Welcome to Choosing Wisely in West Virginia
More health care is not always better health care. Some tests, procedures and drugs are ineffective and can actually do harm. For example, taking antibiotics for viral infections like colds and most sinus infections is ineffective since antibiotics have no effect on viruses. The wrong use of antibiotics can have serious side effects for the patient and is creating new antibiotic resistant bacteria.
Choosing Wisely is a national initiative to educate providers and patients on the appropriate use of health care services. Under the leadership of the American Board of Internal Medicine (ABIM) Foundation, more than 60 physician and nursing organizations have each identified at least five tests, procedures or drugs in their area of expertise that have questionable value. Altogether, more than 250 tests, procedures and drugs have been identified as having low-value and should be ordered only after an informed discussion between the provider and the patient. All of these low-value tests, procedures and drugs have been selected by a health care provider organization based on current clinical evidence.
Choosing Wisely in West Virginia is a group of diverse organizations that is partnering with the national effort to promote high value health care in the state. It includes physicians, nurses, other health care providers, consumers, state agencies and payers.
Consumer Reports has partnered with the ABIM Foundation to produce over thirty summaries of the questionable tests, procedures and drugs. These summaries are valuable tools for medical providers to use with their patients on why a test, procedure or drug is inappropriate and the potentially adverse consequences. Summaries may be accessed by clicking on the tabs to the left. They may be printed and distributed for free. However, they may not be used for commercial purposes.
Consumers Reports has also developed five questions patients should ask their health care provider to ensure the right care is delivered at the right time.
- Do I really need this test, procedure or drug?
- What are the risks? Ask about side effects and the chances of getting inaccurate tests results.
- Are there simpler, safer options? A lifestyle change may help.
- What happens if I don’t do anything? Ask if your condition might get worse – or better – if you don’t have a test, procedure or drug.
- How much does it cost? Ask if insurance will cover the treatment. Are there less-expensive tests, treatments or procedures? Ask about generic drugs instead of brand-name drugs.
Patients and health care providers working together and having meaningful discussions on the appropriate and wise use of health care can improve the quality of health care and contain cost. It’s in everyone’s best interest to begin this important process.
The Choosing Wisely in West Virginia is funded by generous grants from the Claude Worthington Benedum Foundation and the Sisters of St. Joseph Charitable Fund.
For information about this campaign, contact Terri Giles.
Antibiotic Stewardship
Antibiotics have saved millions of lives. But in the future they might not work, because all of us — patients and doctors — are using too many antibiotics.
Antibiotics: When You Need Them and When You Don’t
Antibiotics for Ear Infections in Children (AAFP)
Antibiotics For Pink Eye (AAO)
Antibiotics for Respiratory Illness in Children (AAP)
Antibiotics for Urinary Tract Infections in Older People (AGS)
Antibiotics For Your Skin (AAD)
Oral Antibiotics for Ear Infections (AAO-HNSF)
Tests
Choosing Wisely helps doctors and patients together avoid needless and even harmful procedures.
Each PDF file may be read here, printed or downloaded to the user’s own device.
