of impact of new guidelines on practice
Series article: Impact of National Clinical Guideline Recommendations for Revascularization of Persistently Occluded Infarct-Related Arteries on Clinical Practice in the United States, by Deyell et al.

Press coverage
*Forbes: OAT Trial Had Little Impact on Clinical Practice
*Reuters: Doctors overuse heart treatment, despite guidelines
*Bloomberg: Guidelines Don’t Curb Unnecessary Treatment for Heart Attack Patients
* U.S. News & World Report: Adherence to Angioplasty/Stent Guidelines Lacking: Study
*Huffington Post: Heart Stents Still Overused, Despite Guidelines: Study
*Doctors Lounge: Adherence to Angioplasty/Stent Guidelines Lacking: Study

Colonoscopy
Significant Number of Medicare Patients Getting Too-Frequent Colonoscopies. 5/2011, Wall Street Journal Health Blog
Medicare Breaks Own Rules to Pay for Multiple Colonoscopies, Study Finds. 5/2011, Bloomberg

About the journal
The Journal of the American Medical Association (JAMA) Internal Medicine, with a print circulation of over 100,000 physicians in 75 countries, began publication in 1908. It is an international peer-reviewed journal published 22 times per year and reaches the majority of office- and hospital-based general internists and significant numbers of internal medicine subspecialists in the United States. JAMA Internal Medicine has a high impact factor, meaning that its articles are highly cited. The Editor of the Archives of Internal Medicine is Rita F. Redberg, MD, MSc, University of California San Francisco School of Medicine, San Francisco, California, who is the foundation grantee.

Parsemus Foundation made an unrestricted gift to support “Less is More” activities and has no financial interest and no editorial control over the series.