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Choosing Wisely Australia

Medical Oncology Group of Australia

For some patients with advanced cancer, chemotherapy is no longer effective. Symptom relief and palliative care should become the primary modes of care. The Eastern Cooperative Oncology Group (ECOG) performance status is a valid predictor of poor survival, reduced response, and worsened toxicity from chemotherapy. Patients with advanced solid tumours, with an ECOG performance status of 3 or 4, generally exhibit a poor response to chemotherapy. There are well known exceptions to this. These are ...

NICE

NICE

In infants under the age of 4 weeks, it is recommended to measure body temperature with an electronic thermometer in the axilla. In children aged 4 weeks to 5 years, measure body temperature by one of the following methods: electronic thermometer in the axilla, chemical dot thermometer in the axilla or infra-red tympanic thermometer. The aim is to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and ...

Choosing Wisely ® : Things we do for no reason

Berk, J.

For low-risk febrile infants with signs of bronchiolitis, evaluation for bacterial meningitis is not necessary. The low prevalence of meningitis in this age range along with the even lower likelihood of meningitis when bronchiolitis is identified suggests that the procedure is unnecessary. Moreover, the risks associated with LP—including trauma, hospitalization, costs, and family stress—likely outweigh the benefits of cerebrospinal fluid analysis. In febrile infants, determine the risk of ...

Choosing Wisely ® : Things we do for no reason

O Jones

"There are few randomized controlled trials evaluating the efficacy of SCS in preschool-aged children with viral-induced wheezing, and these children are often grouped with younger or older children in studies. While limited in number, these studies have evaluated SCS efficacy with acute wheezing in preschool-aged children in outpatient, ED, and inpatient setting. The majority of trials of SCS in this age group have shown mixed or negative results. For preschool-aged children with a history of ...

Choosing Wisely ® : Things we do for no reason

Society of Hospital Medicine

Echocardiography should be used to exclude other causes of hypotension in patients with presumed PE-related shock and to improve clinicians’ confidence prescribing systemic thrombolytics in the face of hemodynamic instability. Otherwise, echocardiography should be reserved for highly selected intermediate-risk patients with acute PE. Among patients with intermediate-risk PE, those most likely to decompensate or die typically satisfy all of the following conditions: (1) highest-risk PESI or ...