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Choosing Wisely Australia

Australasian Faculty of Occupational and Environmental Medicine

Studies demonstrate that prescribing opioids for workers suffering back injuries is correlated with significantly longer periods of disability and a higher risk of surgery. Some of these relationships may be attributable to the higher likelihood of opiate prescription for people with more serious injuries. However, other studies have documented that long-term opioid use for chronic pain is associated with serious risks such as abuse and dependence, overdose, myocardial infarction, and motor ...

Choosing Wisely Australia

Australasian Faculty of Occupational and Environmental Medicine

As little as two per cent of low back pain cases represent potentially serious conditions requiring surgical or medical intervention. The majority of acute low back pain episodes are benign, self-limiting cases that do not warrant any X-ray or imaging studies. Indeed, unnecessary X-rays and imaging can be harmful due to the potential adverse health effects associated with radiation exposure, incidental findings that trigger more imaging to be performed, and description of asymptomatic, ...

Choosing Wisely Australia

Australasian Faculty of Occupational and Environmental Medicine

The purpose of preplacement medical examinations should be to determine an individual’s ability to perform the job. However, such examinations are generally not recommended unless there is a reason for using them to assess some specific occupational risks. Even if a routine preplacement medical examination is justified, low back X-rays and other imaging are not useful preplacement tests to undertake because they have not been found to predict future injuries. These tests also result in ...

Choosing Wisely Australia

Australasian Paediatric Endocrine Group

Aromatase inhibitors are used as adjuvant therapy for breast cancer. There is growing acceptance of their use to increase the adult height of children with short stature and some evidence that aromatase inhibitors can at least improve short-term growth outcomes. One recent clinical trial of aromatase inhibitors used in paediatric patients found them to be safe and effective. Even so, there is still little evidence overall that this treatment improves final adult height or is sufficiently safe. ...

Choosing Wisely Australia

Australasian Paediatric Endocrine Group

While there is some evidence that the use of GnRH agonists can achieve improvements in height in females with early puberty, it is also associated with the development of polycystic ovary syndrome (PCOS) in adolescence and risks compromising bone health. Its use outside of clinical trials is not recommended. Given that the treatment duration must also be lengthy for its benefits to be manifested, its use is not recommended to augment height in adolescents with short stature and normally timed ...