Curated by Claudia Shannon / Research Scientist / ishonest

Top 5 ‘Wasteful Treatments’

These top five lists are part of Choosing Wisely, a campaign launched by the ABIM Foundation in 2012.

Choosing Wisely calls on medical organizations such as the American Academy of Pediatrics (AAP) to come up with their own list of medical tests and treatments that may be unnecessary.

• anti-reflux medications to treat acid reflux or apnea/desaturation in preterm infants
• use of antibiotics beyond 48 hours if there is no evidence of a bacterial infection
• pneumogram (breathing test) for assessment of ongoing or prolonged apnea (frequent pauses in breathing) in premature infants
• daily chest X-rays for infants with a breathing tube inserted when there is no indication for use of this test
• brain MRIs for screening in premature infants

Parents Heavily Involved in Infant Care

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In its efforts to reduce waste in the healthcare system, the Choosing Wisely campaign encourages greater involvement of patients.

“The Choosing Wisely program was started in the beginning to encourage conversations between patients and physicians around issues of overuse, which we saw as a problem that affected quality and safety and could cause potential harm of patients,” said Daniel Wolfson, executive vice president and chief operating officer of the ABIM Foundation, a nonprofit organization that supports the campaign.

In the case of children, this advocacy role falls to the parents. It includes talking to the doctor about the potential benefits and harms of tests and treatments, and whether there is strong enough scientific evidence to support their use.

“We’re interested in the public beginning to ask questions of their physicians,” said Wolfson, “and [having] conversations with them about whether this test is really needed.”

This is especially important for parents of newborns because neonatologists only care for infants for the first one to two months of their lives. After that, it falls on the parents to ensure that their child receives the best medical care.

“If we’ve done our job and we do what Choosing Wisely tells us to do, then these parents are going to take this message and carry it throughout their children’s lives,” said Ho.

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