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Choosing Wisely Australia

The Thoracic Society of Australia and New Zealand

There is a lack of direct evidence related to cancer probability in small nodules in low-risk patients. The National Lung Screening Trial, the largest randomised study of lung cancer screening in a high-risk population to date, showed that that CT lung screening reduces lung cancer mortality in high-risk patients when the minimum size of a positive pulmonary nodule is set at 4 mm. As more than half of baseline examinations in the study were positive for nodules 4 to 6 mm in size, raising the ...

Choosing Wisely Australia

The Thoracic Society of Australia and New Zealand

Most patients with COPD present with mild disease and few complaints but tend to live a very sedentary lifestyle. The cornerstone of management of mild COPD is smoking cessation, the only proven intervention to relieve symptoms, modify the natural history of disease and lower mortality rates. For asymptomatic or minimally symptomatic patients, quitting smoking is often the only required therapy. Other effective behavioral interventions include maintaining or increasing physical activity, ...

Choosing Wisely Australia

The Thoracic Society of Australia and New Zealand

Despite their ongoing and frequent use, there is insufficient evidence regarding efficacy of systemic corticosteroids in the treatment of COPD without exacerbations. Well-known side-effects of this drug group are obesity, respiratory and peripheral muscle weakness, hypertension, psychiatric disorders, diabetes mellitus, osteoporosis, skin thinning and bruising. The burden of cardiovascular disease has a significant impact on all-cause mortality in COPD patients. The combination of limited ...

Choosing Wisely Australia

The Thoracic Society of Australia and New Zealand

The sequence for diagnostic testing in patients with suspected pulmonary embolism depends on the clinical circumstances. The certainty of a negative diagnosis for PE via an algorithm including a negative D-dimer result is enhanced when the algorithm follows a multibranch diagnostic pathway. While combining a negative D-dimer result with a low or moderate clinical probability for PE rules out these diagnoses, the use of D-dimer is not helpful in patients with a high probability clinical ...

NICE

NICE

This technique has a limited quantity and quality effectiveness, so it is not recommend except in some specific cases in which these instructions must be followed. Clinicians wishing to do lateral elbow resurfacing for arthritis should: -Inform the clinical governance leads in their healthcare organisation. -Give patients (and their families and carers as appropriate) clear written information to support shared decision making, including NICE's information for the public. -Ensure that ...