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Choosing Wisely®

American Academy of Pediatrics Council on Environmental Health

The “chelation challenge” was formerly used to assess whether a child had a significant body burden of lead, or “lead poisoning,” and whether formal chelation would result in significant clearance of lead. Evidence exists that suggests that the chelation challenge has no better prognostic value than the standard blood lead level. Further, there is some evidence that the chelation challenge may in fact be potentially dangerous. In summary, chelation challenge has no clinical utility in ...

Choosing Wisely®

American Academy of Pediatrics Council on Environmental Health

It is virtually impossible for people not to come into contact with hundreds of chemicals each day—whether those chemicals are in our food, air, water, soil, dust, or the products we use. And it is even more difficult for people to know whether those chemicals are harmful to their health or not. Presence does not mean toxicity. The measurement of an environmental chemical in a person’s blood or urine does not by itself mean that the chemical causes disease. Advances in analytical methods ...

Choosing Wisely®

American Occupational Therapy Association

Best practice occupational therapy relies on a practitioner’s understanding of a client’s occupational history and experiences, patterns of daily living, interests, values, and needs, as well as active partnership with the client and care partners (e.g., partners, parents, caregivers) to develop meaningful goals. As stated in the fourth edition of the Occupational Therapy Practice Framework: Domain and Process (OTPF-4), “only clients can identify the occupations that give meaning to their ...

Choosing Wisely®

American Occupational Therapy Association

Occupational therapy practitioners should provide person-centered, strengths-based interventions, and advocate for autistic persons on individual and societal levels by providing information to promote inclusivity and belonging, and to decrease stigma. Actions that are considered “restricted and repetitive behaviors” by the DSM-5 (American Psychiatric Association, 2013) may serve as meaningful activities for self-regulation, communication, or self-expression. Attempting to change or ...

Choosing Wisely Canada

Canadian Nurses Association

While it’s common to insert indwelling urinary catheters for critical care patients, prolonged use can lead to catheter-associated urinary tract infections (CAUTI), urosepsis, increased hospital stays and other complications. Although critical illness can be a legitimate indication for urinary catheter use, daily assessment of urinary catheters is recommended. Some evidence indicates that reminder systems or stop orders in critical care settings can reduce the incidence of CAUTI and catheter ...