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EVOLVE: The Australian Rheumatology Association's 'top five' list of investigations and interventions doctors and patients should question
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ORCID: 0000-0002-9814-0006, Katikireddi, VS, Keen, H, Laurent, R, Nikpour, M, Poulsen, K, Robinson, P, Soden, M, Wood, N, Cook, N, Hill, C and Buchbinder, R 2017
, 'EVOLVE: The Australian Rheumatology Association's 'top five' list of investigations and interventions doctors and patients should question'
, Internal Medicine Journal, vol. 48, no. 2
, pp. 135-143
, doi: https://doi.org/10.1111/imj.13654.
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Abstract
Background: The EVOLVE (evaluating evidence. enhancing efficiencies) initiative aims to drive safer, higher-quality patient care through identifying and reducing low-value practices.Aims: To determine the Australian Rheumatology Association's (ARA's) 'top 5' list of low-value practices.Methods: A working group comprising 19 rheumatologists and three trainees compiled a preliminary list. Items were retained if there was strong evidence of low-value and there was high or increasing clinical use and/or increasing cost. All ARA members (356 rheumatologists and 72 trainees) were invited to indicate their 'top 5' list from a list of 12 items via MonkeySurvey in December 2015 (reminder February 2016) .Results: 179 rheumatologists (50.3%) and 19 trainees (26.4%) responded. The top 5 list (percent of rheumatologists including item in their top 5 list) was: Do not perform arthroscopy with lavage and/or debridement for symptomatic osteoarthritis of the knee nor partial meniscectomy for a degenerate meniscal tear (73.2%); Do not order ANA testing without symptoms and/or signs suggestive of a systemic rheumatic disease (56.4%); Do not undertake imaging for low back pain for patients without indications of an underlying serious condition (50.8%); Do not use ultrasound guidance to perform injections into the subacromial space as it provides no additional benefit in comparison to landmark-guided injection (50.3%); and Do not order anti dsDNA antibodies in ANA negative patients unless the clinical suspicion of SLE remains high (45.3%).Conclusions: This list is intended to increase awareness among rheumatologists, other clinicians and patients about commonly used low-value practices that should be questioned.
| Item Type: | Article |
|---|---|
| Authors/Creators: | Morrisroe, K and Nakayama, A and Soon, J and Arnold, M and Barnsley, L and Barrett, C and Brooks, PM and Hall, S and Hanrahan, P and Hissaria, P and Jones, G and Katikireddi, VS and Keen, H and Laurent, R and Nikpour, M and Poulsen, K and Robinson, P and Soden, M and Wood, N and Cook, N and Hill, C and Buchbinder, R |
| Keywords: | EVOLVE, evidence-based practice, implementation, low-value care, rheumatology |
| Journal or Publication Title: | Internal Medicine Journal |
| Publisher: | Blackwell Publishing Asia |
| ISSN: | 1444-0903 |
| DOI / ID Number: | https://doi.org/10.1111/imj.13654 |
| Copyright Information: | Copyright 2017 Internal Medicine Journal |
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| Item Statistics: | View statistics for this item |
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