Annette M Langer-Gould1, Wayne E Anderson, Melissa J Armstrong, Adam B Cohen, Matthew A Eccher, Donald J Iverson, Sonja B Potrebic, Amanda Becker, Rod Larson, Alicia Gedan, Thomas S D Getchius, Gary S Gronseth. 1. From the Neurology Department, Los Angeles Medical Center (A.M.L.-G.), Southern California Kaiser Permanente Medical Group (S.B.P.), Los Angeles; Department of Research & Evaluation (A.M.L.-G.), Kaiser Permanente Southern California, Pasadena; California Pacific Neurosciences Institute (W.E.A.), San Francisco; Department of Neurology (M.J.A.), University of Maryland School of Medicine, Baltimore; Massachusetts General Hospital (A.B.C.), Harvard Medical School, Cambridge; Geisinger Medical Center (M.A.E.), Danville, PA; Humboldt Neurological Medical Group, Inc. (D.J.I.), Eureka, CA; American Academy of Neurology (A.B., R.L., A.G., T.G.), Minneapolis, MN; and University of Kansas Medical Center (G.S.G.), Kansas City.
Abstract
OBJECTIVE: To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. METHODS: A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. RESULTS AND RECOMMENDATIONS: The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).
OBJECTIVE: To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. METHODS: A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. RESULTS AND RECOMMENDATIONS: The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).
Authors: John N Mafi; Samuel T Edwards; Nigel P Pedersen; Roger B Davis; Ellen P McCarthy; Bruce E Landon Journal: J Gen Intern Med Date: 2015-01-08 Impact factor: 5.128
Authors: Jeffrey L Jackson; Josephine M Mancuso; Sarah Nickoloff; Rebecca Bernstein; Cynthia Kay Journal: J Gen Intern Med Date: 2017-07-18 Impact factor: 5.128