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Top POEMs of 2019 Consistent with the Principles of the Choosing Wisely Campaign
1McGill University, Montreal, Quebec, Canada.
Insights
Patient-Oriented Evidence that Matters (POEMs) from 2019 align with the Choosing Wisely campaign to reduce unnecessary medical tests and treatments. These evidence-based recommendations guide clinicians and patients toward avoiding ineffective or harmful interventions.
Area of Science:
- Evidence-based medicine
- Clinical practice guidelines
- Health services research
Background:
- The Choosing Wisely campaign promotes reducing unnecessary medical tests and treatments.
- Patient-Oriented Evidence that Matters (POEMs) highlight clinically significant research findings.
- Identifying POEMs aligned with Choosing Wisely principles can improve healthcare quality.
Purpose of the Study:
- To identify and discuss the 2019 POEMs most consistent with Choosing Wisely principles.
- To provide evidence-based recommendations for clinical practice.
- To facilitate informed discussions between clinicians and patients.
Main Methods:
- Crowdsourcing strategy using the Canadian Medical Association's daily POEMs information service.
- Selection of POEMs based on primary research or meta-analysis.
- Categorization of recommendations across various medical domains.
Main Results:
- Recommendations cover musculoskeletal, respiratory, screening, and miscellaneous conditions.
- Examples include avoiding platelet-rich plasma for osteoarthritis and limiting antibiotic duration for pneumonia.
- Selected POEMs identify interventions with limited benefits, higher costs, or increased risks.
Conclusions:
- The identified POEMs offer valuable guidance for avoiding unnecessary interventions.
- Aligning POEMs with Choosing Wisely principles supports evidence-based, patient-centered care.
- Enhanced understanding of these POEMs can improve clinician-patient communication and shared decision-making.
Abstract:
In this article, we discuss the POEMs (patient-oriented evidence that matters) of 2019 judged to be most consistent with the principles of Choosing Wisely, an international campaign to reduce unnecessary testing and treatments. We selected these POEMs through a crowdsourcing strategy of the daily POEMs information service for the Canadian Medical Association's physician members. We present recommendations from these top POEMs of primary research or meta-analysis that identify interventions to encourage or consider avoiding in practice. The recommendations cover musculoskeletal conditions (e.g., do not recommend platelet-rich plasma injections for rotator cuff disease or knee osteoarthritis), respiratory disease (e.g., in clinically stable patients with community-acquired pneumonia, antibiotics can be stopped after five days), screening or preventive care (e.g., patients who take their blood pressure at home or in a pharmacy should know what to do when they have an elevated reading), and miscellaneous topics (e.g., in healthy adults treated for dermatophyte infection, do not obtain baseline or follow-up alanine transaminase level, aspartate transaminase level, or complete blood count). These POEMs describe interventions whose benefits are not superior to other options, are sometimes more expensive, or put patients at increased risk of harm. Knowing more about these POEMs and their connection with the Choosing Wisely campaign will help clinicians and patients engage in conversations better informed by high-quality evidence.
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