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Choosing Wisely ® : Things we do for no reason

Benjamin Kinnear et al.

Despite constant change in medical education, traditional practices such as “pimping” during teaching rounds have persevered and remain in widespread use. “Pimping” is often described as the practice of asking trainees questions in a manner that establishes and reinforces a dominant intellectual hierarchy and stresses the trainee. Pimping aims to induce shame, humiliation, or distress, and often involves asking difficult questions about recall of facts rather than clinical reasoning. As ...

NICE

NICE

The cost-effectiveness evidence showed that first-line treatment with 360° SLT was more effective and less costly compared with eye drops, with at least 90% probability of being the more cost-effective option. For costs, this result was driven by treatment involving 360° SLT costing less overall compared with eye drops alone. This is because the additional upfront costs of 360° SLT were outweighed by the accumulating costs of eye drops over time. For quality of life, 360° SLT resulted in a ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire

The use of ulipristal 5 mg is authorized for the treatment of uterine fibroids, it has an unfavorable harm-benefit balance because it can cause serious liver damage, sometimes even requiring a liver transplant. When its use seems necessary while waiting for the menopause or when surgery is not an option, there are other less risky options: the insertion of a levonorgestrel intrauterine device as a first option, or the taking of an oral progestogen for a time limited by its uncertain balance of ...

Choosing Wisely ® : Things we do for no reason

Larsen et al.

Postoperative pulmonary complications (PPCs) are one of the leading causes of morbidity and mortality after surgery and have a wide range in reported incidence from 1% to >80%. CPPs include conditions of varying severity, such as atelectasis, pneumonia, pleural effusions, respiratory failure, and acute respiratory distress syndrome. Bartlett introduced the incentive spirometer in the 1970s to reverse or prevent atelectasis by promoting alveolar recruitment through maximal inspiration. Incentive ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire

Fenfluramine is an amphetamine licensed in combination with antiepileptic therapy in Dravet syndrome, a rare and severe form of childhood epilepsy. Fenfluramine increases the incidence of convulsive status epilepticus, despite a decrease in the incidence of seizures overall. The long-term impact on psychomotor development and mortality in children by the end of 2021 is unknown. Fenfluramine can cause heart valve disease and pulmonary arterial hypertension, so its use as an appetite suppressant ...