- Plain English: Allergy Tests
- Spanish: Pruebas para Alergias
- Plain English: Alzheimer’s Disease Testing (SNMMI)
- Spanish: Pruebas para la enfermedad de Alzheimer
- Plain English: Blood Tests for Miscarriage Risk (SMFM)
- Spanish: Pruebas de sangre para mostrar el riesgo de un aborto espontáneo
- Plain English: Blood Tests in the Hospital (SHM)
- Spanish: Pruebas de sangre cuando usted está en el hospital
- English: Cancer Tests and Treatments (ASCO)
- Plain English: Cervical Cancer Screening
- Spanish: Prueba de detección de cáncer cervical
- Plain English: Echocardiography for Heart Valve Disease
- Spanish: Ecocardiografía para valvulopatías cardíacas
- Plain English: EKGs and Exercise Stress Tests
- Spanish: Los electrocardiogramas (ECG) (EKG) y las pruebas de esfuerzo durante el ejercicio
- Plain English: Health Checkups (SGIM)
- Spanish: Exámenes médicos
- Plain English: HIV: When You Need CD4 Tests
- Spanish: Virus de inmunodeficiencia humana (HIV)
- Plain English: Imaging and Blood Tests in Early Breast Cancer (ASCO)
- Spanish: Pruebas de marcadores tumorales y de imágenes para el cáncer de seno
- Plain English: Lab Tests Before Surgery (ASCP)
- Spanish: Pruebas de laboratorio antes de una cirugía
- Plain English: Lyme Disease Tests (ACR)
- Spanish: Pruebas para la Enfermedad de Lyme
- Plain English: Making Smart Decisions About Genetic Testing (ACMG)
- Spanish: Cómo tomar decisiones inteligentes sobre las pruebas genéticas
- Plain English: Medical Tests Before Eye Surgery
- Lower Literacy: Medical Tests Before Eye Surgery
- Spanish: Pruebas médicas antes de una cirugía de ojo
- Lower Literacy Spanish: Hazte exámenes médicos antes de una cirugía de ojos, pero solo si lo necesitas
- Plain English: Medical Tests Before Surgery - When You Need Them, and When You Don't
- Spanish: Pruebas médicas antes de una cirugía
- Plain English: Neck and Back Pain: When You Need Tests (AANEM)
- Spanish: Dolor de cuello y espalda
- Plain English: Pap Tests
- Lower Literacy: Pap Tests
- Spanish: Pruebas de Papanicolaou
- Lower Literacy Spanish: Hazte una prueba de Papanicolau, pero solo cuando la necesites
- Plain English: PSA Test for Prostate Cancer (AAFP)
- Spanish: La prueba de sangre PSA para detectar cáncer de próstata
- Plain English: PSA Tests for Prostate Cancer (AUA)
- Spanish: Las pruebas de sangre del antígeno prostático específico o PSA para el cáncer de próstata
- Plain English: Screening Tests for Ovarian Cancer (SGO)
- Spanish: Exámenes de detección para el cáncer de ovario
- Plain English: Screening Tests: When You Need Them, When You Don't
- Spanish: Pruebas de detección
- Plain English: Spirometry for Asthma
- Spanish: Espirometría para el asma
- Plain English: Stress Tests After a Stent Procedure (SCAI)
- Spanish: Pruebas de esfuerzo después de un procedimiento de endoprótesis o colocación de stent
- Plain English: Stress Tests Before Surgery
- Lower Literacy: Stress Tests Before Surgery
- Spanish: Pruebas de esfuerzo del corazón antes de una cirugía
- Lower Literacy Spanish: Hazte una prueba de esfuerzo cardíaco antes de una cirugía, pero solo si la necesitas
- Plain English: Stress Tests for Chest Pain
- Spanish: Pruebas de esfuerzo para el dolor de pecho
- Plain English: Testing after heart procedures
- Spanish: Pruebas después de procedimientos cardíacos
- Plain English: Tests Before Heart Surgery (STS)
- Spanish: Pruebas antes de una cirugía del corazón
- Plain English: Urinary Tract Infections in Older People (AGS, AMDA)
- Spanish: Pruebas y tratamientos para infecciones de las vías urinarias (UTI) en personas mayores
- Plain English: Vitamin D Tests
- Lower Literacy: Vitamin D Tests
- Spanish: Pruebas de Vitamina D
- Lower Literacy Spanish: Obtén una prueba de vitamina D, pero solo si la necesitas
Allergy Tests (AAAAI)
If you don’t have symptoms or a medical evaluation that points to allergy, think twice about skin or blood tests.
Alzheimer’s Disease Testing (SNMMI)
If you're having memory problems, your doctor should look for other causes before ordering a brain scan.
Blood Tests for Miscarriage Risk (SMFM)
Blood tests for thrombophilia often are not needed, even if you have had a pregnancy problem.
Blood Tests in the Hospital (SHM)
In the hospital, if your blood test results stay the same after a day or two, you may not need them again.
Cancer Tests and Treatments (ASCO)
Some tests, treatments, and procedures are not only unnecessary, they can even prove harmful.
Cervical Cancer Screening (ASCCP)
Young women with an abnormal Pap test don’t always need to be treated right away.
Echocardiography for Heart Valve Disease (ACC)
When do you need an echocardiogram?
EKGs and Exercise Stress Tests (AAFP)
EKGs or exercise stress tests usually aren't necessary for people without symptoms.
