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Avoid using robotic assisted laparoscopic surgery for benign gynecologic disease when it is feasible to use a conventional laparoscopic or vaginal approach.
Choosing Wisely®
American College of Obstetricians and Gynecologists
Robotic-assisted and conventional laparoscopic techniques are comparable with respect to perioperative outcomes, intraoperative complications, length of hospital stay and rate of conversion to open surgery. However, evidence shows that robotic-assisted laparoscopic surgery has similar or longer operating times and higher associated costs. Therefore, the limited available data does not show any benefits of robotic surgery for patients with benign gynecologic disease.
ver más ... 2016Offering life support to patients at high risk of death or severely impaired functional recovery is not recommended.
Choosing Wisely UK
Faculty of intensive care medicine
Life support for patients at high risk of death or severely impaired functional recovery should not be offered. A discussion with patients and their families should focus on the goals of comfort care. Life support for patients at high risk of death or severely impaired functional recovery should not be offered. A discussion with patients and their families should focus on the goals of comfort care.
ver más ... 2015Ultrasonography (transabdominal and transvaginal) is recommended as the main imaging test in the evaluation of ovarian masses in the female population.
Choosing Wisely UK
Royal College of Obstetricians and Gynaecologists
Ovarian masses are very common in pre- and postmenopausal women and are typically an incidental finding. Although ultrasonography is the best mode of imaging we have for assessment of ovarian pathology, its sensitivity and specificity for the diagnosis of ovarian cancer is only 86–91% and 68–81% respectively.
ver más ... 2015The current test for dementia, which is a form of questionnaire, is not recommended as it does not accurately identify people who have dementia and those who do not.
Choosing Wisely UK
Royal College of General Practitioners
It is not recomended. The Committee concluded that the current test for dementia, which is a form of questionnaire, does not accurately identify those people who have dementia and those who do not. To recommend screening, the Committee would need to be confident that by acting early, treatments would slow or even prevent this serious disease. At the moment these treatments do not exist.
ver más ... 2015It is recommended that day surgery be considered as the default option for many elective surgical procedures. Variation in the use of day surgery for these operations should be measured and this ...
Choosing Wisely UK
Royal College of Anaesthetists & Royal College of Surgeons England
The increase in the proportion of operations performed as day cases in recent decades has been good for patients and has meant a much more efficient use of NHS resources and the ability to treat large numbers of additional patients. The recommendations are based on the opinion of an economic expert in an article on the internet.
ver más ... 2015