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Choosing Wisely Australia

Paediatrics & Child Health Division

There is extensive evidence that the majority of X-rays ordered for children admitted for asthma and wheezing disorders do not provide clinically relevant information and therefore do not contribute to their diagnosis and management. Clear clinical criteria outlining the indications for X-rays in asthma should be defined to avoid unwarranted chest X-rays in children with acute wheeze.

Choosing Wisely Australia

Paediatrics & Child Health Division

Chest X-rays Chest X-rays for patients with acute lower respiratory tract infections rarely affect clinical treatments and outcomes. Chest X-ray films do not discriminate well between bronchiolitis and other forms of lower respiratory tract infection and in mild cases do not offer information that is likely to affect treatment. It is estimated that 133 children with typical bronchiolitis would have to undergo radiography to identify one radiograph that is suggestive of an alternate diagnosis. ...

Choosing Wisely Australia

Paediatrics & Child Health Division

The vast majority of children presenting with fever do not have a bacterial infection and therefore will not benefit from being prescribed oral antibiotics. For instance, one study of febrile infants found overall bacteraemia frequency of well below one per cent. Sometimes, in exception to this, oral antibiotics are prescribed to treat an unapparent bacterial infection or prevent development of severe bacterial infection and appear to have beneficial effects, though even the significance of ...

Choosing Wisely Australia

Royal Australasian College of Surgeons

Examination of the larynx with mirror or fibre optic scope is the primary method for evaluating patients with hoarseness. Imaging is unnecessary in most patients and is both costly and has potential for radiation exposure. After laryngoscopy, evidence supports the use of imaging to further evaluate 1) vocal fold paralysis, or 2) a mass or lesion of the larynx. It is essential to have the larynx examined by a specialist if the hoarseness has not resolved within 4 weeks.

Choosing Wisely Australia

Royal Australasian College of Surgeons

Imaging of the paranasal sinuses, including plain film radiography, computed tomography (CT) and magnetic resonance imaging (MRI) is unnecessary in patients who meet the clinical diagnostic criteria for uncomplicated acute rhinosinusitis. Acute rhinosinusitis is defined as up to four weeks of purulent nasal drainage (anterior, posterior or both) accompanied by nasal obstruction, facial pain-pressure-fullness or both. Imaging is costly and exposes patients to radiation. Imaging may be ...