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明智選擇 聰明就醫

2012年由美國內科醫學會 (American Board of Internal  Medicine Foundation,  ABIM),發起除美國,加拿大外,許多歐洲 國家和日本都有響應此活動,目前已有20個國家響應此活動。主要目的為:促進醫病溝通,減少醫療浪費。

The Choosing Wisely International Top 10 recommendations

1

Don’t do imaging for low back pain within the first six weeks, unless red flags are present.

6Don’t use antipsychotics as the first choice to treat behavioral and psychological symptoms of dementia.

2

Don’t routinely prescribe antibiotics for acute  mild-to-moderate sinusitis unless symptoms last  for seven or more days, or symptoms worsen  after initial clinical improvement.7Don’t perform routine preoperative testing before low-risk surgical procedures.

3

Don’t use benzodiazepines or other sedative-  hypnotics in older adults as first choice for  insomnia, agitation, or delirium.8Don’t use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present.

4

Don’t maintain long-term Proton Pump Inhibitor (PPI) therapy for gastrointestinal symptoms without an attempt to stop/reduce PPI at least once per year in most patients.

9Don’t place, or leave in place, urinary catheters for incontinence, convenience, or monitoring in noncritically ill patients.

5

 

Don’t perform stress cardiac imaging or advanced noninvasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present.

10Don’t perform annual stress cardiac imaging as part of routine follow-up in asymptomatic patients.

明智選擇 聰明就醫科別