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Choosing Wisely Australia

The Royal Australian College of General Practitioners List 2

This ‘screening’ recommendation does not apply to people with symptoms suggestive of thyroid disease. The prevalence in adults of subclinical hypothyroidism is about 4.3% (0.7% for subclinical hyperthyroidism), and prevalence is higher in older adults and women. About 2-5 percent of people with subclinical hypothyroidism and 1-2 percent with subclinical hyperthyroidism will develop overt thyroid disease per year. However, many patients with subclinical thyroid dysfunction revert to normal ...

Choosing Wisely Australia

Australasian Society for Infectious Diseases

Multiple serological testing as investigation for a patient with fatigue, is not recommended. If such testing is not clinically indicated there is a risk of false positive results leading to further unnecessary investigations and useless treatments.

Choosing Wisely Australia

Australasian Society for Infectious Diseases

Testing of faeces for microscopy and culture or by PCR methods should not be performed in the absence of diarrhoea or other gastro-intestinal symptoms. Similarly antimicrobial treatment for a gastrointestinal pathogen is not indicated in the absence of symptoms. For immunocompetent non-traveller children with acute gastroenteritis, there are very few circumstances when a stool test for infection would alter clinical management. Possible exceptions include refugee screening and some neurological ...

Choosing Wisely Australia

Australasian Society for Infectious Diseases

Most uncomplicated upper respiratory infections are viral in aetiology and antibiotic therapy is not indicated. Oral antibiotic therapy of presumed URTI in febrile young infants is not only 'low value' but can be actively dangerous, in delaying presentation to hospital (inappropriately reassuring parents and confounding investigations of sepsis). This is a major issue for paediatrics primary care and ED presentations. Patient education is an important component of management together with ...

Choosing Wisely Australia

Australasian Society for Infectious Diseases

Lower leg ulcers, most commonly venous ulcers are often treated with oral antibiotics, even in the absence of evidence of clinical infection. There is no evidence to support this use, except if screening for carriage of multi-resistant organisms. Also a swab for microscopy and culture, in the absence of signs of infection is not recommended. Unnecessary antibiotics and swabbing will add to healthcare costs, antimicrobial resistance and patient allergy.