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Choosing Wisely®

American Podiatric Medical Association

The Ponseti method has become the standard of care worldwide for treatment of pediatric clubfoot deformity. The success rates for clubfoot treatment with the Ponseti method, when properly administered, is 95%. In cases where rigid or neglected deformities are encountered, the Ponseti method can reduce the complexity of the deformity, thereby reducing complexity of surgical intervention and potential complications. Failure to consider Ponseti therapy first, may subject patients to unnecessary ...

Choosing Wisely®

Society of Hospital Medicine

It is recommended to redesign workflow to promote sleep at night. Inadequate sleep in hospitalized patients has been associated with poor outcomes including high blood pressure, hyperglycemia, immune dysfunction, and delirium. Environmental factors (noise, light disruptions), care-related factors (blood draws, vital signs), and patient factors (illness, pain) all contribute to sleep disruption. It is generally recommended that non-pharmacologic interventions be the first line of prevention. ...

Choosing Wisely®

American Academy of Pediatrics

In 2012, hypospadias, congenital chordee, and deficient shaft skin, were listed as contraindications to newborn circumcision. For patients with hypospadias, preservation of the prepuce is important for use in future reconstruction. Additionally, abnormal urethral anatomy may predispose to urethral injury during clamp circumcision. As such, best practice dictates consulting a urologist to help assess these anatomic penile anomalies prior to initiation of circumcision.

Choosing Wisely®

American Medical Society for Sports Medicine

Rotator cuff tears are one of the most common causes of shoulder pain. Determining rotator cuff integrity is pivotal in deciding between surgical and non-surgical management. Given its comparable diagnostic accuracy, low cost and convenience, high-frequency ultrasound may be considered prior to MRI, based on clinical determination via medical history, physical examination and review of relevant imaging, for the evaluation of rotator cuff tears. Furthermore, the cost of MRI and some ...

Choosing Wisely®

Society of Hospital Medicine

Ideal oxygen saturation levels for patients getting supplemental oxygen therapy is at or below 96%. The overuse of supplemental oxygen has been shown to increase mortality in numerous studies of patients with a variety of critical illnesses, including cardiac arrest, stroke, and trauma, as well as following emergency surgery. Higher oxygen levels may be needed for those with certain medical conditions such as carbon monoxide poisoning, special types of headaches like cluster headaches, ...