Health Checkups (SGIM)
You probably don't need that yearly checkup. In fact, it can do more harm than good.
HIV: When You Need CD4 Tests (HIVMA)
If your treatment for HIV is working well, you usually need the CD4 count less often, if at all. Here’s why.
Imaging and Blood Tests in Early Breast Cancer (ASCO)
When do cancer experts recommend imaging tests and tumor marker tests?
Lab Tests Before Surgery (ASCP)
Most healthy people don't need blood or urine tests done before surgery, especially low-risk surgery. Here's why.
Lyme Disease Tests (ACR)
There are two blood tests for Lyme disease, but usually you don't need them. Here's why.
Making Smart Decisions About Genetic Testing (ACMG)
Sometimes a genetic test is not the best way to find an inherited condition or disease risk.
Medical Tests Before Eye Surgery (AAO)
Most people don't need to have their blood tested or their heart checked before they have eye surgery. Here's why.
Medical Tests Before Surgery
Often, pre-operative tests are not necessary. It is not a good idea to get them just because you’re having surgery.
Neck and Back Pain: When You Need Tests (AANEM)
If the symptoms are severe or continue for a while, you may need an electrodiagnostic test.
Pap Tests (AAFP)
Many teenage girls and some women have the test when they don’t need it. Here’s why.
PSA Test for Prostate Cancer (AAFP)
The PSA screening test is widely used, but often is not needed.
PSA Tests for Prostate Cancer (AUA)
The PSA test is the only available screening test for prostate cancer, but it can have serious risks.
Screening Tests for Ovarian Cancer (SGO)
Ultrasound and the CA-125 blood test are not useful for screening low-risk women for ovarian cancer.
Screening Tests: When You Need Them, When You Don’t
It’s important to know which tests you need, and how often you need them.
Spirometry for Asthma (AAAAI)
Many people who need the test don’t receive it.
Stress Tests After a Stent Procedure (SCAI)
Stress tests usually aren’t helpful after a stent procedure, unless you have symptoms of heart disease.
Stress Tests Before Surgery (SVM)
If you’re having surgery, you will probably not need a heart stress test beforehand if you are healthy, active, and feeling well, or if you’re having minor surgery.
Stress Tests for Chest Pain (ASNC)
If you’re at low risk for having a heart problem, even if you have symptoms, you usually don’t need this imaging test.
Testing After Heart Procedures (ASNC)
Unless you're experiencing symptoms, this test usually isn't helpful in the first few years after heart bypass surgery or a stent procedure.
Tests Before Heart Surgery (STS)
Before heart surgery, you probably don't need a breathing test or carotid ultrasound test, unless you have breathing problems or symptoms.
Urinary Tract Infections in Older People (AGS, AMDA)
Older adults are often tested for UTIs. But if you don’t have symptoms, the tests are not very useful.
Vitamin D Tests (ASCP)
Doctors often order a blood test to measure your vitamin D, but the results are unlikely to change their advice.
Imaging
Choosing Wisely helps doctors and patients together avoid needless and even harmful procedures.
Each PDF file may be read here, printed or downloaded to the user’s own device.
- Plain English: Bone-Density Tests
- Lower Literacy: Bone-Density Tests
- Spanish: Pruebas de Densidad de los Huesos
- Lower Literacy Spanish: Realízate una densitometría ósea, pero solo si la necesitas
- Plain English: Brain Scans for Head Injuries
- Spanish: Las tomografías del cerebro para las lesiones de la cabeza
- Plain English: Cardiac Imaging Stress Tests
- Spanish: Pruebas de esfuerzo con imágenes
- Plain English: Chest X-rays Before Surgery
- Spanish: Radiografía del tórax antes de una cirugía
- Video: Do You Need a Chest X-ray Before Surgery?
- Plain English: Clogged Neck Arteries (AAFP)
- Spanish: Arterias del cuello obstruidas
- Plain English: CMR Tests for Chest Pain and Cardiac Screening (SCMR)
- Spanish: Pruebas de CMR para el dolor de pecho y examen cardíaco
- Plain English: CT Scans for Children With Head Injuries (AAP)
- Spanish: Tomografías (CT scans) para niños con lesiones en la cabeza
- Plain English: CT Scans in the Emergency Department
- Plain English: CT Scans in the Emergency Department (for printer)
- Spanish: CT scans en el departamento de emergencias
- Spanish: CT scans en el departamento de emergencias (for printer)
- Plain English: CT Scans to Find Lung Cancer in Smokers (CHEST/ATS)
- Spanish: Tomografías (CT scans) para detectar cáncer de pulmón en fumadores
- Plain English: Do You Need a CT Scan for a Head Injury?
