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Don’t use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present.
Choosing Wisely Canada
Canadian Geriatrics Society -Canadian Medical Association - University of Toronto
Cohort studies have found no adverse outcomes for older men or women associated with asymptomatic bacteriuria. Antimicrobial treatment studies for asymptomatic bacteriuria in older adults demonstrate no benefits and show increased adverse antimicrobial effects. Consensus criteria has been developed to characterize the specific clinical symptoms that, when associated with bacteriuria, define urinary tract infection. Screening for and treatment of asymptomatic bacteriuria is recommended before ...
ver más ... 2014Don’t order annual electrocardiograms (ECGs) for low-risk patients without symptoms.
Choosing Wisely Canada
Canadian Cardiovascular Society - Canadian Medical Association - University of Toronto
Don’t obtain screening electrocardiogram testing in individuals who are asymptomatic and at low risk for coronary heart disease. In asymptomatic individuals at low risk for coronary heart disease (10-year risk <10%), screening for coronary heart disease with electrocardiography does not improve patient outcomes.
ver más ... 2014Don’t perform echocardiography as routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms.
Choosing Wisely Canada
Canadian Cardiovascular Society - Canadian Medical Association - University of Toronto
Patients with native valve disease usually have years without symptoms before the onset of deterioration. An echocardiogram is not recommended yearly unless there is a change in clinical status.
ver más ... 2014Don’t perform stress cardiac imaging or advanced non-invasive imaging as a pre-operative assessment in patients scheduled to undergo low-risk non-cardiac surgery.
Choosing Wisely Canada
Canadian Cardiovascular Society - Canadian Medical Association - University of Toronto
Non-invasive testing is not useful for patients undergoing low-risk non-cardiac surgery (e.g., cataract removal). These types of tests do not change the patient’s clinical management or outcomes.
ver más ... 2014Don’t perform annual stress cardiac imaging or advanced non-invasive imaging as part of routine follow-up in asymptomatic patients.
Choosing Wisely Canada
Canadian Cardiovascular Society - Canadian Medical Association - University of Toronto
Performing stress cardiac imaging or advanced non-invasive imaging in patients without symptoms on a serial or scheduled pattern (e.g., every one to two years or at a heart procedure anniversary) rarely results in any meaningful change in patient management. This practice may, in fact, lead to unnecessary invasive procedures and excess radiation exposure without any proven impact on patients’ outcomes. An exception to this rule would be for patients more than five years after a bypass ...
ver más ... 2014