In 1987 more than 230,000 Americans had coronary bypass operations, twice as many as in 1980, but only few are life-and-death affairs performed on patients who have just had heart attacks. It has been estimated that 44% of bypass operations are inappropriate. Life expectancy is improved only if the left main artery was diseased and if there was damage to the left ventricular muscle. The operation does give significant relief from chest pain, but for that purpose the alternative methods are less costly and sometimes as effective.
Glue ear involves a painless accumulation of mucus-like fluid in the ear and can cause partial deafness. Some 100,000 operations are conducted each year in England and Wales. A controlled trial involving 149 children found that about one-third of the operations were inappropriate, as surgery was effective only for those with a severe form of the disease.