No feeding tubes for advanced dementia patients. Fewer Pap smears for women. No automatic CT scans for kids with minor head injuries.
They’re all on an expanded annual list of 90 procedures to question or avoid from 17 doctor groups.
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Some of the treatments “Choosing Wisely” groups today say are often unnecessary or even harmful:
—Ease up on the stress tests. Avoid doing tests using echocardiographic images to assess heart risk in persons who have no symptoms and a low risk of coronary disease.
—Avoid feeding tubes in patients with advanced dementia. Studies show the tubes do not result in better outcomes for patients. Recommended: assistance with oral feeding.
—No annual Pap tests in women 30 to 65 years of age. It’s been a controversial topic for a while, but this recommendation says in average-risk women, annual tests hold no advantage over screenings at 3-year intervals.
—Don’t automatically use CT scans to evaluate minor head injuries in kids. About 50 percent of children at emergency rooms with head injuries get a scan, but they involve radiation exposure. Recommended: clinical observation first.
—Think twice on drugs for older diabetics. American Geriatrics Society recommends: When prescribing medication for most people age 65 and older with type 2 diabetes, avoid attempting to achieve tight glycemic control. There is no evidence that using medicine to tightly control blood sugar in older diabetics is beneficial, the group says, and could lead to harm including higher chance of death.