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It is not recommended ordering segmental pressures of the lower extremities without toe pressures in patients with diabetes and foot ulceration.
Choosing Wisely®
American Podiatric Medical Association
Systolic ankle pressures can lack predictive validity for wound healing due to calcification of the ankle arteries. This is especially true of patients with diabetes and advanced complications where vessel calcifications are observed in 53–66% of patients. Compared to ankle pressures, toe pressures appear to be more predictive of distal arterial perfusion and wound healing potential in patients with diabetes. If toe pressures are requested at the time of the initial order, repeat studies ...
ver más ... 2022It is not recommended to use tests of ovarian reserve (oocyte quantity measures such as AMH or FSH levels) to judge a woman’s reproductive potential (whether someone is likely or unlikely to become ...
Choosing Wisely®
American Society for Reproductive Medicine
Markers of ovarian reserve, such as early follicular phase FSH or antimüllerian hormone (AMH) levels, have been shown to be poor independent predictors of reproductive potential. Therefore, they should not be used as a “fertility test” for women who are not infertile or who have untested fertility.
ver más ... 2022It is recommended to routinely assess activity levels and recommend appropriate physical activity to your patients.
Choosing Wisely®
American Medical Society for Sports Medicine
Studies have shown a decrease in all-cause mortality associated with increasing levels of energy expenditure. It has also been shown to decrease risk of coronary artery disease, diabetes, hypertension, many types of cancers, and a host of other medical conditions with strong, consistent epidemiologic evidence and moderately strong supporting evidence from clinical trials. Benefits on bone health and mental health have also been demonstrated. Practitioners should routinely assess physical ...
ver más ... 2022Imaging tests are not recommended in adults over 50 years of age with chronic non-traumatic knee pain and typical symptoms of osteoarthritis.
Iniciativa MAPAC (Mejorar la Adecuación de la Práctica Asistencial y Clínica)
Servicio Navarro de Salud - Osasunbidea
It is considered that the initial diagnosis in patients over 50 years of age who present chronic knee pain of non-traumatic cause and typical symptoms of osteoarthritis should be established routinely through review of the medical history and physical examination. In those specific cases in which it is considered necessary to have an imaging test for the initial diagnosis, simple radiography is the test of choice, and routine magnetic resonance imaging is not justified in this situation. ...
ver más ... 2022The recommendations and proposals only refer to adult patients (≥18 years) who are going to undergo a radiological test prior to which the administration of iodinated contrast is required by ...
Iniciativa MAPAC (Mejorar la Adecuación de la Práctica Asistencial y Clínica)
Servicio Navarro de Salud - Osasunbidea
Antithrombotic prophylaxis after hip/knee arthroplasty: All three types of drugs [direct-acting oral anticoagulants (DOACs), heparins and ASA] are considered valid alternatives. In the case of using anticoagulants, issues such as the cost of treatment, the need for interconsultation and the associated cost, differences in the method of administration, the possibility of requiring urgent reoperation, prior anticoagulation should be considered when choosing the drug. , drug interactions or ...
ver más ... 2022