Newswise — Dr. Adam Cifu studies medical reversals -- when accepted medical interventions and dogma are abandoned because they are found to be ineffective. He and co-authors of a book, "Ending Medical Reversal," say this is one of the most important issues in medicine today.

With the American Cancer Society's shift in its mammogram guidelines, Dr. Cifu would lend a critical perspective to the conversation about frequency and at what age women should have mammograms.

Medical reversal occurs when interventions, such as medications, procedures or diagnostic tests, are adopted without a robust evidence base. Reversal is distinct from replacement, when a good therapy is replaced by a better one.

Reversals are distressingly common. In previously published research, Cifu and Vinayak K. Prasad of the National Cancer Institute combed through the most prestigious American medical publication, the New England Journal of Medicine. They found that from 2001 through 2010, 40 percent of the articles about a new or recently adopted medical practice described a "clear-cut reversal." Only 38 percent of the articles affirmed the benefit of a new practice.

"It is not because a drug or procedure worked and then stopped working or because someone discovered a harm that no one else had noticed," Cifu said. "It's because the practice never worked. We were wrong all along."

Sometimes -- when faced with limited evidence and a genuine need for better therapies -- doctors are tempted to adopt a promising procedure or prescribe a new drug before they have robust clinical data. "This is one reason," the authors wrote, "why health care costs are soaring without improving people's health."