Technology follies: the uncritical acceptance of medical innovation

Article Abstract:

The medical community should demand the same proof of usefulness and safety of new tests and surgical procedures that is required of new medicines. Although criteria exist for evaluating new technologies, medical innovations tend to be adopted and disseminated after little assessment. A number of widely used diagnostic tests, treatments and operations have quickly gained acceptance in the US. When finally subjected to rigorous testing, they often have proved useless or even harmful. These include such procedures as electronic fetal monitoring during labor, episiotomy during vaginal delivery, and colectomy for epilepsy. New technologies are often inadequately assessed because of a false worship of technology, the tendency to evaluate something on the basis of associated prestige rather than the weight of scientific evidence, and the tendency to accept things because that is the way they have always been done. As the first step toward raising the standards of technological assessment, manufacturers should devote more money to the study of new products and less to sales and marketing.

Evaluation, Column, Public opinion, Medical innovations, Medical technology

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A 17-year-old mother seeking contraception

Article Abstract:

Effective information about contraceptives and social programs could reduce the rate of teenage pregnancies in the US. Eighty-five percent of teen pregnancies are unplanned and the increase in teen pregnancies parallels the increase in sexual activity among teens. Family planning clinics are the best places to get contraceptives, since many physicians will not prescribe them without parental consent. Teens who have an adverse reaction to birth control pills can try Norplant injections. They should also be encouraged to use condoms to reduce their risk of sexually transmitted diseases.

Sexual behavior, Prevention, Teenage girls, Teenage pregnancy, Contraception

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Clinical Breast and Pelvic Examination Requirements for Hormonal Contraception: Current Practice vs Evidence

Article Abstract:

It is probably unnecessary to give women who seek hormonal contraception a breast exam and pelvic exam. Counseling and education about sexually transmitted diseases can still be provided in the absence of a physical exam.

Women, Medical examination, Contraceptives

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