- Plain English: Do You Need a CT Scan for a Head Injury? (for printer)
- Spanish: ¿Necesita una tomografía computarizada (CT scan) por una lesión en la cabeza?
- Spanish: ¿Necesita una tomografía computarizada (CT scan) por una lesión en la cabeza? (for printer)
- Plain English: Echocardiogram Before Surgery (ASE)
- Spanish: Un ecocardiograma antes de una cirugía
- Plain English: Echocardiography After Valve Surgery (STS)
- Spanish: Un ecocardiograma después de una cirugía para reemplazar una válvula cardíaca
- Plain English: Echocardiography for Heart Valve Disease
- Spanish: Ecocardiografía para valvulopatías cardíacas
- Plain English: Five Ways to be Smart About Back Pain
- Plain English: Five Ways to be Smart About Back Pain (for printer)
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente (for printer)
- Plain English: Five Ways to be Smart About Back Pain
- Plain English: Five Ways to be Smart About Back Pain (for printer)
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente (for printer)
- Plain English: Heart Imaging Before Surgery
- Spanish: Pruebas de imágenes del corazón antes de una cirugía
- Plain English: Heart Imaging Tests Before Surgery
- Spanish: Pruebas de imágenes del corazón antes de una cirugía
- Plain English: Heart Stress Tests Before Chest Surgery (STS)
- Spanish: Pruebas de esfuerzo del corazón antes de una cirugía de tórax
- Plain English: Imaging and Blood Tests in Early Breast Cancer (ASCO)
- Spanish: Pruebas de marcadores tumorales y de imágenes para el cáncer de seno
- Plain English: Imaging for Headaches
- Plain English: Imaging for Headaches (for printer)
- Spanish: Pruebas de imagen por dolores de cabeza
- Spanish: Pruebas de imagen por dolores de cabeza (for printer)
- Plain English: Imaging for Hearing Problems
- Spanish: Problemas auditivos
- Plain English: Imaging Tests After a Heart Procedure (ACC)
- Spanish: Pruebas de imágenes después de un procedimiento cardíaco
- Plain English: Imaging Tests for Back Pain
- Lower Literacy: Imaging Tests for Back Pain
- Spanish: Pruebas radiológicas debido a dolor en la parte baja de la espalda
- Lower Literacy Spanish: ¿Tienes dolor en la espalda baja?
- Plain English: Imaging Tests for Colorectal Cancer
- Spanish: Pruebas de imágenes para el cáncer colorrectal
- Plain English: Imaging Tests for Early Prostate Cancer (ASCO)
- Spanish: Pruebas de imágenes para el cáncer de próstata en su etapa temprana
- Plain English: Imaging Tests for Headaches (ACR)
- Spanish: Pruebas de imágenes para dolores de cabeza
- Plain English: Imaging Tests for Heart Disease
- Spanish: Pruebas de Imágenes para la enfermedad cardíaca
- Plain English: Imaging Tests for Lower-Back Pain
- Spanish: Pruebas radiológicas debido a dolor en la parte baja de la espalda
- Plain English: Imaging Tests for Melanoma
- Spanish: Pruebas de imágenes para el melanoma
- Plain English: Imaging Tests for Ovarian Cysts
- Spanish: Pruebas de imágenes para quistes ováricos
- Plain English: Does your lower back hurt?
- Plain English: Does your lower back hurt? (For printer)
- Spanish: ¿Le duele la parte baja de la espalda?
