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It is not recommended to perform a laparotomy for the management of non-malignant disease when surgical management is indicated and a vaginal, laparoscopic or robotic-assisted approach is feasible ...
Choosing Wisely®
AAGL – Elevating Gynecologic Surgery
Selection of an endoscopic approach should be tailored to patient selection, surgeon ability, and equipment ability. The surgeon should take into consideration how the procedure may be performed cost-effectively with the fewest complications.
ver más ... 2017It is not recommended magnetic resonance imaging for routine evaluation because it does not add value to the management of the patient in children with a simple febrile seizure,
Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]
Sociedad Catalana de Pediatría
Simple febrile seizures (SFS) represent the majority of febrile seizures. Although they recur in approximately one third of children during early childhood, it is a benign phenomenon associated with a risk of future epilepsy that is only slightly higher than that of the general population. The current recommendations on the management of SFS emphasize the minimum realization of interventions and explorations. Also, there are no recommendations for the management of complex febrile seizures ...
ver más ... 2017It is not recommended to perform exercise stress test as screening of ischemic heart disease in asymptomatic patients at low cardiovascular risk.
Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)
Italian Association of Hospital Cardiologists (ANMCO)
In asymptomatic patients without risk factors, the likelihood of coronary heart disease is very low. The stress test increases risk of false positives and induces further diagnostic tests to rule out the doubts raised by the test.
ver más ... 2017Don’t routinely perform stress cardiac imaging test during the initial evaluation of suspected ischemic heart disease.
Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)
Italian Association of Hospital Cardiologists (ANMCO)
Stress cardiac imaging test should be performed only when relevant risk factors are present: diabetes in patient older than 4 - years-old, peripheral arterial disease, greater than 20% Framingham risk, or in the presence of EKG modification affecting the interpretation of the stress test.
ver más ... 2017It is not recommended to perform 24 hour Holter monitoring in patients with effort chest pain who can perform exercise stress test, unless arrhythmias should be investigated.
Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)
Italian Association of Hospital Cardiologists (ANMCO)
Since during Holter monitoring the amount of stress could not be calibrated, sensitivity and specificity for detecting ischemia in patients with chest pain are low. In these conditions stress test is superior.
ver más ... 2017