Sometimes medicine has no clothes!!

David H. Newman’s book Hippocrates’ Shadow is a treasure trove of nuggets on how medicine is practiced which many times has little to do with science and evidence. In this essay is quickly covers a number of medical areas that lack a real rationale.

http://well.blogs.nytimes.com/2009/04/02/the-ideology-of-health-care/

By David H. Newman, M.D. April 2, 2009

In the early throes of a heart attack, caused by an abruptly clotted artery, the stunned heart often beats quickly and forcefully. For decades doctors have administered “beta-blockers” as a remedy, to reduce consumption of limited oxygen supplies by calming and slowing the straining heart. Giving these drugs in the early stages of a heart attack represents elegant medical ideology.

But it doesn’t work.

Studies show that the early administration of beta-blockers to heart attack victims does not save lives, and occasionally causes dangerous heart failure. While two studies support the use of beta-blockers after heart attack, there are 26 studies that found no survival benefit to administering beta-blockers early on. Moreover, in 2005, the largest, best study of the drugs showed that beta-blockers in the vulnerable, early hours of heart attacks did not save lives, but did cause a definite increase in heart failure.

Remarkably, the medical community has continued to strongly recommend immediate beta-blocker treatment. Why? Because according to the theory of the straining heart, the treatment makes sense. It should work, even though it doesn’t. Ideology trumps evidence. much more at the link:

http://well.blogs.nytimes.com/2009/04/02/the-ideology-of-health-care/

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