- Spanish: ¿Le duele la parte baja de la espalda? (For printer)
- Plain English: PET Scans After Cancer Treatment (ASCO)
- Spanish: Tomografías (PET scans) después del tratamiento contra el cáncer
- Plain English: Screening Tests for Brain Aneurysms
- Spanish: Pruebas de detección para aneurismas cerebrales
- Plain English: When You Need a CT Scan to Check for a Blood Clot in Your Lungs
- Plain English: When You Need a CT Scan to Check for a Blood Clot in Your Lungs (for printer)
- Spanish: Cuándo necesita una CT scan para saber si tiene un coágulo en los pulmones
- Spanish: Cuándo necesita una CT scan para saber si tiene un coágulo en los pulmones (for printer)
- Plain English: Whole-Body Scans to Screen for Cancer (ACPM)
- Spanish: Tomografías de todo el cuerpo para detectar cáncer
- Plain English: Why the Doctor May Not Order a CT Scan for Kidney Stones
- Plain English: Why the Doctor May Not Order a CT Scan for Kidney Stones (for printer)
- Spanish: Por qué el médico podría decidir no hacerle una CT scan para saber si tiene piedras en el riñón
- Spanish: Por qué el médico podría decidir no hacerle una CT scan para saber si tiene piedras en el riñón (for printer)
Bone-Density Tests (AAFP)
If you’re not at higher risk for weak bones, you should think twice about the bone-density test. Here’s why.
Brain Scans for Head Injuries (AMSSM)
Brain scans are usually not helpful for a concussion.
Cardiac Imaging Stress Tests (ASNC)
In some cases, especially in healthy people without chest pain, you should be cautious about the tests.
Chest X-rays Before Surgery (ACR)
If you don’t have signs or symptoms of heart or lung disease, think twice about having a pre-operative X-ray.
Clogged Neck Arteries (AAFP)
Do you need a screening test for clogged neck arteries?
CMR Tests for Chest Pain and Cardiac Screening (SCMR)
CMR is an imaging test for heart disease. But it may not be the best test for you.
CT Scans for Children With Head Injuries (AAP)
For children with head injuries, a CT scan often is not needed.
CT Scans in the Emergency Department (ACEP)
They may not be needed as often as you think.
CT Scans to Find Lung Cancer in Smokers (CHEST/ATS)
The CT scan, used to look for early signs of lung cancer, is not useful for many smokers.
Do You Need a CT Scan for a Head Injury? (ACEP)
A health history and physical exam can help the doctor decide if you need a Computerized Tomography (CT) scan.
Echocardiogram Before Surgery (ASE)
If you’re having surgery, you may wonder if you need an echocardiogram first.
Echocardiography After Valve Surgery (STS)
Sometimes the echocardiogram imaging test is done very soon after heart valve surgery, while you are still in the hospital. Usually that's not useful.
Echocardiography for Heart Valve Disease (ACC)
When do you need an echocardiogram?
Five Ways to be Smart About Back Pain (large poster)
Don’t rush to MRIs, CT scans or X-rays for back pain.
Five Ways to be Smart About Back Pain (small poster)
Don’t rush to MRIs, CT scans or X-rays for back pain.
Heart Imaging Before Surgery (ACC)
If you’re having surgery, you may wonder if you need a heart imaging test first to make sure it is safe.
Heart Imaging Tests Before Surgery (ASNC)
If you don't have heart problems, you probably don't need a heart test before an operation.
Heart Stress Tests Before Chest Surgery (STS)
Stress tests usually aren’t helpful if you don’t have heart problems.
Imaging and Blood Tests in Early Breast Cancer (ASCO)
When do cancer experts recommend imaging tests and tumor marker tests?
Imaging for Headaches (rack card)
Imaging tests usually don’t show why you’re having headaches, and they won’t ease your pain.
Imaging for Hearing Problems (AAO-HNSF)
For tinnitus or sudden hearing loss, imaging tests such as CT scans or MRIs can be unnecessary, costly, or even harmful.
Imaging Tests After a Heart Procedure (ACC)
If you’ve had bypass surgery or a stent inserted to open a blocked artery, do you need regular imaging tests?
Imaging Tests for Back Pain (AAFP)
It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.
Imaging Tests for Colorectal Cancer (SSO)
Imaging tests for colorectal cancer use radiation, may be costly, and may not change how you are treated. Your doctor should only order tests if they are needed.
Imaging Tests for Early Prostate Cancer (ASCO)
It's not always a good idea to get all the tests that are available. You may not need them.
Imaging Tests for Headaches (ACR)
Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.
Imaging Tests for Heart Disease (ACC)
If you are a healthy person without symptoms, you should think twice about having these tests.
