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Choosing Wisely Canada rhinology recommendations.

Neil Arnstead1, Yvonne Chan2, Shaun Kilty3

  • 1Department of Otolaryngology - Head & Neck Surgery, University of Toronto, C. David Naylor Building, Suite 120, 6 Queen's Park Crescent West, Toronto, ON, M5S 3H2, Canada. neil.arnstead@mail.utoronto.ca.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|March 1, 2020
PubMed
Summary

Choosing Wisely Canada recommends avoiding unnecessary antibiotics and imaging for acute rhinosinusitis and nasal fractures. Evidence-based guidelines aim to improve patient care by reducing unindicated diagnostic tests and treatments.

Keywords:
Anti-bacterial agentsChoosing Wisely CanadaComputed tomographyDrug utilizationMedical overuseNasal fractureRadiographyRhinologySinusitis

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Area of Science:

  • Otolaryngology
  • Evidence-Based Medicine
  • Health Policy

Background:

  • Choosing Wisely Canada promotes shared decision-making between physicians and patients.
  • Unnecessary medical tests and treatments can lead to increased healthcare costs and potential patient harm.

Purpose of the Study:

  • To present evidence-based recommendations for managing acute rhinosinusitis and nasal fractures.
  • To reduce the incidence of unnecessary diagnostic procedures and treatments in otolaryngology.

Main Methods:

  • Development of five key recommendations by the Rhinology Subspecialty Group of the Canadian Society of Otolaryngology - Head & Neck Surgery.
  • Focus on evidence-based guidelines for common otolaryngologic conditions.

Main Results:

  • Recommendation 1: Avoid antibiotics for acute sinusitis without bacterial criteria.
  • Recommendation 2: Do not order CT scans for uncomplicated acute rhinosinusitis.
  • Recommendation 3: Avoid plain film sinus X-rays.
  • Recommendation 4: Do not swab nasal cavities for rhinosinusitis workup.
  • Recommendation 5: Avoid plain film X-rays for nasal fracture evaluation.

Conclusions:

  • Implementation of these guidelines can optimize patient care for acute rhinosinusitis and nasal fractures.
  • Reducing unnecessary interventions aligns with the goals of the Choosing Wisely campaign.
  • Promoting evidence-based practices is crucial for efficient and effective healthcare delivery.