Recommendations target overuse of unnecessary medical procedures

Issue: BCMJ, vol. 57 , No. 6 , July August 2015 , Pages 237 News

Avoid CT scans for mild head injury and avoid psychostimulants for preschool children with ADHD. These are 2 of the 49 new recommendations pertaining to various medical specialties recently released by Choosing Wisely Canada.

The recommendation concerning CT scans was developed by the Canadian Association of Emergency Physicians and recognizes that most adults and children with minor head injuries do not suffer from serious brain injuries requiring hospitalization or surgery. Further, performing CT head scans without signs of significant injuries can expose patients to unnecessary radiation that can increase a patient’s lifetime risk of cancer.

Avoiding psychostimulants as first treatment for preschool children with ADHD recognizes the need to assess children for environmental stressors such as neglect, abuse, or exposure to domestic violence before prescribing drugs as the solution. In some cases, education and support of parents followed by advice on behavioral management and community placement might be the alternative. The recommendation was developed through collaboration of the Canadian Psychiatric Association, the Canadian Academy of Child and Adolescent Psychiatry, and the Canadian Academy of Geriatric Psychiatry.

Choosing Wisely Canada is a campaign aiming to provide information to help physicians and patients make effective choices about tests, treatments, and procedures to ensure high-quality care. To access all of Choosing Wisely Canada’s 150 physician recommendations, patient materials, and additional resources, visit

. Recommendations target overuse of unnecessary medical procedures. BCMJ, Vol. 57, No. 6, July, August, 2015, Page(s) 237 - News.

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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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