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Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Screening for primary aldosteronism (PA) remains underused in people with resistant hypertension, despite PA being a common and potentially curable cause of secondary hypertension. PA is the most frequent cause of secondary hypertension, with a prevalence estimated at 5–10% in the general hypertensive population, and up to 20% in those with resistant or difficult-to-treat hypertension. The article emphasizes several reasons why PA is often overlooked: the perception that it is rare, the ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Routinely maintaining peripheral intravenous (PIV) catheters in hospitalized patients without an ongoing clinical indication is a widespread but low-value practice. This habit offers minimal benefit and poses unnecessary risks. Patients with idle PIVs are exposed to discomfort, localized infections, and phlebitis, with no clear advantage when IV access is not actively needed. While some clinicians justify keeping PIVs in place for possible emergency access, evidence shows no meaningful delay ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Routine ordering of arterial blood gas (ABG) testing in patients presenting with acute dyspnea is not supported by current evidence. Although ABG has historically been used to assess hypercapnia and acid-base disturbances, this practice often represents low-value care, especially when less invasive and more cost-effective options like venous blood gas (VBG) testing and pulse oximetry are readily available and sufficiently informative. The article reviews multiple studies demonstrating strong ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Potassium supplementation is frequently used in hospitalized patients to prevent potentially life-threatening arrhythmias associated with hypokalemia. However, current evidence suggests that routine administration of potassium to achieve target serum levels within the normal range (typically 4.0 to 4.5 mEq/L) provides no meaningful clinical benefit and may instead introduce unnecessary risks. Hospitalized patients are often prescribed potassium supplements even when serum potassium is within ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Incidental coronary artery calcifications (CAC) are commonly identified on non-cardiac chest CT scans conducted for other indications, such as lung nodule evaluation or infectious/inflammatory diseases. Despite their frequency, these findings are often ignored or omitted from radiology reports, under the assumption that they are incidental and clinically irrelevant. However, evidence suggests that this oversight may result in missed opportunities to identify patients at increased cardiovascular ...