1. Choosing Wisely is a campaign by the American Board of Internal Medicine Foundation encouraging physicians and patients to promote high-value, cost-conscious care.
2. This national survey concluded on 5 practice parameters in newborn medicine that can help increase value in care delivered.
Evidence Rating Level: 1 (Excellent)
Study Rundown: In 2011, the American Board of Internal Medicine Foundation launched the Choosing Wisely campaign, an initiative that promotes high-value, cost-conscious medicine. The campaign asks all subspecialties across medicine to each identify their “top 5” list of practice patterns most fitting to the campaign’s objectives. This national survey aimed to build such a list for newborn medicine; the survey was sent to 2872 neonatologists in the American Academy of Pediatrics Section on Perinatal Pediatrics and to 1053 members of the Vermont Oxford Network Annual Congress, a multidisciplinary perinatal pediatrics research group. This initial survey included 1047 respondents, who together provided 2870 suggestions for tests or treatments to be included in the Choosing Wisely Newborn Medicine list. An expert panel of 51 leaders evaluated the survey recommendations and underwent 3 Delphi rounds to finalize the top 5 list. The list is as follows:
- Avoid routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux or for treatment of apnea and desaturation in preterm infants.
- Avoid routine continuation of antibiotic therapy beyond 48 hours for initially asymptomatic infants without evidence of bacterial infection.
- Avoid routine use of pneumograms for predischarge assessment of ongoing and/or prolonged apnea of prematurity.
- Avoid routine daily chest radiographs without an indication for intubated infants.
- Avoid routine screening term-equivalent or discharge brain MRIs in preterm infants.
Relevant Reading: Choosing Wisely: an initiative of the ABIM Foundation
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