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Don’t order ankle and/or foot X-rays in patients who have a negative examination using the Ottawa ankle rules.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Foot and ankle injuries in children and adults are very common presentations to emergency departments. The Ottawa Ankle Rules (OAR) have been validated in both children (greater than 2 years old) and adult populations, and have been shown to reduce the number of X-rays performed without adversely affecting patient care. In alert, cooperative and sensate patients with blunt ankle and/or foot trauma within the previous ten days and who are not distracted by other injuries, only those who fulfill ...
ver más ... 2016Don’t use antibiotics in adults and children with uncomplicated sore throats.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Adults and children frequently present to the emergency department with sore throats (pharyngitis). The vast majority of cases of pharyngitis are caused by self-limiting viral infections that do not respond to antibiotics. The benefit of antibiotics for the approximately 10% of cases in adults (25% in children), caused by bacteria (principally Group A Streptococcus (GAS)) is modest at best, although is associated with fewer complications and a slightly shorter course of illness. There is strong ...
ver más ... 2016Don’t order CT pulmonary angiograms or VQ scans in patients with suspected pulmonary embolism until risk stratification with decision rule has been applied and when indicated, D-dimer biomarker ...
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Many adults present to the emergency department with chest pain and/or shortness of breath. The majority of adult patients with these symptoms do not have a pulmonary embolism (PE) that requires investigation with a CT pulmonary angiogram (CTPA) or ventilation perfusion (VQ) lung scan. CTPAs or VQ scans expose patients to ionizing radiation that has the potential to increase patients’ lifetime risk of cancer. CTPAs also place patients at risk for potential allergic reaction and acute kidney ...
ver más ... 2016The determination of serotonin plasma levels should not be performed since this practice has no value as a diagnostic marker or predictor of therapeutic response.
Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]
Sociedad Catalana de Psiquiatría
Major depressive disorder (MDD) is a disease of complex etiology with a marked personal and socioeconomic burden. Currently the diagnosis and choice of treatment is made only based on the evaluation and clinical examination of the patient. In this context, an important effort has been devoted to the search of biological markers in the diagnosis and prediction of response to antidepressant treatments. Among the different markers, those related to the serotonergic system have been one of the most ...
ver más ... 2016It is not indicated to conduct blood tests routinely every year in the healthy and asymptomatic adult population.
Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]
CAMFIC-Sociedad Catalana de Medicina Familiar y Comunitaria
The conduction of health reviews in the general population is a phenomenon that began decades ago and has continued to grow as a result of a growing demand from patients but also from the health professionals, partly backed by the existence of review and screening programs implemented. Although the components of these reviews are not consensual and may vary, they usually include performing a blood test, usually on an annual basis. The goal of routine health checks and blood tests performed on ...
ver más ... 2016