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Choose wisely

Adam Fleischer
No abstract text is available yet for this article.
January 2018: Journal of the American Podiatric Medical Association
Marc-Etienne Parent, François Vézina, Nathalie Carrier, Ariel Masetto
OBJECTIVE: To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. DESIGN: We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. SETTING: Centre hospitalier universitaire de Sherbrooke in Quebec. PARTICIPANTS: Patients 50 years of age and older who underwent a knee MRI in 2009...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Dr Rebecca Powell
No abstract text is available yet for this article.
March 2018: Canadian Family Physician Médecin de Famille Canadien
Paul Atkinson, Eddy Lang, Meaghan Mackenzie, Rashi Hirandani, Rebecca Lys, Megan Laupacis, Heather Murray
No abstract text is available yet for this article.
March 2018: CJEM
Kelsey Chalmers, Tim Badgery-Parker, Sallie-Anne Pearson, Jonathan Brett, Ian A Scott, Adam G Elshaug
OBJECTIVE: Low-value health care refers to interventions where the risk of harm or costs exceeds the likely benefit for a patient. We aimed to develop indicators of low-value care, based on selected Choosing Wisely (CW) recommendations, applicable to routinely collected, hospital claims data. RESULTS: We assessed 824 recommendations from the United States, Canada, Australia and the United Kingdom CW lists regarding their capacity to be measured in administrative hospital admissions datasets...
March 5, 2018: BMC Research Notes
Luis C L Correia, Guilherme B Barcellos, Vitor Calixto, André Volschan, José A S Barreto-Filho, Renato D Lopes, Anis Rassi, Wendy Levinson, Angelo A V de Paola
Objective: (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Design: Cross-sectional study. Setting: Brazilian Society of Cardiology. Participants: Cardiologists who agree to fill a web questionary. Intervention: A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation...
March 1, 2018: International Journal for Quality in Health Care
Ana D Mandić, Michael Blaut
In a recent article in Cell Reports, Dalby and colleagues convincingly demonstrate that choosing an inadequate control diet in animal experiments that investigate the interaction of nutrition, gut microbiota, and obesity development may lead to the wrong conclusions. The authors systematically compared the effects of refined high- and low-fat diets (rHFD and rLFD) with those of a standard chow diet on mouse physiology, microbiota composition, cecal fermentation, and intestinal morphology. The results obtained in this study question the conclusions drawn from animal studies that compared the effects of HFDs with those of chow diets...
March 1, 2018: Trends in Endocrinology and Metabolism: TEM
Jason Chui, Rasha Saeed, Luke Jakobowski, Wanyu Wang, Basem Eldeyasty, Angel Zhu, LeeAnne Fochesato, Ronit Lavi, Daniel Bainbridge
BACKGROUND: A routine chest X-ray (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. We sought to assess the value of a routine post-procedural CXR in the era of ultrasound-guided CVC insertion. METHODS: We performed a population-based retrospective cohort study to review the records of all adult patients who had a CVC inserted in the operating room in a tertiary institution between July 1, 2008 and December 31, 2015. We determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion...
February 28, 2018: Chest
Deborah Kim, Kyung Min Lee, Marc R Freiman, W Ryan Powell, Elizabeth S Klings, Seppo Rinne, Donald Miller, Adam J Rose, Renda Soylemez Wiener
RATIONALE: Care of patients with pulmonary hypertension (PH) is complex. While pulmonary vasodilators are effective for Group 1 PH, clinical guidelines and the Choosing Wisely Campaign recommend against routine use for Groups 2 and 3 PH (the most common types of PH) due to a lack of benefit, potential for harm, and high cost ($10,000-$13,000 per patient per year treated). Little is known about how these medications are used in practice. OBJECTIVE(S): To determine national patterns of phosphodiesterase-5-inhibitor (PDE5i) prescribing for PH in the Veterans Health Administration (VA)...
February 27, 2018: Annals of the American Thoracic Society
Jeremy N Friedman, Sanjay Mahant
The Choosing Wisely campaign has stimulated many clinicians to think about the appropriateness of various tests and treatments. Most of the recommendations published thus far are adult-focused. In this commentary, we discuss the development and early implementation of a Choosing Wisely 'top 5' list specifically aimed at children being cared for at our tertiary care children's hospital. We hope that this will encourage others involved in the health care of infants and children to engage in further thought and discussion about the appropriateness of current tests and therapies...
