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Choosing Wisely®

American Academy of Pediatrics – Section on Dermatology

Alopecia areata is a hair loss disorder believed to have an autoimmune origin. It is well-established that patients with alopecia areata have an increased risk of other autoimmune conditions, with thyroid disease being the most common. As in the case of vitiligo, it is more common to find thyroid autoantibodies or subclinical hypothyroidism than overt thyroid disease, unless there are clinically suspicious findings. Patients identified as having subclinical hypothyroidism are not currently ...

Choosing Wisely®

American Academy of Pediatrics – Section on Neurological Surgery

Most infants with macrocephaly do not have abnormalities that require neuroimaging or neurosurgical evaluation. Imaging should generally be reserved for infants with clinical concerns such as abnormal neurological examination findings, significant developmental delay, or rapidly increasing head circumference measurements (such as those crossing growth curves). When imaging is indicated, head ultrasonography should typically be considered as the first-line test for infants with an open ...

Choosing Wisely®

Society of Critical Care Medicine

Patients in intensive care units typically require insertion of catheters and drains for fluid and medication delivery, pressure and flow monitoring, and fluid and gas evacuation. The majority of hospital-acquired infections and unintended safety events are associated with such devices. Daily assessment of need for invasive devices should be an essential element of critical care workflow, to reduce time of exposure by identifying the earliest opportunity for their discontinuation

Choosing Wisely Australia

Australasian Chapter of Sexual Health Medicine

Hypogonadism justifying testosterone therapy regardless of age is confirmed based on measurement of circulating testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) concentrations. There is limited high-quality evidence to justify testosterone treatment in older men, usually with chronic disease, who have low circulating testosterone levels but without confirmed pathological hypogonadism, whether due to hypothalamic, pituitary or testicular disease. Moreover, excess ...

Choosing Wisely®

American Society of Consultant Pharmacists

The risk of adverse drug reactions (ADR) and hospital admissions related to ADRs increases with age, polypharmacy and comorbidities. It is prudent for clinicians to be aware of the prescribing cascade to reduce the prescription of potentially unnecessary medications that may cause patient harm. Prescribing cascades are a type of problematic polypharmacy that occur when an adverse drug event (ADE) is misinterpreted as a new medical condition, and a second medication is prescribed to address this ...