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Choosing Wisely Canada

Canadian Society of Clinical Chemists

Iron measurement is a poor biomarker for acquired iron deficiency as it is susceptible to preanalytical factors such as diurnal variation, diet, and exercise and ultimately does not represent iron storage. In patients with complicated comorbidities (e.g., infection, autoimmune disease, kidney disease, or cancer), ferritin is an acute phase reactant and may be falsely elevated. In this context, ordering a fasting transferrin saturation is useful to help diagnose iron deficiency along with the ...

Choosing Wisely Canada

Canadian Society of Clinical Chemists

A directed clinical care plan and laboratory information for ordering urine drug testing are needed to support clinical management. Immunoassays are known for their false positives that can mislead patient treatment. Mass spectrometry testing offers the most reliable and complete results. Physicians considering drug testing should consider consulting with the laboratory for advice on choosing the best testing methodology available and help interpreting the results.

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Screen for opioid withdrawal and offer and initiate evidence-based treatment, using shared decision making, regardless of the patient's plan to discontinue opioid use or continue treatment after discharge. More than 50 years of data demonstrate that methadone is safe and effective when appropriately titrated. In one study, methadone dose was only weakly associated with QT prolongation and not with cardiac events.

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Las afecciones en las que la presión arterial desempeña un papel importante, como la exacerbación de la insuficiencia cardíaca congestiva, el accidente cerebrovascular agudo o el síndrome coronario agudo, probablemente se benefician de la intensificación de los antihipertensivos. La evidencia de un estudio de cohorte retrospectivo de pacientes mayores de 65 años hospitalizados por diagnósticos no cardíacos en el sistema de administración de salud para veteranos.

NICE

NICE

Before offering iodine-based contrast media to adults, it is recommended to evaluate their risk of acute kidney injury, but without delaying emergency imaging. An increased risk is associated with chronic kidney disease (adults with an eGFR less than 40 ml/min/1.73 m2 are at particular risk), diabetes, but only with chronic kidney disease, heart failure, kidney transplant, over 75 years, hypovolemia, increased volume of contrast agent, intra-arterial administration of contrast medium with ...