BOX 3-3

Examples of Widely Adopted Health Interventions Found to Be Ineffective or Harmful

  • Antihistamines and oral decongestants to treat otitis media with effusion

  • Autologous bone marrow transplant with high-dose chemotherapy for advanced breast cancer

  • Chelation therapy to prevent or reverse atherosclerosis

  • Diethylstilbestrol (DES) to prevent miscarriage

  • Electronic fetal monitoring during labor without access to fetal scalp sampling

  • Episiotomy (routine) for birth

  • Extracranial-intracranial bypass to reduce the risk of ischemic stroke

  • Fenfluramine plus phentermine to treat obesity

  • Gastric bubble for morbid obesity

  • Gastric freezing for peptic ulcer disease

  • Home uterine activity monitoring to prevent preterm birth

  • Hydralazine for chronic heart failure

  • Lidocaine to prevent arrhythmia and sudden death in acute myocardial infarction

  • Mammary artery ligation for coronary artery disease

  • Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy

  • Quinidine for suppressing recurrences of atrial fibrillation

  • Radiation therapy for acne

  • Spinal manipulation to treat migraine or cluster headaches

  • Subcutaneous interferon alfa-2a to treat age-related macular degeneration

  • Supplemental oxygen for healthy premature babies

  • Thalidomide for sedation in pregnant women

  • Traction to treat low back pain

  • Triparanol (MER-29) for cholesterol reduction

NOTE: Adapted from Goodman (2004).

SOURCES: AHCPR (1990, 1993); BMJ (2004a,b,c); Coplen et al. (1990); Enkin et al. (1995); Feeny et al. (1986); Fletcher and Colditz (2002); Grimes (1993); The Ischemic Optic Neuropathy Decompression Trial Research Group (1995); Mello and Brennan (2001); Passamani (1991); Rossouw et al. (2002).

UnitedHealthcare had reviewed. All the services were recent health care innovations or new technologies. The committee was not able to determine if the duplicate independent reviews yielded similar results. Interestingly, AHRQ EPCs had reviewed only five of the topics.

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