Imaging Tests for Lower-Back Pain (NASS)
You may think you need an X-ray, MRI or CT scan to find out what is causing your back pain. But these imaging tests usually don’t help.
Imaging Tests for Melanoma (SSO)
Imaging tests usually don’t help if you have early-stage skin cancer. Here’s why.
Imaging Tests for Ovarian Cysts (ACR)
Repetitive ultrasound exams may not be necessary.
Lower Back Pain (rack card)
Does your lower back hurt? You probably don’t need an MRI, CT scan, or X-ray.
PET Scans After Cancer Treatment (ASCO)
If you've been treated for cancer, you may not need PET scans to check for a return of the cancer.
Screening Tests for Brain Aneurysms (AANS)
Screening healthy people for weak areas in the brain's blood vessels can do more harm than good.
When You Need a CT Scan to Check for a Blood Clot in Your Lungs (ACEP)
If you have most of the signs and risk factors for a blood clot in your lungs, it may be wise to have a CT scan. If not, you may receive a D-dimer blood test first.
Whole-Body Scans to Screen for Cancer (ACPM)
No medical society recommends whole-body scans. There is no evidence that they are a good screening tool.
Why the Doctor May Not Order a CT Scan for Kidney Stones (ACEP)
For most people, a urine test, blood test and health history are all that's needed to diagnose kidney stones.
Drugs
Choosing Wisely helps doctors and patients together avoid needless and even harmful procedures.
Each PDF file may be read here, printed or downloaded to the user’s own device.
- Plain English: Antibiotic Treatment in the Hospital (SHEA)
- Spanish: Tratamiento antibiótico en el hospital
- Plain English: Five Questions to Ask Your Doctor Before You Take Antibiotics
- Plain English: Five Questions to Ask Your Doctor Before You Take Antibiotics (for printer)
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos (for printer)
- Plain English: Five Questions to Ask Your Doctor Before You Take Antibiotics
- Plain English: Five Questions to Ask Your Doctor Before You Take Antibiotics (for printer)
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos (for printer)
- Plain English: Antibiotics for Ear Infections in Children (AAFP)
- Spanish: Antibióticos para infecciones del oído en niños
- Plain English: Antibiotics for People With Catheters (AUA)
- Spanish: Antibióticos para personas con sondas
- Plain English: Antibiotics for Pink Eye (AAO)
- Spanish: Antibióticos para la conjuntivitis
- Plain English: Antibiotics for Respiratory Illness in Adults
- Lower Literacy: Can Antibiotics Help You Feel Better?
- Spanish: Resfriados, influenza y otras enfermedades respiratorias en adultos
- Lower Literacy Spanish: ¿Pueden los antibióticos ayudarte a sentirte mejor?
- Plain English: Antibiotics for Respiratory Illness in Children (AAP)
- Spanish: Antibióticos para garganta irritada, tos o nariz tapada
- Plain English: Antibiotics for Urinary Tract Infections in Older People (AGS)
- Spanish: Antibióticos para las infecciones de las vías urinarias en personas mayores
- Plain English: Antibiotics For Your Skin
- Plain English: Antibiotics For Your Skin (for printer)
- Spanish: Antibióticos para la piel
- Spanish: Antibióticos para la piel (for printer)
- Plain English: Antibiotics: When You Need Them and When You Don't
- Spanish: Antibióticos: Cuándo se necesitan y cuándo no
- Plain English: Antibiotics: Will They Help You or Hurt You?
- Plain English: Antibiotics: Will They Help You or Hurt You? (For offset printing)
- Spanish: Antibióticos: ¿Te ayudarán o te harán daño?
