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Choosing Wisely ® : Things we do for no reason

American Society of Consultant Pharmacists

Co-prescribing of benzodiazepines or gabapentinoids (gabapentin, pregabalin) with opioids is increasingly utilized in the multimodal treatment of acute and chronic pain despite limited evidence to support the effectiveness of this practice. Population studies have demonstrated that these combinations are associated with increased risk of serious adverse outcomes such as excessive sedation, overdose events, and death. In 2019, The FDA required new warnings about the risk of serious breathing ...

Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

Although neuromuscular ustrasound can be used as a reasonable alternative to electrodiagnostic evaluation (nerve conduction studies and electromyography) for the diagnosis of carpal tunnel syndrome in some patients, its ability to determine severity is uncertain. Carpal tunnel syndrome is due to pressure on the median nerve. The carpal tunnel is a narrow passage surrounded by bones and ligaments located in the palm of the hand. When the median nerve is compressed, symptoms can include numbness, ...

Choosing Wisely Australia

Australian and New Zealand Society of Blood Transfusion

Modern on-site laboratories can issue compatible blood within minutes if the patient has a valid group and screen and no clinically significant red cell antibodies. Cross-matching blood unnecessarily increases total inventory levels, increases the average age at which units are transfused, increases blood wastage and creates additional work and costs associated with transfusion. If an on-site laboratory is not available, then cross-matching should be guided by a Maximum Surgical Blood ...

Choosing Wisely®

Society of Hospital Medicine

Patients in intensive care units have historically had daily chest x-rays as part of routine management. Evidence suggests that this does not lead to change in management, unless there are specific clinical indications to obtain a chest x-ray. The use of routine daily chest x-rays leads to unnecessary test utilization, unwarranted exposure to radiation, and downstream testing

NICE

NICE

Clinicians wanting to use intramedullary distraction for upper limb lengthening should: Inform the clinical governance leaders in their healthcare organization, give people (and their families and carers as appropriate) written information to support shared decision-making, including NICE information for the public. They make sure that people understand the safety and efficacy of the procedure, and any uncertainties about it. They must audit and review clinical outcomes of everyone having the ...