Top POEMs of 2018 Consistent with the Principles of the Choosing Wisely Campaign

Area of Science:

• Medical Informatics
• Clinical Practice Guidelines
• Evidence-Based Medicine

Background:

• The Choosing Wisely campaign promotes evidence-based practices to reduce unnecessary medical interventions.
• Patient-Oriented Evidence that Matters (POEMs) distill research into actionable clinical recommendations.
• Identifying high-impact POEMs consistent with Choosing Wisely principles is crucial for clinical decision-making.

Purpose of the Study:

• To identify and discuss the top Patient-Oriented Evidence that Matters (POEMs) from 2018.
• To evaluate the alignment of these POEMs with the Choosing Wisely campaign's goals.
• To present evidence-based recommendations for interventions to avoid in clinical practice.

Main Methods:

• A crowdsourcing strategy was employed using the daily POEMs information service for Canadian Medical Association physician members.
• Selected POEMs were based on primary research or meta-analyses.
• Recommendations focused on interventions with questionable benefit, higher cost, or increased risk.

Main Results:

• Key recommendations included avoiding decompression surgery for subacromial shoulder pain.
• For mild asthma, avoiding routine long-term inhaled steroids over as-needed budesonide/formoterol was advised.
• Avoiding routine broad-spectrum antibiotics for respiratory infections in children and blanket troponin testing in low-risk myocardial infarction patients were highlighted.

Conclusions:

• The selected POEMs offer valuable guidance for clinicians and patients to avoid potentially harmful or ineffective interventions.
• These findings support shared decision-making and the judicious use of healthcare resources.
• Integrating these POEMs into practice can enhance the quality and efficiency of patient care.