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Choosing Wisely: More Good Clinical Recommendations - American Family Physician

Choosing Wisely: More Good Clinical Recommendations to Improve Health Care Quality and Reduce Harm

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/search.htm

Choosing Wisely: Don’t use antibiotic therapy for stasis dermatitis of lower ...

Don’t use antibiotic therapy for stasis dermatitis of lower extremities.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=255

Choosing Wisely: Don’t perform chest CT (CT angiography) to evaluate for possible ...

Don’t perform chest CT (CT angiography) to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=155

Choosing Wisely: Don’t routinely recommend follow-up mammograms more often than ...

Don’t routinely recommend follow-up mammograms more often than annually for women who have had radiotherapy following breast conserving surgery.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=213

Choosing Wisely: Don’t order HFE genetic testing for a patient without iron overload or...

Don’t order HFE genetic testing for a patient without iron overload or a family history of HFE-associated hereditary hemochromatosis.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=284

Choosing Wisely: Don’t transfuse more than the minimum of red blood cell units ...

Don’t transfuse more than the minimum of red blood cell units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable patients).

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=372

Choosing Wisely: Don’t prescribe antipsychotic medications to patients for any ...

Don’t prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=110

Choosing Wisely: Don’t perform voiding cystourethrogram routinely in first febrile ...

Don’t perform voiding cystourethrogram routinely in first febrile urinary tract infection (UTI) in children aged two to 24 months.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=117

Choosing Wisely: Don’t recommend imaging of the spine within the first six weeks of an ...

Don’t recommend imaging of the spine within the first six weeks of an acute episode of low back pain in the absence of red flags.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=127

Choosing Wisely: Don’t perform CT surveillance for evaluation of indeterminate ...

Don’t perform CT surveillance for evaluation of indeterminate pulmonary nodules at more frequent intervals or for a longer period of time than recommended by established guidelines.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=153

Choosing Wisely: Avoid CT pulmonary angiography in emergency department patients with a...

Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria or a negative D-dimer.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=223

Choosing Wisely: Avoid lumbar spine imaging in the emergency department for adults with...

Avoid lumbar spine imaging in the emergency department for adults with non-traumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition (such as vertebral infection, cauda equina syndrome, or cancer with ...

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=224

Choosing Wisely: Avoid prescribing antibiotics in the emergency department for ...

Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=225

Choosing Wisely: Don’t treat with an anticoagulant for more than three months in a ...

Don’t treat with an anticoagulant for more than three months in a patient with a first VTE occurring in the setting of a major transient risk factor.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=227

Choosing Wisely: Don’t order imaging studies in patients with non-pulsatile bilateral ...

Don’t order imaging studies in patients with non-pulsatile bilateral tinnitus, symmetric hearing loss, and an otherwise normal history and physical examination.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=240

Choosing Wisely: Don’t order more than one CT scan of the paranasal sinuses within 90 ...

Don’t order more than one CT scan of the paranasal sinuses within 90 days to evaluate uncomplicated chronic rhinosinusitis patients when the paranasal sinus CT obtained is of adequate quality and resolution to be interpreted by the clinician and used for clinical decision-making and/or ...

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=241

Choosing Wisely: Don’t routinely perform sinonasal imaging in patients with symptoms ...

Don’t routinely perform sinonasal imaging in patients with symptoms limited to a primary diagnosis of allergic rhinitis alone.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=242

Choosing Wisely: Don’t administer prn (i.e., as needed) sedative, antipsychotic, or ...

Don’t administer prn (i.e., as needed) sedative, antipsychotic, or hypnotic medications to prevent and/or treat delirium without first assessing for, removing, and treating the underlying causes of delirium and using nonpharmacologic delirium prevention and treatment approaches.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=310

Choosing Wisely: Don’t perform pelvic exams on asymptomatic nonpregnant women, unless ...

Don’t perform pelvic exams on asymptomatic nonpregnant women, unless necessary for guideline-appropriate screening for cervical cancer.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=368

Choosing Wisely: Don’t routinely use graduated compression stockings in surgical ...

Don’t routinely use graduated compression stockings in surgical patients as mechanical prophylaxis for preventing venous thromboembolism (VTE) after surgery, but do consider using intermittent pneumatic compression devices.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=383

Choosing Wisely: Don’t transfuse plasma to correct a laboratory value; treat the ...

Don’t transfuse plasma to correct a laboratory value; treat the clinical status of the patient.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=388

Choosing Wisely: Don’t routinely obtain radiographic imaging for patients who meet ...

Don’t routinely obtain radiographic imaging for patients who meet diagnostic criteria for uncomplicated acute rhinosinusitis.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=51

Choosing Wisely: Don’t prescribe oral antibiotics for uncomplicated external otitis. - ...

Don’t prescribe oral antibiotics for uncomplicated external otitis.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=52

Choosing Wisely: Don’t order CT scan of the head/brain for sudden hearing loss. - ...

Don’t order CT scan of the head/brain for sudden hearing loss.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=54

Choosing Wisely: Don’t obtain CT or MRI in patients with a primary complaint of ...

