The WHI trial reversing the "standard of care" promoting postmenopausal hormone replacement therapy for cardiovascular disease prevention is one of the easiest to recognize, though data before the WHI trial was congruent -- an EBM approach was different than the popular/accepted approach before the WHI trial was published.
Use of antiarrythmics to treat PVCs after a heart attack (PVCs are associated with increased mortality and specific antiarrythmics flecainide and encainide are effective in reducing PVCs) was a classic example in the need for a clinical outcome focus. This was done as "good patient care" (Do you want to die while waiting for study results?) and a randomized placebo-controlled trial (I think it was called the CAST trial) found the drug reduced PVCs but killed more patients. End of that practice.
Brian S. Alper, MD, MSPH, FAAFP
Founder of DynaMed
Vice President of Innovations and EBM Development
http://www.dynamed.com/
Twitter: @BrianAlperMD
Make INCREMENTAL progress to make great progress ... https://www.linkedin.com/pulse/incremental-brian-alper
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Phyll Buchanan
Sent: Monday, May 23, 2016 12:24 PM
To: [log in to unmask]
Subject: Re: concrete contributions for EBM timeline change medicine
Hi Amy,
These 3 reviews have been the most significant in early postnatal care/ infant feeding.
Timing of the introduction solid food, kangaroo care for low birth weight babies and skin to skin for term infants.
http://www.cochrane.org/CD003517/PREG_optimal-duration-of-exclusive-breastfeeding
http://www.cochrane.org/CD003519/PREG_early-skin-to-skin-contact-for-mothers-and-their-healthy-newborn-infants
http://www.cochrane.org/CD002771/NEONATAL_kangaroo-mother-care-to-reduce-morbidity-and-mortality-in-low-birthweight-infants
Phyll
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