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Choosing Wisely Australia

Australian and New Zealand Society of Blood Transfusion

Blood transfusion has become a routine medical response despite cheaper and safer alternatives in some settings. Pre-operative patients with iron deficiency and patients with chronic iron deficiency without hemodynamic instability (even with low haemoglobin levels) should be given oral and/or intravenous iron. Possible exceptions are where reliable ingestion of iron may not occur or gastrointestinal issues exist.

Choosing Wisely Australia

Australian and New Zealand Society of Blood Transfusion

There is no evidence to support the prophylactic administration of fresh frozen plasma to correct a mildly elevated international normalized ratio prior to procedure. The evidence supports the use of Vitamin K and suggests the use of fresh frozen plasma correlated with an increased risk of intra-operative bleeding and/or increased risk of transfusion reactions.

Choosing Wisely®

American Society of Consultant Pharmacists

To identify older adults for whom medications are most likely to benefit (and most likely to harm), a framework that compares an individual’s life expectancy with the time to benefit (TTB) has been proposed. TTB may be defined as the point in time at which patients are expected to derive a benefit from a treatment. TTB is increasingly considered in addition to other measures of medication effectiveness to understand and contextualize the benefits and harms of a therapy for an individual ...

Choosing Wisely Australia

Australian and New Zealand Society of Blood Transfusion

Peri-operative transfusions as a means of addressing untreated preoperative anaemia is associated with decreased overall survival rates but not with recurrence free survival. There is some new evidence that these negative associations are due to the clinical circumstances requiring transfusions rather than the transfusions themselves, but this still suggests that it is preferable to identify and manage anaemia prior to surgery

Choosing Wisely®

Society of Hospital Medicine

Pharmacologic prophylaxis has been shown to reduce the risk of clinically significant VTE. While VTE prevention should be considered for every hospitalized patient, excess VTE prophylaxis – either prophylaxis inappropriately administered to patients at low risk of VTE or to high risk patients with contraindications – can be harmful. National guidelines recommend objective risk stratification for venous thromboembolism (VTE) prevention in hospitalized medical patients.