“Choosing Wisely” in Paediatrics

EAP is preparing its contribution to the “Choosing Wisely” campaign, a growing action targeted at physicians and the general public to reduce overdiagnosis and overtreatment instances. The campaign started 2012 in the United States (registered by the ABIM Foundation), and currently comprises several countries and multiple medical specialities. Some countries have renamed the campaign, such as Switzerland (“Smarter Medicine”), Australia and New Zealand (“EVOLVE”), or the Netherlands (“Awareness Project).

Studies have shown an estimated overuse of medical expenditure up to 30%, a value which is similar in all highly developed countries. To our knowledge, few European countries have a paediatric-specific “Choosing Wisely” list. Children and young people, as a vulnerable patient group, deserve a thorough evaluation of tests and treatments in order to avoid unnecessary or harmful procedures. It is the role of the physician to guide and advise patients and their parents on the most effective and least harmful care option. This can only be done by promoting meaningful and informed conversations between physicians and patients and their parents, so that paediatricians can rebut the idea that “more care is better care”.

These lists are neither quality indicators, nor intended to cut expenditures in healthcare. Unfortunately, it is still challenging to measure outcomes in all existing lists. This is mainly due to the fact that there is no baseline for waste; and that it’s hard to measure complications and inappropriate use of tests.

EAP’s goal is to form a paediatric-specific “Choosing Wisely” list, which can then be adapted to each country’s needs. Moreover, we do not want this to be a solely physician-driven campaign: other paediatric healthcare workers, as well as also patients their families, should be included. Since many European countries rely on General Practitioners (GPS) for child healthcare, their needs and concerns must also be taken into account.

 As a first step, EAP would like to conduct a short survey with our member societies to gather all information about ongoing or finalised “Choosing Wisely” programmes, or similar paediatric campaigns, in Europe. If you would like to participate actively in this important and interesting topic, please contact Corinne Wyder, EAP Swiss Delegate (wyder@kurwerk.ch).

More information about paediatric-centred “Chosing Wisely” campaign can be found at Choosing Wisely Canada and on the website of the American Academy of Pediatrics.

Keep checking the EAP Newsletter for further updates!

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