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Don’t provide sensory-based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information.
Choosing Wisely®
The American Occupational Therapy Association, Inc.
Many children and youth are affected by challenges in processing and integrating sensations that negatively affect their ability to participate in meaningful and valued occupations. Processing and integrating sensations are complex and result in individualized patterns of dysfunction that must be addressed in personalized ways. Interventions that do not target the documented patterns of dysfunction can produce ineffective or negative results. Therefore, it is imperative to assess and document ...
ver más ... 2018Don’t provide intervention activities that are non-purposeful (e.g., cones, pegs, shoulder arc, arm bike).
Choosing Wisely®
The American Occupational Therapy Association, Inc.
Purposeful activities—tasks that are part of daily routines and hold meaning, relevance, and perceived utility such as personal care, home management, school, and work—are a core premise of occupational therapy. Research shows that using purposeful activity (occupation) in interventions is an intrinsic motivator for patients. Such activities can increase attention, endurance, motor performance, pain tolerance, and engagement, resulting in better patient outcomes. Purposeful activities build ...
ver más ... 2018Do not repeat colorectal cancer screening (by any method) in average risk individuals for 10 years after a high-quality colonoscopy that does not detect neoplasia.
Choosing Wisely®
American Gastroenterological Association
A screening colonoscopy every 10 years is the recommended interval for adults without increased risk for colorectal cancer, beginning no later than age 50. Published studies indicate the risk of cancer is low for 10 years after a high-quality colonoscopy fails to detect neoplasia in this population. Therefore, following a high-quality colonoscopy that does not detect neoplasia, the next interval for any colorectal screening should be 10 years following that normal colonoscopy.
ver más ... 2018Do not order follow-up X-rays for buckle (or torus) fractures if they are no longer tender or painful.
Choosing Wisely®
American Academy of Pediatrics and the Pediatric Orthopaedic Society of North America
Buckle (torus) fractures are very common injuries in young children, especially in the distal radius. The fracture is one of compression, where the metaphyseal bone impacts on itself, and actually becomes denser. These fractures are inherently stable and do not necessarily require a formal cast, unless severe pain or fracture instability necessitates a cast for 4 weeks. Instead immobilization with a simple wrist brace or removable splint is often preferable. The mild cortical angular deformity ...
ver más ... 2018Do not order advanced imaging studies (MRI or CT) for most musculoskeletal conditions in a child until all appropriate clinical, laboratory and plain radiographic examinations have been completed.
Choosing Wisely®
American Academy of Pediatrics and the Pediatric Orthopaedic Society of North America
History, physical examination, and appropriate radiographs remain the primary diagnostic modalities in pediatric orthopaedics, as they are both diagnostic and prognostic for the great majority of pediatric musculoskeletal conditions. Examples of such conditions would include, but not be limited to, the work up of injury or pain (spine, knees and ankles), possible infection, and deformity. MRI examinations and other advanced imaging studies are costly, frequently require sedation in the young ...
ver más ... 2018