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Choosing Wisely®

American Academy of Pediatrics

Troponin-I levels are a valuable tool for the assessment of adult patients who present with chest pain. However, these levels are not as useful in the pediatric population. Troponin levels in the great majority of pediatric patients presenting with chest pain are normal. Furthermore, troponin levels have not been shown to reliably correlate with disease severity or prognosis in many cardiac diseases known to cause chest pain in pediatric patients. However, in a few circumstances, such as a ...

Choosing Wisely ® : Things we do for no reason

Crowe B. J Hosp Med. Published Online First September 23, 2020

Advances in our understanding of coagulation in cirrhosis demonstrate neither INR nor platelet count accurately predict bleeding risk in this population. Additionally, evidence demonstrates the overall safety of paracentesis in cirrhosis—even in the presence of high INR and thrombocytopenia—and the lack of benefit from prophylactic transfusions with FFP or platelets. Substantial evidence in patients with cirrhosis demonstrates that changes in coagulation and platelet function confer a ...

Evidencias COVID-19

Evidence Aid

Universal screening, such as asking people about symptoms, taking their temperature or doing a quick saliva test, has been suggested as a way to detect people who are infected with SARS-CoV-2, which is the virus that causes COVID-19. In this Cochrane rapid review, the authors searched for research into the effects of universal screening for SARS-CoV-2 in various community settings. They included 17 cohort studies and 3 modelling studies that reported on screening test accuracy and 2 modelling ...

Too Much Medicine - theBMJ [Demasiada Medicina-TheBMJ]

Mahase E. BMJ

Compared with other members of the population, young adults have a higher chance of asymptomatic infection. Public health experts have therefore called for asymptomatic screening in high risk settings, such as universities. University of Cambridge said that all students living in college accommodation would be eligible to take part in the sreening, which has a capacity of 2000 tests a week and can test around 16 000 students using the pooling method. However, there are downsides to pooling. ...

Too Much Medicine - theBMJ [Demasiada Medicina-TheBMJ]

Torjesen I. BMJ

A systematic review, looked at 287 studies involving more than 280 000 older adults. It found that, while screening tools could adequately detect cognitive impairment, “there is no empirical evidence... that screening for cognitive impairment improves patient or caregiver outcomes or causes harm.”. In terms of treatment,“It remains unclear whether interventions for patients or caregivers provide clinically important benefits for older adults with earlier detected cognitive impairment or ...