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Choosing Wisely ® : Things we do for no reason

Choosing Wisely: Things we do for no reason

Quantitative studies of effectiveness usually involve experiences at single centers and are without adequate control groups. BAs were created as a tool for safety, a mechanism through which clinical teams may anticipate and take action to mitigate risk. However, this type of communication facilitates prejudice towards patients. While intended to alter provider behavior to promote safety indiscriminately in the workplace, there is little evidence that BAs actually reduce incidents of violence. ...

NICE

NICE

If a person develops mania or hypomania and is not taking an antipsychotic or mood stabiliser, offer haloperidol, olanzapine, quetiapine or risperidone, taking into account any advance statements, the person's preference and clinical context If an alternative antipsychotic is not sufficiently effective at the maximum licensed dose, consider adding lithium. the first antipsychotic is poorly tolerated at any dose (including rapid weight gain) or ineffective at the maximum licensed dose, offer an ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Hospital discharge should include effective patient education and care coordination. To optimize patients' understanding of their current medication, don't miss the opportunity to counsel patients on medication adherence. Many studies reveal that patients adhere less frequently to new medications after discharge. Emphasize that inpatient blood pressure may not reflect its baseline value and that overtreatment may be harmful.

NICE

NICE

High risk of breast cancer (not proven but greater than 30% probability of being a TP53 carrier): surveillance recommendations reflect the fact that women who at first evaluation had a 30% probability of being TP53 carriers or older and reach 50 years of age without developing breast cancer or any other type of cancer. TP53-related malignancies will now have a carrier probability of less than 30% and should no longer be offered MRI surveillance. The recommendations in this guide apply to women ...

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 ...