Surgery, The Ultimate Placebo: A surgeon cuts through the evidence

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NewSouth Publishing, Mar 1, 2016 - Medical - 240 pages
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 For many complaints and conditions, the benefits from surgery are lower, and the risks higher, than you or your surgeon think. In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. That these claims come from an experienced, practising orthopaedic surgeon who performs many of these operations himself, makes the unsettling argument particularly compelling.

Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?

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An interesting overview of mostly surgery with a fair bit of placebo effects. The author makes a very good case, through a litany of examples, of surgical techniques that should have been tested first before being widely offered. He either doesn't spend as much time on placebo effects, or I skimmed the section as I have enough background that it was more of a refresher. One area where it fell down, was in pointing out the areas where surgery is evidence-based and valuable, because otherwise the book leaves you with the impression that surgery is completely ineffective and to be avoided in all circumstances, which isn't true - as Harris tells you right at the end. A list and examples of surgical practices that were either tested first, or tested and were successful, would have rounded out the book very nicely. Otherwise, the book trends strongly towards nihilism, which I don't believe was his intent. 

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About the author (2016)

Professor Ian Harris is an orthopaedic surgeon who works at Liverpool, St George, St George Private and Sutherland Hospitals in Sydney. His academic affiliation is with UNSW, South Western Sydney Clinical School at Liverpool Hospital, in Sydney.

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