Don’t obtain CT or MRI in patients with a primary complaint of hoarseness prior to examining the larynx.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=55

Choosing Wisely: Don’t prescribe testosterone to men with erectile dysfunction who have...

Don’t prescribe testosterone to men with erectile dysfunction who have normal testosterone levels.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=89

Choosing Wisely: Don't obtain a urine culture unless there are clear signs and symptoms...

Don't obtain a urine culture unless there are clear signs and symptoms that localize to the urinary tract.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=96

Choosing Wisely: Don’t prescribe antipsychotic medications for behavioral and ...

Don’t prescribe antipsychotic medications for behavioral and psychological symptoms of dementia (BPSD) in individuals with dementia without an assessment for an underlying cause of the behavior.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=97

Choosing Wisely: Avoid prescribing antibiotics for upper respiratory infections. - ...

Avoid prescribing antibiotics for upper respiratory infections.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=254

Choosing Wisely: Don’t reimage deep vein thrombosis in the absence of a clinical ...

Don’t reimage deep vein thrombosis in the absence of a clinical change.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=33

Choosing Wisely: Don’t perform population-based screening for 25-OH-vitamin D ...

Don’t perform population-based screening for 25-OH-vitamin D deficiency.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=67

Choosing Wisely: Don’t place an indwelling urinary catheter to manage urinary ...

Don’t place an indwelling urinary catheter to manage urinary incontinence.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=263

Choosing Wisely: Don’t do imaging for uncomplicated headache. - American Family Physician

Don’t do imaging for uncomplicated headache.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=38

Choosing Wisely: Don’t use glucosamine and chondroitin to treat patients with ...

Don’t use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=103

Choosing Wisely: Don’t use lateral wedge insoles to treat patients with symptomatic ...

Don’t use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=104

Choosing Wisely: Don’t routinely prescribe two or more antipsychotic medications ...

Don’t routinely prescribe two or more antipsychotic medications concurrently.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=111

Choosing Wisely: Don’t use antipsychotics as first choice to treat behavioral and ...

Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=112

Choosing Wisely: Don’t administer packed red blood cells in a young healthy patient ...

Don’t administer packed red blood cells in a young healthy patient without ongoing blood loss and hemoglobin of ≥ 6 g/dL unless symptomatic or hemodynamically unstable.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=132

Choosing Wisely: Don’t routinely measure 1,25-dihydroxyvitamin D unless the patient has...

Don’t routinely measure 1,25-dihydroxyvitamin D unless the patient has hypercalcemia or decreased kidney function.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=140

Choosing Wisely: Don’t routinely order a thyroid ultrasound in patients with abnormal ...

Don’t routinely order a thyroid ultrasound in patients with abnormal thyroid function tests if there is no palpable abnormality of the thyroid gland.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=141

Choosing Wisely: Don’t order a total or free triiodothyronine (T3) level when assessing...

Don’t order a total or free triiodothyronine (T3) level when assessing levothyroxine (T4) dose in hypothyroid patients.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=142

Choosing Wisely: Don’t prescribe testosterone therapy unless there is biochemical ...

Don’t prescribe testosterone therapy unless there is biochemical evidence of testosterone deficiency.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=143

Choosing Wisely: Don’t test for Lyme disease as a cause of musculoskeletal symptoms ...

Don’t test for Lyme disease as a cause of musculoskeletal symptoms without an exposure history and appropriate exam findings.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=152

Choosing Wisely: Don’t perform cardiac imaging for patients who are at low risk. - ...

Don’t perform cardiac imaging for patients who are at low risk.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=165

Choosing Wisely: Don’t perform cardiac imaging as a preoperative assessment in patients...

Don’t perform cardiac imaging as a preoperative assessment in patients scheduled to undergo low- or intermediate-risk noncardiac surgery.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=166

Choosing Wisely: Don’t transfuse more than the minimum number of red blood cell (RBC) ...

Don’t transfuse more than the minimum number of red blood cell (RBC) units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable, noncardiac inpatients).

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=168

Choosing Wisely: Don’t administer plasma or prothrombin complex concentrates for ...

Don’t administer plasma or prothrombin complex concentrates for nonemergent reversal of vitamin K antagonists (i.e., outside of the setting of major bleeding, intracranial hemorrhage, or anticipated emergent surgery).

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=170

Choosing Wisely: Don’t prescribe opioid analgesics as first-line therapy to treat ...

Don’t prescribe opioid analgesics as first-line therapy to treat chronic non-cancer pain.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=178

Choosing Wisely: Avoid imaging studies (MRI, CT or X-rays) for acute low back pain ...

Avoid imaging studies (MRI, CT or X-rays) for acute low back pain without specific indications.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=180

Choosing Wisely: Don’t prescribe opioids for treatment of chronic or acute pain for ...

Don’t prescribe opioids for treatment of chronic or acute pain for workers who perform safety-sensitive jobs such as operating motor vehicles, forklifts, cranes, or other heavy equipment.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=184

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