Some treatments and procedures become routine despite lacking strong evidence to show that they’re beneficial. Recent studies have called a few into question.
An older patient with dementia is in the hospital and has trouble swallowing. A speech pathologist recommends thickening the liquids the patient drinks with starch or gum and specifies how viscous her tea, water or juice should be. Should it resemble honey? Or apricot nectar?
A doctor writes the order, and the discharged patient returns to her home or nursing facility. She may be drinking thickened liquids from then on.
The rationale is that this sludgy stuff prevents patients from drawing liquids into their lungs and from developing aspiration pneumonia. But does the practice work? Some geriatricians have doubted it for years.
Now, a large-scale study from the Feinstein Institutes for Medical Research in Manhasset, N.Y., has found that liquid thickening doesn’t actually help such patients.
This happens with some frequency: Medical practices so commonplace they rarely raise eyebrows turn out, after further investigation, to have scant basis in fact.
“There are plenty of things we do in medicine that have no evidence,” said Dr. Matthieu Legrand, an anesthesiologist and critical care doctor at the University of California, San Francisco.