SGEM Xtra: CAEP Choosing Wisely

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Date: November 29th, 2016

Guest Skeptic: Dr. Amy Cheng is an Emergency Physician, the Emergency Department Director of Quality Improvement and the Interim Medical Director of Quality and Patient Safety, at St. Michael’s Hospital in Toronto. She is also the National Co-Chair for Choosing Wisely Canada in Emergency Medicine.

This is another SGEM Xtra over the holiday season. There are a lot of top ten lists released at this time of year. The Canadian Association of Emergency Physicians (CAEP) published a top ten list in October of this year called Ten Things Physicians and Patients Should Question. I thought this would be a perfect time to review the list as an SGEM Xtra.

This initiative is part of the Choosing Wisely campaign that was launched in 2012 by the American Board of Internal Medicine (ABIM). We covered this campaign before on SGEM#15.

“The goal of the campaign is to reduce waste in the health care system and avoid risks associated with unnecessary treatment. It calls upon leading medical specialty societies and other organizations to identify tests or procedures commonly used in their field whose necessity should be questioned and discussed with patients”. ABIM Choosing Wisely

There is a Canadian Version of the campaign called Choosing Wisely Canada. CAEP is part of this group and followed this process in selecting items to be on its list:

CAEP established its Choosing Wisely Canada Top 10 (phase 1 and phase 2) recommendations by forming an Expert Working Group to generate an initial list of potentially overused tests, procedures, and treatments in emergency medicine that do not add value to care. CAEP subcommittee chairs were invited  to provide further input to the initial list. The list of potential items was then sent to more than 100 selected emergency physicians to vote on the items based on: action-ability by emergency physicians, effectiveness, safety, economic burden, and frequency of use. The CAEP working group discussed the items with the highest votes, and the ten Choosing Wisely Canada recommendations were generated by consensus. The first five recommendations (items 1-5) were released in June 2015, and the second five recommendations (items 6-10) were released in October 2016.

The American College of Emergency Physicians (ACEP) also came out with a list of things physicians and patients should question in October 14, 2013 (1-5) and October 27, 2014 (6-10).

CAEP: Ten Things Physicians and Patients Should Question

Dr. Amy Cheng

Click on links for PDF copy of CAEP Choosing Wisely Canada in ENGLISH or FRENCH that include how the list was created all the references.

Listen to the SGEM podcast on iTunes to hear Dr. Amy Cheng explain each of these ten things physicians and patients should question.

Dr. Cheng summarizes CAEP Choosing Wisely campaign into a tweet – These are 10 recommendations from CAEP but we should always be choosing wisely.

Happy holidays everyone and the SGEM will be back in 2017 trying to cut the knowledge translation window down from over ten years to less than one year.