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Choosing Wisely Canada

Public Health Physicians of Canada

Antibiotic prophylaxis for iGAS is currently offered routinely for household and other close contacts of those infected with severe iGAS. However, it may not be necessary for all such contacts. Individuals in which prophylaxis should be considered are those who are immunocompromised or may be more susceptible to infection, particularly neonates. Prevention and monitoring measures should be discussed with all household and close contacts of confirmed iGAS cases.

Choosing Wisely Canada

Public Health Physicians of Canada

Pre-placement screening tuberculin skin tests (TSTs) should not be a universal requirement of employees and volunteers in settings where healthcare services are not delivered. Workplace tuberculosis screening policies should only be implemented based on the findings of an organization-specific tuberculosis risk assessment. If implemented, workplace tuberculosis screening should avoid universal TST/IGRA (interferon-γ release assays) testing by screening for individual tuberculosis risk factors ...

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

Standing orders without an expiry or review date allow testing to be performed repetitively for extended periods of time. This type of testing is rarely clinically necessary without regularly reviewing the validity of the order. This contributes to overutilization of laboratory tests, and may exacerbate the development of iatrogenic anemia.

Choosing Wisely Canada

Public Health Physicians of Canada

Understanding a patient’s perspective with a thorough social history will provide valuable information about their determinants of health, which is critical for nuanced diagnoses and a better adapted management plan. As barriers are identified and addressed management plans can be re-evaluated in collaboration with the patient.

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

Over-testing is a recognized problem, and evidence supports multi-faceted interventions that capitalize on advances in computer-based ordering technology. Bundling of tests may provide results that are not necessary for the ordering professional and may lead to duplication of testing or unnecessary follow-up. Order sets should be regularly reviewed. Research supports increased collaboration of all healthcare providers, including laboratory personnel, in combating over-testing. Laboratory ...