Choosing Wisely List released by The American Academy of Orthopaedic Surgeons

Sep 12 2013

Academy focuses on quality and value in treatment protocols

The American Academy of Orthopaedic Surgeons (AAOS) today released a list of specific tests or procedures that are commonly ordered but not always necessary in orthopaedics as part of the Choosing Wisely- campaign, an initiative of the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about what care is really necessary.

The Academy's list identified the following five recommendations:

• Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
• Don't use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
• Don't use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
• Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
• Don't use post-operative splinting of the wrist after carpal tunnel release for long-term relief.

"More than one in four Americans require medical attention due to a musculoskeletal condition and that number continues to grow," explained Joshua J. Jacobs, MD, AAOS president. "As orthopaedic surgeons, our duty to our patients is to restore mobility and improve their quality of life through evidence-based, high-quality treatment. Our participation in the Choosing Wisely campaign will help shape patient-physician dialogue, which as we all know is the cornerstone of optimal care. Identifying tests, procedures or treatments that show little to no value not only helps our patients by preventing unnecessary care, but will end up saving health care dollars."

The Academy's Choosing Wisely list was developed after months of careful consideration and review, using the most current evidence about management and treatment options. AAOS routinely develops evidence-based clinical guidelines and appropriate use criteria as valuable tools to advance the physician-patient communications process and enhance the diagnosis and treatment of musculoskeletal conditions. The final topics selected for this campaign came out of those clinical practice guidelines.

"The Academy has shown tremendous leadership by releasing its list of tests and procedures they say are commonly done in orthopaedics, but aren't always necessary," said Richard J. Baron, MD, president and CEO of the ABIM Foundation. "The content of this list and all of the others developed through this effort are helping physicians and patients across the country engage in conversations about what care they need, and what we can do to reduce waste and overuse in our health care system."

Over the next year, more than 30 other specialty society partners will release Choosing Wisely lists.

A full list of participating societies can be viewed here: http://www.abimfoundation.org/News/ABIM-Foundation-News/2013/More-Than-30-Specialty-Societies-to-Release-New-Choosing-Wisely-Lists.aspx

To date, over 80 national and state medical specialty societies, regional health collaboratives and consumer partners have joined the conversations about appropriate care. With the release of these new lists, the campaign will have covered more than 250 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.

The campaign also continues to reach millions of consumers nationwide through a stable of consumer and advocacy partners, led by Consumer Reports-the world's largest independent product-testing organization-which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations. Choosing Wisely consumer partners include:

• AARP
• Alliance Health Networks
• Covered California
• Midwest Business Group on Health
• Minnesota Health Action Group
• National Business Coalition on Health
• National Business Group on Health
• National Center for Farmworker Health
• National Hospice and Palliative Care Organization
• National Partnership for Women & Families
• Pacific Business Group on Health
• Puget Sound Health Alliance
• SEIU
• The Leapfrog Group
• Washington State Medical Association
• Union Plus
• Wikipedia

To learn more about Choosing Wisely and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit http://www.ChoosingWisely.org.

Source: American Academy of Orthopaedic Surgeons