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!
New ways to test high-risk medical devices.
Manufacturers of medical devices need to test their products before being allowed to market them. Specifically, they require clinical data showing their medical device is safe and efficient. In this context, the EU-funded CORE-MD project will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators. The project will propose how new trial designs can contribute and suggest ways to aggregate real-world data from medical device registries.
It will also conduct multidisciplinary workshops to propose a hierarchy of levels of evidence from clinical investigations, as well as educational and training objectives for all stakeholders, to build expertise in regulatory science in Europe. CORE–MD will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators, to achieve an appropriate balance between innovation, safety, and effectiveness. A unique collaboration between medical associations, regulatory agencies, notified bodies, academic institutions, patients’ groups, and health technology assessment agencies, will systematically review methodologies for the clinical investigation of high-risk medical devices, recommend how new trial designs can contribute, and advise on methods for aggregating real-world data from medical device registries with experience from clinical practice The consortium is led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, and involves all 33 specialist medical associations that are members of the Biomedical Alliance in Europe.
