Editorial: How Many Contemporary Medical Practices Are Worse Than Doing Nothing or Doing Less?

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"....Other empirical approaches may also offer some insight about how commonly useless or even harmful treatments are endorsed. The Cochrane Database of Systematic Reviews has assembled considerable current medical evidence from clinical trials on diverse interventions. An empirical evaluation of Cochrane reviews in 2004 showed that most (47.8%) concluded that there is insufficient evidence to endorse the examined interventions.⁷ A repeated evaluation in 2011 showed that this trend has not changed, with the percentage of insufficient evidence remaining as high as 45%.⁸ Often, non-Cochrane reviews tend to have more positive conclusions about the assessed interventions, but it is unclear whether this finding reflects genuine superiority of the assessed interventions or bias in the interpretation of the results.⁹ Although a substantial proportion of interventions are clearly harmful or inferior to others, many are still being used because of reluctance or resistance to abandoning them.¹⁰ ....