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Choosing Wisely UK

Royal College of Pathologists

The optimal hemoglobin threshold for administration of red blood cell transfusions in patients with anemia is unknown. Blood is a scarce resource and in some countries transfusions are less safe than in others due to a lack of testing for viral pathogens. Evidence from a Cochrane systematic review and from a NICE clinical practice guideline suggest that allogeneic RBC transfusions can be avoided in most patients with hemoglobin thresholds above 7 g/dL to 8 g/dL.

Choosing Wisely UK

Royal College of Paediatrics and Child Health

Lactulose and Polyethylene Glycol (PEG) are both commonly used osmotic laxatives that have been shown to be effective and safe treatments for chronic constipation. Evidence from the MEDLINE, EMBASE and CINAHL databases, and the Cochrane Central Register of Controlled Trials for all randomised controlled trials (RCTs) comparing the use of lactulose and polyethylene glycol in the management of faecal impaction and chronic constipation suggests that polyethylene glycol is better than lactulose ...

Choosing Wisely UK

Royal College of Obstetricians & Gynaecologists:

Endometrial hyperplasia can often be treated without surgery. Hysterectomy should not be considered as first-line treatment for hyperplasia without atypia. Progestogen therapy induces histological and symptomatic remission in most women and avoids the morbidity associated with major surgery. The patient should be given information, questions should be answered and her individual circumstances and preferences should be discussed.

Choosing Wisely UK

Royal College of General Practitioners

Polycystic ovaries do not have to be present to make the diagnosis, and the finding of polycystic ovaries does not alone establish the diagnosis. Symptoms and a hormonal profile* will usually be enough to establish a diagnosis. *NICE recommends: Testosterone/SHBG/LH/FSH/Prolactin/TSH

Choosing Wisely UK

Royal College of Obstetricians and Gynaecologists

It is not recommended aspirin as a way of reducing the chances of pregnant women developing blood clots (thromboprophylaxis).