CHOOSING WISELYOUR MISSIONCLINICIAN LISTSFOR PATIENTSGETTING STARTEDSUCCESS STORIES Choosing Wisely ®. Choosing Wisely. During this time of great stress, Choosing Wisely is providing information from our partner societies about appropriate tests and treatments that are relevant to addressing the impact of the COVID-19 outbreak on the health care system. SOCIETY OF SURGICAL ONCOLOGY Founded in 1940 as the James Ewing Society, the Society of Surgical Oncology® is the preeminent organization for surgeons, scientists and health care specialists dedicated to advancing the treatment of cancer through leading edge scientific research and surgical techniques. The Society’s 2,800 U.S. and international members are at the CHOLESTEROL DRUGS FOR PEOPLE 75 AND OLDER Statins have risks. Compared to younger adults, older adults are more likely to suffer serious side effects from using statins. Statins can cause muscle problems, such as aches, pains, or weakness. Rarely, there can be a severe form of muscle breakdown. In older adults, THE SOCIETY OF SURGICAL ONCOLOGY ROSEMONT, IL – The Society of Surgical Oncology (SSO) today released a list of specific tests or procedures that are commonly ordered but not always necessary in surgical oncology as part of Choosing Wisely, an initiative of the ABIM Foundation and Consumer Reports. The list identifies five targeted, evidence-based recommendations that can support conversations between OVERACTIVE BLADDER AND PELVIC ORGAN PROLAPSE Many things can weaken the muscles that support these organs: pregnancy and childbirth, chronic constipation, aging, coughing, and being overweight. Weak pelvic muscles can lead to: Overactive bladder (OAB): A strong, frequent urge to urinate. Pelvic organ prolapse (POP): The uterus, bladder, or rectum slips out of place and presses

into the

TREATING BLOCKED LEG ARTERIES Bypass surgery on your legs has all the dangers of major surgery. It takes two to three weeks for the wound to heal. Risks include infection, bleeding from the wound, and complications from anesthe­sia, such as trouble breathing or pneumonia. And about three out of 100 people who have bypass surgery have a heart attack or die. LOW-RISK PROSTATE CANCER Many prostate cancers are found with a PSA blood test. Often these cancers are low-risk. This means: The tumor is small. It is contained within the prostate. It is probably growing so slowly that it will not become life-threatening. Usually a man with low-risk prostate cancer dies of something else, even if he doesn’t get treatment. TESTOSTERONE FOR ERECTION PROBLEMS But some men have erectile dysfunction, or ED. This is when it is difficult to get or keep an erection that’s firm enough for sexual intercourse. If you have ED, you may think that testosterone treatment will help. Testosterone is a male sex hormone. After age 50, men’s levels of testosterone slowly go down and ED becomes more common. PAINKILLER CHOICES WITH KIDNEY OR HEART PROBLEMS Over-the-counter Tylenol (generic acetaminophen) is often the best choice for people with high blood pressure, heart failure, or kidney problems. However, high doses of Tylenol can damage the liver, so take the lowest dose you can to get enough pain relief. Never take more than 4,000 milligrams (mg) a day. That’s equal to twelve 325 mg

pills.

TWENTY THINGS PHYSICIANS AND PATIENTS SHOULD QUESTION Society for Maternal-Fetal Medicine Twenty Things Physicians and Patients Should Question Don’t perform routine cell-free DNA screening for microdeletions. CHOOSING WISELYOUR MISSIONCLINICIAN LISTSFOR PATIENTSGETTING STARTEDSUCCESS STORIES Choosing Wisely ®. Choosing Wisely. During this time of great stress, Choosing Wisely is providing information from our partner societies about appropriate tests and treatments that are relevant to addressing the impact of the COVID-19 outbreak on the health care system. SOCIETY OF SURGICAL ONCOLOGY Founded in 1940 as the James Ewing Society, the Society of Surgical Oncology® is the preeminent organization for surgeons, scientists and health care specialists dedicated to advancing the treatment of cancer through leading edge scientific research and surgical techniques. The Society’s 2,800 U.S. and international members are at the CHOLESTEROL DRUGS FOR PEOPLE 75 AND OLDER Statins have risks. Compared to younger adults, older adults are more likely to suffer serious side effects from using statins. Statins can cause muscle problems, such as aches, pains, or weakness. Rarely, there can be a severe form of muscle breakdown. In older adults, THE SOCIETY OF SURGICAL ONCOLOGY ROSEMONT, IL – The Society of Surgical Oncology (SSO) today released a list of specific tests or procedures that are commonly ordered but not always necessary in surgical oncology as part of Choosing Wisely, an initiative of the ABIM Foundation and Consumer Reports. The list identifies five targeted, evidence-based recommendations that can support conversations between OVERACTIVE BLADDER AND PELVIC ORGAN PROLAPSE Many things can weaken the muscles that support these organs: pregnancy and childbirth, chronic constipation, aging, coughing, and being overweight. Weak pelvic muscles can lead to: Overactive bladder (OAB): A strong, frequent urge to urinate. Pelvic organ prolapse (POP): The uterus, bladder, or rectum slips out of place and presses

