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Choosing Wisely Canada

Canadian Rheumatology Association

It is not recommended to order labs for drug toxicity monitoring (i.e. CBC, liver enzymes, creatinine) more often than every 12 weeks for patients on a stable dose of non-biologic DMARDsPediatric patients on stable doses of non-biologic disease modifying anti-rheumatic drugs (DMARDs) (e.g. methotrexate, sulfasalazine) without specific risk factors (e.g. obesity, diabetes mellitus, renal disease, alcohol use, concomitant use of hepatotoxic or myelosuppressive medications) are at a low overall ...

NICE

NICE

Peritoneal carcinomatosis is an advanced form of cancer resulting from the regional spread of gastrointestinal, gynaecological and other malignancies. It is associated with short survival and poor quality of life. It may lead to bowel obstruction, ascites and pain. Cytoreduction surgery is done to remove all macroscopic tumours within the abdominal cavity. Hyperthermic intraoperative peritoneal chemotherapy is then used to distribute a chemotherapeutic drug uniformly to all surfaces within ...

NICE

NICE

The evidence on the safety of the free-functioning gracilis transfer to restore upper limb function in brachial plexus injury shows well-recognized complications. Evidence on its efficacy is adequate to support the use of this procedure, provided that standard agreements for clinical management, consent and audit are in place. Find out what standard arrangements mean on the NICE website. The brachial plexus is a network of nerves that carries signals from the spinal cord to the shoulder, arm, ...

NICE

NICE

Evidence on efficacy for tumors 2 cm or larger shows that minimally invasive radical hysterectomy has shorter overall and disease-free survival compared with open hysterectomy surgery. Therefore, this procedure should not be used for tumors that are 2 cm or larger. Evidence on efficacy for tumors smaller than 2 cm is inconclusive for disease-free and overall survival compared to open hysterectomy surgery. Therefore, for tumors smaller than 2 cm, this procedure should only be used in the ...

NICE

NICE

Evidence on the safety of magnetic resonance therapy for knee osteoarthritis shows no major safety concerns. Evidence on efficacy is inadequate in quality and quantity and shows no benefit over placebo. Therefore, this procedure should not be used unless it is part of a research study.