This population-level analysis of early trends in use of the services targeted by the Choosing Wisely campaign showed both desirable and undesirable modest changes in use of low-value services, suggesting that additional interventions are necessary for wider implementation of the recommendations.
This case report uses the example of an older patient undergoing hip fracture surgery to discuss judicious use of preoperative testing.
This Teachable Moment highlights the importance of advance risk-benefit analysis before initiating total parenteral nutrition administration.
This analysis shows that the release of 2002 guidance on use of routine preoperative testing was associated with a reduced incidence of routine electrocardiogram but not of plain radiography, hematocrit, urinalysis, or cardiac stress testing.
This Special Communication discusses the changes in perioperative cardiovascular care during the past 3 decades and lessons learned to reduce morbidity and mortality.
Brinkman et al determine whether preoperative β-blocker use within 24 hours of coronary artery bypass grafting (CABG) surgery is associated with reduced perioperative mortality in a contemporary sample of patients. See also the Invited Commentary by Shahian.
Onuoha et al develop a “top-five” list of unnecessary medical services in anesthesiology by undertaking a multistep survey of anesthesiologists, most of whom were in academic practice, and a consequent iterative process with the committees of the American Society of Anesthesiologists.
Schwartz et al develop claims-based measures of low-value services, examine service use (and associated spending) detected by these measures in Medicare, and determine whether patterns of use are related across different types of low-value services. See also the editor’s note by Katz et al.
Thilen et al assess temporal trends, explanatory factors, and geographic variation for preoperative consultation in Medicare beneficiaries undergoing cataract surgery, a common low-risk elective procedure. Fleisher provides an Invited Commentary.