Choosing Wisely UK brings together a range of patient and health related organisations from across the country and is hosted at the Academy of Medical Royal Colleges, the coordinating body for the UK and Ireland’s 24 medical royal colleges and faculties. 2011 Mar 14;171(5):438-43. Acute Crit Care. PMID: 28114551. Chest. Cawley P, Deitelzweig S, Flores L, Miller JA, Nelson J, Rissmiller S, Wellikson L, Whitcomb WF. Inpatient pharmacological sleep aid utilization is common at a tertiary medical center. Gupta A, et al.

PMID: 24733711. 2009 Nov;30(21):2631-71. J Am Geriatr Soc. 1994 Aug;42(8):809-15. Gardam MA, et al. J Am Geriatr Soc. Am J Manag Care. Read Dr. Baron and Daniel Wolfson’s letter to the Choosing Wisely Community. Smoller BR, et al. Guidelines support routine assessment of the indications for urinary catheters and minimizing their duration of use.

British Geriatrics Society. The inappropriate treatment of ASB represents a leading misuse of antimicrobial therapeutics. 2006 Aug;126(2):200-6. The AAFP has identified a list of tests and procedures that both doctors and patients should carefully consider and openly discuss before incorporating them into a treatment plan.

Tapaskar N, Kilaru M, Puri TS, Martin SK, Edstrom E, Leung E, Ahmed F, Kondo R, Norenberg A, Poli E, Arora VM. 2013 Jun;34(6):631-3. Routine Postoperative Hemoglobin Assessment Poorly PredictsTransfusion Requirement among Patients Undergoing Minimally Invasive Radical Prostatectomy. Use of urinary catheters without an acceptable indication of use increases the likelihood of infection leading to greater morbidity and health care costs. Lancet. In 2018, recommendations 6-11 were added, following the same process. J Community Hosp Intern Med Perspect. PMID: 17324689.

PMID: 27353273. PMID: 23844751. Each Committee member was invited to anonymously rank all recommendations online. PMID: 21810710. PMID: 21292654. Canadian Thoracic Society 2012 guideline update: Diagnosis and management of asthma in preschoolers, children and adults: Executive summary. Epub 2013 Aug 19. This grassroots movement founded by emergency physicians is the largest coalition of PPE donor projects and seeks to ensure that as many medical professionals as possible have the equipment they need to protect themselves and their patients. (5) Do not perform repetitive complete blood count and chemistry testing in the face of clinical and lab stability. PMID: 17387127. PMID: 7794092. 2008 Mar;140(5):496-504. CMAJ. N Engl J Med. “There are many guidelines, so it’s a matter of simplicity.” 2014 May;35(5):464-79. 2011 Dec 6;9(2):85-93.

Browse downloadable resources that clinicians can place in waiting or exam rooms, or give to patients as handouts to educate them about overuse. The QI Committee vetted each recommendation and conducted a literature review to determine the strength of the supporting evidence. Crit Care Med. 2006 Jan [cited 2015 Apr 9]. Follow #ChoosingWisely on the ABIM Foundation’s Twitter and Facebook pages. 2010 Nov 25;363(22):2124-34. Marik PE, et al. Grossman SA, et al.

Reducing unnecessary inpatient laboratory testing in a teaching hospital.

Nat Rev Urol. Gillis CM, et al.

Thus, inappropriate use of this diagnostic imaging modality carries high costs and subject patients to the risks of radiation exposure. PMID: 7794092. A cost-effective method for reducing the volume of laboratory tests in a university-associated teaching hospital. Potential of missing life-threatening arrhythmias after limiting the use of cardiac telemetry. Delirium is a common problem among hospitalized patients. J Am Coll Cardiol.

American Geriatrics Society 2012 Beers Criteria Update Expert Panel. Yield of diagnostic tests in evaluating syncopal episodes in older patients. PMID: 20175247. PMID: 23248807. In April 2019, the Society for Maternal-Fetal Medicine (SMFM) released its list of “ Fifteen Things Physicians and Patients Should Question” in high-risk obstetrics as part of the Choosing Wisely® campaign, led by the American Board of Internal Medicine (ABIM) Foundation. Arch Intern Med. 2017 Nov 7;136(19):e273-e344. During this time of great stress, Choosing Wisely is providing information from our partner societies about appropriate tests and treatments that are relevant to addressing the impact of the COVID-19 outbreak on the health care system. May TA, et al.

2014 Aug;30(8):837–849. Copyright © 2020 American Academy of Family Physicians.

The use of urinary catheters among hospitalized patients is common. 2005 Jun;20(6):520-4. 2012 Mar;56(3):339-50. Busse JW, et al. Cochrane Database Syst Rev. Emerg Med Australas. Don’t place or leave in place a urinary catheter without reassessment. 2009 Nov;30(21):2631-71. Risk of fractures requiring hospitalization after an initial prescription for zolpidem, alprazolam, lorazepam, or diazepam in older adults. Sandau KE, et al. Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association. In 2016 the Academy asked all royal colleges and faculties to identify five treatments or procedures commonly used in their field, which are of questionable value and therefore the appropriateness of their use should be discussed carefully with patients before being carried out. While it may have been true a generation or so ago, it is no longer always the case that the ‘doctor knows best.’ Medical advances have been so dramatic that there is now an armoury of tests, treatments and procedures available to patients. Log in for the AAFP’s Family Medicine Update Livestream, November 10–14—now offered in flexible half-day sessions. Match season is complex—especially this year. 2012 Apr 18;4:CD002042. The American Academy of Family Physicians (AAFP) is committed to supporting the Choosing Wisely® campaign with the goal of ensuring high-quality, cost-effective care for patients. Lin RJ, et al. Choosing Wisely’s key aim is to change the culture when it comes to prescribing. PMID: 19713422. 2012 Jan 9;172(1):33-8. Repetitive inpatient blood testing occurs frequently and is associated with adverse consequences for the hospitalized patient such as iatrogenic anemia, and pain.

In all other situations, antimicrobial therapy should be targeted to those who have symptoms of urinary tract infections in the presence of bacteriuria. Benarroch-Gampel J, et al. 2018 Feb;33(1):1-6. doi: 10.4266/acc.2018.00052. United States Centers for Disease Control and Prevention (CDC), providing information from our partner societies, "Trust produces good outcomes, which then produce more trust. For example, the prescribing of antibiotics can vary by as much as two and a half times between one part of the country and another.

PMID: 16418451. Mendu ML, et al. Fleisher LA, et al. PMID: 28483845. J Gen Intern Med. Allain H, et al. Intern Emerg Med. Impact of cardiac telemetry on patient safety and cost. The Committee chose to adopt pre-existing recommendations that have already undergone rigorous evidence review from the Five Things Physicians and Patients Should Question (© 2013 American College of Physicians; © 2012 Society of Hospital Medicine; © 2013 Society of General Internal Medicine), the American College of Physicians High Value Cost Conscious Care recommendations, and the “do not do” recommendations from the National Institute for Health and Care Excellence (NICE) in the United Kingdom. By having discussions that are informed by the doctor, but take into account what’s important to the patient too, both sides can be supported to make better decisions about care. Studies support the safe reduction of repetitive laboratory testing without negative effects on adverse events, readmission rates, critical care utilization or mortality. PMID: 19713422. PMID: 22232145. Elimination of preoperative testing in ambulatory surgery. Miller BL, et al. Epub 2013 Oct 29. A CT scan is 200,000 more powerful than an airport scanner; a blood test for one patient may have very few side effects but for an elderly patient it may be distressing and painful. Lin E, et al. Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion.

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