Creating value in health by understanding and overcoming resistance to de-innovation.

Published

Journal Article

As hard as it may be for clinicians to adopt new practices, it is often harder for them to "de-innovate," or give up old practices, even when new evidence reveals that those practices offer little value. In this article we explore recent controversies over screening for breast and prostate cancer and testing for sleep disorders. We show that these controversies are not caused solely by a lack of clinical data on the harms and benefits of these tests but are also influenced by several psychological biases that make it difficult for clinicians to de-innovate. De-innovation could be fostered by making sure that advisory panels and guideline committees include experts who have competing biases; emphasizing evidence over clinical judgment; resisting "indication creep," or the premature extension of innovations into unproven areas; and encouraging clinicians to explicitly consider how their experiences bias their interpretations of clinical evidence.

Full Text

Duke Authors

Cited Authors

  • Ubel, PA; Asch, DA

Published Date

  • February 2015

Published In

Volume / Issue

  • 34 / 2

Start / End Page

  • 239 - 244

PubMed ID

  • 25646103

Pubmed Central ID

  • 25646103

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

International Standard Serial Number (ISSN)

  • 0278-2715

Digital Object Identifier (DOI)

  • 10.1377/hlthaff.2014.0983

Language

  • eng