A coalition of nine medical groups, led by the Canadian Medical Association, has unveiled a list of 40 medical interventions that they want to be used less frequently. The Choosing Wisely campaign, launched with a news conference in Ottawa on Wednesday, is part of a bid to shift thinking in medical circles to consider that when it comes to certain tests, medications and procedures, less may be better.
Here are five procedures that should be used less often:
Some CT scans
Computed tomography (CT) scans shouldn’t be performed on patients with minor injuries or trauma limited to one part of the body. The radiation from one CT scan is equivalent to roughly 400 X-Rays and it doesn’t make sense to expose those patients when another scan with less radiation would be as effective.
Imaging for lower-back pain
Doctors should not order imaging for lower-back pain unless certain “red flags” – such as suspected cancer or infection – are present. Imaging is unlikely to help treat many patients with lower-back pain.
Psychoactive drugs for certain conditions
Powerful psychoactive drugs such as benzodiazepines shouldn’t be prescribed for older adults suffering from insomnia, agitation or delirium. Studies have shown the use of those drugs in older adults is linked to a doubling of the risk for car accidents and hip fractures that lead to death.
Doctors shouldn’t use urinary catheters without a good reason, such as critical illness or palliative care. Urinary catheters increase the risk of infection and keep people from being mobile, which can worsen their health and prolong recovery.
Annual electrocardiograms should not be performed on low-risk patients who don’t have symptoms of heart problems. The test is unlikely to help those patients or improve outcomes.