Persistence of Contradicted Claims in the Literature

Tatsioni, Athina; Bonitsis, N.G.; Ioannidis, John P. A.

doi:10.1001/jama.298.21.2517

Cited by 198 publications

(139 citation statements)

References 62 publications

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“…Retractions often do not occur for years after publication (1,18,21,90), which is perhaps understandable given the time required for other researchers to attempt to replicate results and for institutions to perform thorough investigations (100), but this means that erroneous information remains in circulation for prolonged periods before correction (62). Moreover, it is disheartening that retracted articles continue to be cited, sometimes for decades afterward (11,24,45,63,66,88,96).…”

mentioning

confidence: 99%

Retracted Science and the Retraction Index

2011

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Articles may be retracted when their findings are no longer considered trustworthy due to scientific misconduct or error, they plagiarize previously published work, or they are found to violate ethical guidelines. Using a novel measure that we call the “retraction index,” we found that the frequency of retraction varies among journals and shows a strong correlation with the journal impact factor. Although retractions are relatively rare, the retraction process is essential for correcting the literature and maintaining trust in the scientific process.

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confidence: 99%

Retracted Science and the Retraction Index

2011

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“…22 Examples include percutaneous coronary artery intervention in stable, non-critical coronary artery disease, 23 facility-based cardiac rehabilitation programs following myocardial infarction, 24 vertebroplasty for acute osteoporotic fracture 25 and blood glucose self-monitoring in stable type 2 diabetes. 26 Such discredited practices tend to persist, often for years, 27 sustained sometimes by vested commercial interests, but more often by strongly held professional beliefs. 28 Requests for investigations such as vitamin B 12 , folate 29 and vitamin D 30 assays, and computed tomography (CT) scans for back pain and chest diseases 31 have surged in recent years despite considerable doubt as to their usefulness to decision making.…”

Section: Minimise Errors In Diagnosismentioning

confidence: 99%

Ten clinician-driven strategies for maximising value of Australian health care

Scott¹

2014

Aust. Health Review

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Objective. To articulate the concept of high-value care (i.e. clinically relevant, patient-important benefit at lowest possible cost) and suggest strategies by which clinicians can promote such care in rendering the Australian healthcare system more affordable and sustainable.Methods. Strategies were developed by the author based on personal experience in clinical practice, evidence-based medicine and quality improvement. Relevant literature was reviewed in retrieving studies supporting each strategy.Results. Ten strategies were developed: (1) minimise errors in diagnosis; (2) discontinue low-or no-value practices that provide little benefit or cause harm; (3) defer the use of unproven interventions; (4) select care options according to comparative cost-effectiveness; (5) target clinical interventions to those who derive greatest benefit; (6) adopt a more conservative approach nearing the end of life; (7) actively involve patients in shared decision making and self-management; (8) minimise day-to-day operational waste; (9) convert healthcare institutions into rapidly learning organisations; and (10) advocate for integrated patient care across all clinical settings.Conclusions. Clinicians and their professional organisations, in partnership with managers, can implement strategies capable of maximising value and sustainability of health care in Australia.What is known about this topic? Value-based care has emerged as a unitary concept that integrates quality and cost, and is being increasingly used to inform healthcare policy making and reform. What does this paper add? There is scant literature that translates the concept of high value care into actionable enhancement strategies for clinicians in everyday practice settings. This article provides 10 strategies with supporting studies in an attempt to fill this gap. What are the implications for practitioners? If all practitioners, in partnership with healthcare managers, attempted to enact all 10 strategies in their workplaces, a significant quantum of healthcare resources could be redirected from low-to highvalue care, culminating in much greater health benefit from the healthcare dollars currently being spent. However, such reforms will require a shift in clinician thinking and practice away from volume-based care to value-based care.

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“…Tatsioni et al reported that research findings which had been subsequently contradicted often continued to be cited in some scientific literature, most typically by proponents of a particular practice. 19 Although the findings of individual clinical studies may be vulnerable to be eventually overturned, surely the gold standard of evidence-based medicine, the meta-analysis, would prove more durable over time. In fact, Shojania et al reviewed 100 high-quality quantitative systematic reviews, published from 1995 to 2005 and indexed in the ACP Journal ClubÒ, in order to estimate the average time until there were sufficiently important changes in evidence to warrant updating systematic reviews.…”

Section: Principal Findings -Literature Searchmentioning

confidence: 99%

Review article: The role of practice guidelines and evidence-based medicine in perioperative patient safety

Crosby

2012

Can J Anesth/J Can Anesth

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Purpose The purpose of this narrative review is to discuss the impact of clinical practice guidelines on the outcomes of care and patient safety. Principal findings The care provided to patients has a high degree of variability, including some care that is discordant with available evidence. This inconsistency has implications for patient safety as some patients receive care that is unlikely beneficial yet may be harmful, while others are denied care that would clearly be helpful. The medical literature is expanding at an alarming rate; its quality and reliability is often poor; study methodology is frequently suboptimal, and reversal is common, even among frequently cited articles. For decades, specialty societies and other agencies have been providing clinical practice guidelines to assist physicians with the integration of evidence into clinical decision-making. Implementation of guidelines has been variable, and their goals are often not achieved due to failed uptake and application. The reasons for this shortcoming are complex and some explanations are valid. Many guidelines have not been evidence-based and many have been methodologically unsound. Physician autonomy likely also plays an important role in guideline uptake; an updated concept of autonomy that embraces appropriate guidelines is long overdue. Conclusions Under certain conditions, guidelines can add value to care and improve outcomes; they need to be evidence-based, methodologically sound, and appropriately applied to patients and clinical scenarios. Simply summarizing evidence in a guideline is an inadequate process. To achieve the benefit of guidelines, implementation strategies need to be robust. RésuméObjectif L'objectif de cette analyse est de discuter de l'impact des directives de pratique clinique sur les re´sultats des soins et sur la se´curite´des patients. Constatations principales Le niveau des soins fournis aux patients peut varier dans de grandes proportions, et cela concerne e´galement certains soins qui ne concordent pas avec les donne´es probantes disponibles. Ce manque d'homoge´ne´ite´a des implications sur la se´curite´des patients, car certains d'entre eux reçoivent des soins qui ont peu de chances de leur eˆtre be´ne´fiques ou qui leur sont plutôt ne´fastes, tandis que d'autres se voient refuser des soins qui pourraient manifestement leur eˆtre utiles. Les publications me´dicales se multiplient a`un rythme inquie´tant; leur qualite´et leur fiabilite´sont souvent faibles; la me´thodologie des e´tudes est souvent sous-optimale et leurs conclusions sont souvent contredites, meˆme dans le cas d'articles fre´quemment re´fe´rence´s. Pendant des de´cennies, les socie´te´s savantes de spe´cialistes et les agences gouvernementales ont fourni des directives de pratique clinique pour aider les me´decins a`inte´grer les donne´es probantes dans les processus de prise de de´cision clinique. La mise en oeuvre des directives a e´te´variable et, souvent, leurs objectifs ne sont pas atteints en raison de leur non-adoption par les profe...

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Persistence of Contradicted Claims in the Literature

Cited by 198 publications

References 62 publications

Retracted Science and the Retraction Index

Retracted Science and the Retraction Index

Ten clinician-driven strategies for maximising value of Australian health care

Review article: The role of practice guidelines and evidence-based medicine in perioperative patient safety

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