Evidence map›Paper›PMID 28077234›Full record

ReviewLancet (London, England)2017

Evidence for overuse of medical services around the world.

Shannon Brownlee, Kalipso Chalkidou, Jenny Doust, Adam G Elshaug, Paul Glasziou, Iona Heath, Somil Nagpal, Vikas Saini, Divya Srivastava, Kelsey Chalmers and 1 more

Erratum issued 2 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Lancet (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 434 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
434citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03482232 completednot on this mapstarted 2018, after this paper: background citation

Consequences of Doing What Should Not be Done in Primary Care

TypeobservationalSponsorUniversidad Miguel Hernandez de ElcheRan2018 to 2020Enrolled750,000ConditionsOverdose, Adverse EventArmsBenzodiazepines, Non-steroidal anti-inflammatory drugs, paracetamol, Antimicrobial agent, Lipid-lowering drug
NCT05975671 narecruitingnot on this mapstarted 2023, after this paper: background citation

Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)

TypeinterventionalSponsorChildren's Hospital of PhiladelphiaRan2023 to 2026Enrolled52,500ConditionsSepsis, Sepsis Mrsa, Sepsis Bacteremia, Antimicrobial - Induced NephropathyArmsMultifaceted de-implementation strategy to reduce vancomycin overuse
3 · Its place in the literature

Who cites it

434 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
  4. Pooled it
  5. Trial
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  9. Acetylcholine and noradrenaline enhance foraging optimality in humans.Proceedings of the National Academy of Sciences of the United States of America · 2023
    Trial
  10. Trial
  11. Article
  12. Observational
  13. Global under- and overprescribing of drugs-a scoping review.Naunyn-Schmiedeberg's archives of pharmacology · 2026
    Review
  14. Review
  15. Article
  16. Article
  17. Article
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374 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Shannon BrownleeLown Institute, Brookline, MA, USA; Department of Health Policy, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA. Electronic address: sbrownlee@lownistitute.org.
Kalipso ChalkidouInstitute for Global Health Innovation, Imperial College, London, UK.
Jenny DoustCenter for Research in Evidence-Based Practice, Bond University, Gold Coast, QLD, Australia.
Adam G ElshaugLown Institute, Brookline, MA, USA; Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Paul GlasziouCenter for Research in Evidence-Based Practice, Bond University, Gold Coast, QLD, Australia.
Iona HeathRoyal College of General Practitioners, London, UK.
Somil NagpalThe World Bank, Phnom Penh, Cambodia.
Vikas SainiLown Institute, Brookline, MA, USA.
Divya SrivastavaLSE Health, London School of Economics and Political Science, London, UK.
Kelsey ChalmersMenzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Deborah KorensteinMemorial Sloan Kettering Cancer Center, New York, NY, USA.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a pervasive problem. Direct measurement of overuse through documentation of delivery of inappropriate services is challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse can also be measured indirectly through examination of unwarranted geographical variations in prevalence of procedures and care intensity. Despite the challenges, the high prevalence of overuse is well documented in high-income countries across a wide range of services and is increasingly recognised in low-income countries. Overuse of unneeded services can harm patients physically and psychologically, and can harm health systems by wasting resources and deflecting investments in both public health and social spending, which is known to contribute to health. Although harms from overuse have not been well quantified and trends have not been well described, overuse is likely to be increasing worldwide.

Indexed as

Diagnostic Tests, RoutineDrug UtilizationEvidence-Based MedicineGlobal HealthHealth Services MisuseHealth Services ResearchHumansMass ScreeningTerminology as Topic

Identifiers

PMID28077234
PMCPMC5708862

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.