May 2017: Paediatrics & Child Health
Russell Cohen Hoffing, Povilas Karvelis, Samuel Rupprechter, Peggy Seriès, Aaron R Seitz
Task-switching is an important cognitive skill that facilitates our ability to choose appropriate behavior in a varied and changing environment. Task-switching training studies have sought to improve this ability by practicing switching between multiple tasks. However, an efficacious training paradigm has been difficult to develop in part due to findings that small differences in task parameters influence switching behavior in a non-trivial manner. Here, for the first time we employ the Drift Diffusion Model (DDM) to understand the influence of feedback on task-switching and investigate how drift diffusion parameters change over the course of task switch training...
2018: Frontiers in Integrative Neuroscience
Joshua R Niska, Sameer R Keole, Barbara A Pockaj, Michele Y Halyard, Samir H Patel, Donald W Northfelt, Richard J Gray, Nabil Wasif, Carlos E Vargas, William W Wong
Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT...
2018: Breast Cancer: Targets and Therapy
Robyn Ann Lindner
No abstract text is available yet for this article.
February 19, 2018: Medical Journal of Australia
Elizabeth Waibel, Edna Garcia, Melissa Kelly, Ryan Soles, Lee Hilborne
Objectives: To determine non-American Society for Clinical Pathology pathology- and laboratory-related Choosing Wisely recommendations that drive effective test utilization in the laboratory. Methods: Data were collected via a two-part web-based survey distributed to a broad sample of pathologists and laboratory professionals from a variety of institutions. Results: Pathologists' most relevant recommendation: "Do not transfuse more units of blood than absolutely necessary"; highest priority: "Do not transfuse more than the minimum number of RBC units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7-8 g/dL in stable, noncardiac inpatients)...
February 7, 2018: American Journal of Clinical Pathology
Peter Goldbach
No abstract text is available yet for this article.
February 2018: Health Affairs
Sita Bhella, Navneet S Majhail, Jeffrey Betcher, Luciano J Costa, Andrew Daly, Christopher E Dandoy, Zachariah DeFilipp, Vi Doan, Alison Gulbis, Lisa Hicks, Mark Juckett, Nandita Khera, Amrita Krishnan, George Selby, Nirav N Shah, Melisa Stricherz, Auro Viswabandya, Christopher Bredeson, Matthew D Seftel
Choosing Wisely encourages dialogue about reducing unnecessary procedures, tests, or treatments in healthcare. The American Society for Blood and Marrow Transplantation (ASBMT) and Canadian Blood and Marrow Transplant Group (CBMTG) established a Choosing Wisely BMT Task Force whose objective was to create a list of top five practices in blood and marrow transplantation to be questioned. The Task Force consisted of representatives from ASBMT's Quality Outcomes, Education, and Practice Guidelines Committees, ASBMT's Pharmacy Special Interest Group, CBMTG Program Directors, and Center for International Blood and Marrow Transplant Research (CIBMTR)...
January 19, 2018: Biology of Blood and Marrow Transplantation
Christopher J Symonds, Wenxin Chen, Marianne Sarah Rose, Lara J Cooke
OBJECTIVE: To describe the prevalence and geographic distribution of cervical cancer screening, as well as the age groups of those undergoing screening, in Alberta, and to determine if screening practices conform to current guidelines and follow Choosing Wisely Canada recommendations. DESIGN: Descriptive study using data from the Alberta Ministry of Health Analytics and Performance Reporting Branch. SETTING: Alberta. PARTICIPANTS: Women who had 1 or more Papanicolaou tests between 2011 and 2013...
January 2018: Canadian Family Physician Médecin de Famille Canadien
Kevin Wasko
No abstract text is available yet for this article.
January 2018: Canadian Family Physician Médecin de Famille Canadien
Thomas Isaac, Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen, Elizabeth A Kinsella, Thomas D Sequist
OBJECTIVES: To measure overuse of low-value care using electronic health record (EHR) data and manual chart review and to evaluate whether certain low-value services are better captured using EHR data. STUDY DESIGN: We implemented algorithms to extract performance on 13 Choosing Wisely-identified healthcare services using EHR data at a large physician practice group between 2011 and 2013. METHODS: We calculated rates of overuse using automated EHR extracts...
January 2018: American Journal of Managed Care
Fahimeh Khakzad, Ali Reza Mahdavian, Hamid Salehi-Mobarakeh, Mohammad Hossain Sharifian
HYPOTHESIS: Surfactant-free emulsion polymerization has become favorable due to circumventing instability issues reasonably. Incorporation of an appropriate hydrophilic macroRAFT, could provide controlled in-situ self-assembly via copolymerization with hydrophobic monomers into polymer particles. So far, this approach has mostly been studied in dispersion systems and further studies are needed in emulsions. Beside the corresponding mechanistic studies, the prepared latex particles would potentially exhibit smart behaviors by choosing stimuli-responsive monomers...
January 4, 2018: Journal of Colloid and Interface Science
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