Choosing Wisely list unveiled by neurosurgeons

The American Association of Neurological Surgeons and Congress of Neurological Surgeons released the Choosing Wisley list, a document that unveils a number of specific tests or procedures that are commonly ordered, but not always necessary, in neurosurgery, according to a press release.

The Choosing Wisely list is part of the ABIM Foundation. The list targets five evidence-based recommendations that can support physicians in working with their patients to make wise choices about their care.

Robert E. HarbaughThe list includes the following five recommendations, according to a press release:

Don’t administer steroids after severe traumatic brain injury.
Don’t obtain imaging (plain radiographs, MRI, CT, or other advanced imaging) of the spine in patients with non-specific acute low back pain and without red flags.
Don’t routinely obtain CT scanning of children with mild head injuries.
Don’t routinely screen for brain aneurysms in asymptomatic patients without a family or personal history of brain aneurysms, subarachnoid hemorrhage (SAH) or genetic disorders that may predispose to aneurysm formation.
Don’t routinely use seizure prophylaxis in patients following ischemic stroke.
“Neurosurgeons are committed to identifying the right treatment, for the right patient, at the right time to help eliminate unnecessary procedures, optimize outcomes, and reduce healthcare costs,” stated AANS president, Robert E. Harbaugh, MD, in a press release. “Participating in the Choosing Wisely initiative is a key step in this process.”

The AANS and CNS devised the list after months of consideration by the Joint Guidelines Committee, the Quality Improvement Workgroup and seven clinical subspecialty sections according to the press release. The recommendations reflect the most current evidence about management and treatment options for patients facing disorders of the brain and spine.

Robert E. Harbaugh

Daniel K. Resnick

With this new list, the Choosing Wisely campaign will have more than 300 tests and practices that the specialty society partners say are overused and inappropriate. Choosing Wisely is intended for patient and their physicians to discuss the necessity of such testing, according to a press release.

“A broad range of neurosurgeons, from across the spectrum of our specialty, reviewed the evidence and contributed to these recommendations. We anticipate that these will help neurosurgeons and their patients make informed decisions by promoting conversations about the most appropriate tests and treatments, and avoiding care whose potential harm may outweigh the benefits,” CNS president stated, Daniel K. Resnick, MD, in a press release.

Choosing Wisely was first created in December 2011. It is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources, according to a press release.