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Choosing Wisely: Don’t recommend chelation except for documented metal intoxication, ...

Don’t recommend chelation except for documented metal intoxication, which has been diagnosed using validated tests in appropriate biological samples.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=122

Choosing Wisely: Don’t put asymptomatic children in weak reading glasses. - American ...

Don’t put asymptomatic children in weak reading glasses.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=123

Choosing Wisely: Annual comprehensive eye exams are unnecessary for children who pass ...

Annual comprehensive eye exams are unnecessary for children who pass routine vision screening assessments.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=124

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 use electromyography (EMG) and nerve conduction studies (NCS) to...

Don’t use electromyography (EMG) and nerve conduction studies (NCS) to determine the cause of axial lumbar, thoracic or cervical spine pain.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=128

Choosing Wisely: Don’t recommend bed rest for low back pain. Patients should remain as ...

Don’t recommend bed rest for low back pain. Patients should remain as active as possible and be encouraged to find positions of comfort and engage in activities that don’t worsen symptoms during an acute episode.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=129

Choosing Wisely: Don’t leave an implantable cardioverter-defibrillator activated when ...

Don’t leave an implantable cardioverter-defibrillator activated when it is inconsistent with the patient/family goals of care.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=13

Choosing Wisely: Don’t obtain baseline laboratory studies in patients without ...

Don’t obtain baseline laboratory studies in patients without significant systemic disease (ASA I or II) undergoing low-risk surgery–specifically complete blood count, basic or comprehensive metabolic panel, coagulation studies when blood loss (or fluid shifts) is/are expected to be ...

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=130

Choosing Wisely: Don’t obtain baseline diagnostic cardiac testing ...

Don’t obtain baseline diagnostic cardiac testing (transthoracic/esophageal echocardiography) or cardiac stress testing in asymptomatic stable patients with known cardiac disease (e.g., coronary artery disease, valvular disease) undergoing low or moderate risk noncardiac surgery.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=131

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 administer colloid (dextrans, hydroxylethyl starches, ...

Don’t routinely administer colloid (dextrans, hydroxylethyl starches, albumin) for volume resuscitation without appropriate indications.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=133

Choosing Wisely: Avoid CT scans of the head in emergency department patients with minor...

Avoid CT scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=134

Choosing Wisely: Avoid placing indwelling urinary catheters in the emergency department...

Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can void, or for patient or staff convenience.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=135

Choosing Wisely: Don’t delay engaging available palliative and hospice care services in...

Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=136

Choosing Wisely: Avoid antibiotics and wound cultures in emergency department patients ...

Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=137

Choosing Wisely: Avoid instituting intravenous (IV) fluids before doing a trial of oral...

Avoid instituting intravenous (IV) fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration in children.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=138

Choosing Wisely: Avoid routine multiple daily self-glucose monitoring in adults with ...

Avoid routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=139

Choosing Wisely: Don’t do CT for evaluation of suspected appendicitis in children until...

Don’t do CT for evaluation of suspected appendicitis in children until after ultrasound has been considered as an option.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=14

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 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 screen low-risk women with cancer antigen (CA) 125 or ultrasound...

Don’t screen low-risk women with cancer antigen (CA) 125 or ultrasound for ovarian cancer.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=144

Choosing Wisely: Don’t perform Pap tests for surveillance of women with a history of ...

Don’t perform Pap tests for surveillance of women with a history of endometrial cancer.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=145

Choosing Wisely: Don’t perform colposcopy in patients treated for cervical cancer with ...

Don’t perform colposcopy in patients treated for cervical cancer with Pap tests of low-grade squamous intraepithelial lesion or less.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=146

Choosing Wisely: Don’t perform prostate-specific antigen (PSA) testing for prostate ...

Don’t perform prostate-specific antigen (PSA) testing for prostate cancer screening in men with no symptoms of the disease when they are expected to live less than 10 years.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=147

Choosing Wisely: Don’t prescribe oral antifungal therapy for suspected nail fungus ...

Don’t prescribe oral antifungal therapy for suspected nail fungus without confirmation of fungal infection.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=148

Choosing Wisely: Don’t use oral antibiotics for treatment of atopic dermatitis unless ...

Don’t use oral antibiotics for treatment of atopic dermatitis unless there is clinical evidence of infection.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=149

Choosing Wisely: Don’t use coronary CT angiography in high-risk emergency department ...

Don’t use coronary CT angiography in high-risk emergency department patients presenting with acute chest pain. note: Risk defined by the Thrombolysis In Myocardial Infarction risk score for unstable angina/acute coronary syndromes.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=15

Choosing Wisely: Don’t order autoantibody panels unless positive antinuclear antibodies...

Don’t order autoantibody panels unless positive antinuclear antibodies (ANA) and evidence of rheumatic disease.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=151

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 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: For patients recently discharged on supplemental home oxygen following...

For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, don’t renew the prescription without assessing the patient for ongoing hypoxemia.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=154

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 perform neuroimaging studies in patients with stable headaches ...

Don’t perform neuroimaging studies in patients with stable headaches that meet criteria for migraine.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=157

Choosing Wisely: Don’t perform CT screening for lung cancer among patients at low risk ...

Don’t perform CT screening for lung cancer among patients at low risk for lung cancer.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=156

Choosing Wisely: Don’t perform CT imaging for headache when MRI is available, except in...

Don’t perform CT imaging for headache when MRI is available, except in emergency settings.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=158

Choosing Wisely: Don’t recommend surgical deactivation of migraine trigger points ...

Don’t recommend surgical deactivation of migraine trigger points outside of a clinical trial.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=159

Choosing Wisely: Don’t medicate to achieve tight glycemic control in older adults. ...

Don’t medicate to achieve tight glycemic control in older adults. Moderate control is generally better.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=16

Choosing Wisely: Don’t prescribe opioid or butalbital-containing medications as ...

Don’t prescribe opioid or butalbital-containing medications as first-line treatment for recurrent headache disorders.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=160

Choosing Wisely: Don’t recommend prolonged or frequent use of over-the-counter (OTC) ...

Don’t recommend prolonged or frequent use of over-the-counter (OTC) pain medications for headache.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=161

Choosing Wisely: Don’t routinely order thrombophilia testing on patients undergoing a ...

Don’t routinely order thrombophilia testing on patients undergoing a routine infertility evaluation.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=162

Choosing Wisely: Don’t perform immunological testing as part of the routine infertility...

Don’t perform immunological testing as part of the routine infertility evaluation.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=163

Choosing Wisely: Don’t perform stress cardiac imaging or coronary angiography in ...

Don’t perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=164

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: Use methods to reduce radiation exposure in cardiac imaging, whenever ...

Use methods to reduce radiation exposure in cardiac imaging, whenever possible, including not performing such tests when limited benefits are likely.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=167

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 test for thrombophilia in adult patients with venous ...

Don’t test for thrombophilia in adult patients with venous thromboembolism (VTE) occurring in the setting of major transient risk factors (surgery, trauma, or prolonged immobility).

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=169

Choosing Wisely: Don’t use nuclear medicine thyroid scans to evaluate thyroid nodules ...

Don’t use nuclear medicine thyroid scans to evaluate thyroid nodules in patients with normal thyroid gland function.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=17

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

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