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Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

The quality of specimens received in the laboratory is paramount to obtaining accurate results. Proceeding with testing in the presence of poor sample quality may give misleading results. This contributes to delays and unnecessary repeat examinations. Any level of error should be avoided to decrease negative impact on clinical decisions and patient care. Laboratory professionals should be proactive in ensuring that all types of specimens are collected in a high quality manner with correct ...

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

Phlebotomy is not a risk-free event for the patient or the healthcare worker. While rare, injury from needlestick and/or pathogen exposure can occur. Cumulative blood loss due to multiple phlebotomy episodes can result in iatrogenic anemia, particularly in the elderly, children, or those with medical conditions. This anemia can lead to worsened patient outcomes. Employing mechanisms that limit the amount of blood taken has been shown to lessen the severity of iatrogenic anemia. This can range ...

Choosing Wisely Canada

Association of Medical Microbiology and Infectious Disease

The 2014 recommendations of the International Antiviral Society – US Panel state that measurement of CD4 count is optional among patients with suppressed viral loads for >2 years and CD4 counts >500/µL. CD4 measurement in these patients is of low-value and may create unnecessary patient concern in response to normal variation of CD4 counts. In prospective studies of patients who have responded to antiretroviral therapy with HIV-1 RNA suppression and rises in CD4 cell count >200 cells/μL, ...

Choosing Wisely Canada

Canadian Association of General Surgeons

Opioid use poses considerable health risks to patients including opioid use disorder, overdose, and side-effects such as psychomotor impairment. While opioid analgesia may be appropriate in select circumstances, prolonged use of opioids beyond the immediate postoperative period and for chronic non-cancer pain is not recommended. Instead, clinicians and patients should consider alternative therapies, such as non-opioid pharmacologic therapy or non-pharmacologic therapies. If opioid analgesia is ...

Choosing Wisely Canada

Canadian Association of General Surgeons

CPM for early stage breast cancer lacks evidence for survival benefit in average risk women with unilateral breast cancer. CPM can be associated with chronic pain, poor cosmetic outcome, and doubles the risk of post-operative infection and bleeding. Recommended surgical options for treatment for a unilateral early breast cancer in average risk women include lumpectomy and nodal staging or unilateral mastectomy and nodal staging. CPM is recommended for women with unilateral breast cancer and ...