Over the past several years we’ve heard a lot about the effectiveness of medical treatments. It’s frustrating to put together the puzzle parts on this issue, but especially so when a family member is ill with a serious disease. Sometimes going forward with a treatment feels better than seeming to do nothing. When aging issues are added to the thinking mix, decisions become even more complex.
In her New York Times Well blog column, When Less Treatment is More, Pauline W. Chen, M.D., points out that it’s often necessary for a physician to figure out when less treatment is better than more. Although quite a bit of research provides evidence and identifies treatments that are less effective, patients continue to receive those medical treatments, sometimes at great risk, because they or their doctors believe those are better care.
A medical treatment or surgery is considered effective if the desired outcome is achieved.
Dr. Chen describes research at Yale University School of Medicine that investigated whether radiation treatments after surgery were effective for women over age 70 with less invasive breast cancers and whether the patients lived longer. After examining the records of 13,000 women, the researchers found that the addition of radiation therapy to their treatments made little difference in their survival rate. Yet the results of this huge study have made almost no difference in the use of radiation treatment in these situations: most women at the hospital continue to get the radiation. Best Quote in Dr. Chen’s Article:
Our system’s ability to find new treatments has far outpaced its ability to understand the limits of those treatments or to communicate with patients about the best strategies for those treatments. What we need to do is step back and figure out how we can design our health system so that the right patient gets the right care at the right time, rather than all patients getting more care all the time. — Cary P. Gross, M.D., senior author of the study.
- When Less Treatment is More – Dr. Chen’s article
- Assessing the Impact of a Cooperative Group Trial on Breast Cancer Care in the Medicare Population – Abstract for the Yale Med School research
- Few Studies Compare the Efficacy of Medical Treatments – Scientific American, March 2010