into the

TREATING BLOCKED LEG ARTERIES Bypass surgery on your legs has all the dangers of major surgery. It takes two to three weeks for the wound to heal. Risks include infection, bleeding from the wound, and complications from anesthe­sia, such as trouble breathing or pneumonia. And about three out of 100 people who have bypass surgery have a heart attack or die. LOW-RISK PROSTATE CANCER Many prostate cancers are found with a PSA blood test. Often these cancers are low-risk. This means: The tumor is small. It is contained within the prostate. It is probably growing so slowly that it will not become life-threatening. Usually a man with low-risk prostate cancer dies of something else, even if he doesn’t get treatment. TESTOSTERONE FOR ERECTION PROBLEMS But some men have erectile dysfunction, or ED. This is when it is difficult to get or keep an erection that’s firm enough for sexual intercourse. If you have ED, you may think that testosterone treatment will help. Testosterone is a male sex hormone. After age 50, men’s levels of testosterone slowly go down and ED becomes more common. PAINKILLER CHOICES WITH KIDNEY OR HEART PROBLEMS Over-the-counter Tylenol (generic acetaminophen) is often the best choice for people with high blood pressure, heart failure, or kidney problems. However, high doses of Tylenol can damage the liver, so take the lowest dose you can to get enough pain relief. Never take more than 4,000 milligrams (mg) a day. That’s equal to twelve 325 mg

pills.

TWENTY THINGS PHYSICIANS AND PATIENTS SHOULD QUESTION Society for Maternal-Fetal Medicine Twenty Things Physicians and Patients Should Question Don’t perform routine cell-free DNA screening for microdeletions. CHOOSING WISELY RECOMMENDATIONS The Choosing Wisely lists were created by national medical specialty societies and represent specific, evidence-based recommendations clinicians and patients should discuss. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation. Resources for consumers and providers were developed in collaboration with the partner THE SOCIETY OF SURGICAL ONCOLOGY ROSEMONT, IL – The Society of Surgical Oncology (SSO) today released a list of specific tests or procedures that are commonly ordered but not always necessary in surgical oncology as part of Choosing Wisely, an initiative of the ABIM Foundation and Consumer Reports. The list identifies five targeted, evidence-based recommendations that can support conversations between HOME OXYGEN AFTER A HOSPITAL STAY You may still need extra oxygen after you leave the hospital. And you may go home with a prescription for supplemental (extra) oxygen therapy. Supplemental oxygen therapy uses a tank or a machine to give you extra oxygen. This helps oxygen get to your lungs and heart, and other parts of your body. The extra oxygen can make you stronger and

more

PAINKILLER CHOICES WITH KIDNEY OR HEART PROBLEMS Over-the-counter Tylenol (generic acetaminophen) is often the best choice for people with high blood pressure, heart failure, or kidney problems. However, high doses of Tylenol can damage the liver, so take the lowest dose you can to get enough pain relief. Never take more than 4,000 milligrams (mg) a day. That’s equal to twelve 325 mg

pills.

PET SCANS AFTER CANCER TREATMENT PET and PET-CT scans have risks. Having PET and PET-CT scans can add to your stress as a cancer survivor. These tests often find health problems that are not serious. This may lead to more tests and procedures, including follow-up scans, and even biopsies and surgery. Also, PET, and especially PET-CT scans, expose you to high levels of

radiation.

USING OPIOIDS SAFELY AFTER SURGERY If your doctor thinks you will be in a lot of pain after surgery, opioids might be the right choice. Opioids include hydrocodone (Vicodin and generic) and oxycodone (OxyContin, Percocet, and generic). These medicines should only be used to treat extreme short-term pain, like the kind you may feel after surgery. SLEEPING PILLS FOR INSOMNIA AND ANXIETY IN OLDER PEOPLE Almost one-third of older people in the U.S. take sleeping pills. These drugs are called “sedative- hypnotics” or “tranquilizers.” They affect the brain and spinal cord. PSA TEST FOR PROSTATE CANCER The test is often not needed. Most men with high PSAs don’t have prostate cancer. Their high PSAs might be due to: An enlarged prostate gland. A prostate infection. Recent sexual activity. A recent, long bike ride. Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause AMERICAN GERIATRICS SOCIETY American Geriatrics Society Ten Things Clinicians and Patients Should Question . Released February 21, 2013 (1-5) and February 27, 2014 (6-10); Revised April 23, 2015 (2,3,6,7,8 and 10); Last reviewed 2019 ANTIBIOTICS FOR URINARY TRACT INFECTIONS IN OLDER PEOPLE Antibiotics are medicines that can kill bacteria. Doctors often use antibiotics to treat urinary tract infections (UTIs). The main symptoms of UTIs are: A burning feeling when you urinate. A strong urge to urinate often. However, many older people get UTI treatment

even though they do

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CHOOSING WISELY®

PROMOTING CONVERSATIONS BETWEEN PATIENTS AND CLINICIANS

CHOOSING WISELY®

PROMOTING CONVERSATIONS BETWEEN PATIENTS AND CLINICIANS We all recognize that this is a challenging time in medicine. This is a rapidly evolving situation that requires reevaluation daily. We recommend following the United States Centers for Disease Control and

Prevention (CDC)

for the most

up-to-date information on the virus. _Choosing Wisely_ is an initiative of the ABIM Foundation that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. READ MORE ABOUT THE CAMPAIGN

.

During this time of great stress, Choosing Wisely is PROVIDING INFORMATION FROM OUR PARTNER SOCIETIES

about appropriate

tests and treatments that are relevant to addressing the impact of the COVID-19 outbreak on the health care system Read Dr. Baron and Daniel Wolfson’s LETTER TO THE CHOOSING WISELY

COMMUNITY .

------------------------- ADDITIONAL_ _MATERIALS FOR PATIENTS BROWSE DOWNLOADABLE RESOURCES that clinicians can place in waiting or exam rooms, or give to patients as handouts to educate them about overuse. Materials are available in both English and Spanish. __ UPDATES FROM THE FIELD__ Monthly updates on organizations advancing _Choosing Wisely_.

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