- Spanish: Antibióticos: ¿Te ayudarán o te harán daño? (For offset printing)
- Plain English: Treating disruptive behavior in people with dementia
- Spanish: Tratamiento del comportamiento problemático en personas con demencia
- Plain English: Avoid Opioids for Most Long-Term Pain
- Plain English: Avoid Opioids for Most Long-Term Pain (for printer)
- Lower Literacy: Avoid Opioids for Most Long-Term Pain
- Spanish: Evite los opioides contra casi todos los dolores de larga duración
- Spanish: Evite los opioides contra casi todos los dolores de larga duración (for printer)
- Plain English: Cholesterol Drugs for People Over 75 (AMDA)
- Spanish: Medicamentos para el colesterol para personas mayores de 75 años
- Plain English: Diabetes Tests and Treatments
- Plain English: Diabetes Tests and Treatments (for printer)
- Spanish: Pruebas y tratamientos para la diabetes
- Spanish: Pruebas y tratamientos para la diabetes (for printer)
- Plain English: Dietary Supplements to Prevent Heart Disease or Cancer (ACPM)
- Spanish: Suplementos dietéticos para prevenir la enfermedad cardíaca o el cáncer
- Plain English: Drugs for Migraine Headaches
- Spanish: Tratamiento de migrañas
- Plain English: Drugs for Rheumatoid Arthritis
- Spanish: Cómo tratar la artritis reumatoide
- Plain English: Drugs to Prevent Infection During Chemotherapy (ASCO)
- Spanish: Medicamentos para aumentar los glóbulos blancos en pacientes con cáncer que reciben quimioterapia
- Plain English: 5 Questions to Ask Your Doctor Before You Take Antibiotics
- Plain English: 5 Questions to Ask Your Doctor Before You Take Antibiotics (For Printer)
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Plain English: 5 Questions to Ask Your Doctor Before You Take Antibiotics
- Plain English: 5 Questions to Ask Your Doctor Before You Take Antibiotics (For Printer)
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Plain English: Medicines to Relieve Chronic Pain (ASA)
- Spanish: Medicinas para aliviar el dolor crónico
- Plain English: Medicines to Treat Cancer (ASCO)
- Spanish: Medicinas para tratar el cáncer
- Plain English: Opioids for Pain
- Plain English: Opioids for Pain (for printer)
- Spanish: ¿Tienes dolor constante que no es por cáncer o una enfermedad terminal?
- Spanish: ¿Tienes dolor constante que no es por cáncer o una enfermedad terminal? (for printer)
- Plain English: Oral Antibiotics for Ear Infections (AAO-HNSF)
- Spanish: Antibióticos orales para las infecciones del oído
- Plain English: Painkiller Choices With Kidney or Heart Problems (ASN)
- Spanish: Medicinas para el dolor
- Plain English: Preventing Seizures After an Ischemic Stroke (AANS, CNS)
- Spanish: Prevención de convulsiones después de un ataque cerebral isquémico
- Plain English: Sleeping Pills for Children With Insomnia (AASM)
- Spanish: Evite dar somníferos a los niños con insomnio
- Plain English: Sleeping Pills for Insomnia (AASM)
- Spanish: Las pastillas para dormir para el insomnio
- Plain English: Sleeping Pills for Insomnia and Anxiety in Older People
- Lower Literacy: Sleeping Pills for Insomnia and Anxiety in Older People
- Spanish: Insomnio y ansiedad en personas mayores
- Lower Literacy Spanish: Las píldoras para dormir podrían tener riesgos para los adultos mayores
- Plain English: Supplements for Osteoarthritis (AAOS)
- Spanish: El tratamiento de la osteoartritis de la rodilla
- Plain English: Taking Medicines Safely
- Spanish: Cómo tomar medicinas de forma segura
- Plain English: Testosterone for Erection Problems (AUA)
- Spanish: Tratamiento para los problemas de erección
- Plain English: Think Your Child Needs Antibiotics?
- Plain English: Think your child needs antibiotics? (For printing)
- Spanish: ¿Crees que tu hijo necesita antibióticos?
- Spanish: ¿Crees que tu hijo necesita antibióticos? (For printing)
- Plain English: Treating Heartburn and GERD
- Spanish: Cómo tratar las agruras y la enfermedad de reflujo gastroesofágico
- Plain English: Treating Sinusitis
- Spanish: Cómo tratar la sinusitis
- Video: Para tratar la sinusitis
- Video: Treating sinusitis
- Plain English: Treating Sinus Problems
- Spanish: Cómo tratar la sinusitis
- Video: Treating Sinusitis
- Video: Para tratar la sinusitis
- Plain English: Treating Sleep Problems (APA)
- Spanish: Tratamiento de problemas del sueño
- Plain English: Using Opioids Safely After Surgery
- Spanish: El uso seguro de los opioides después de una cirugía
- Plain English: You May Not Need Antibiotics for Your Skin
- Plain English: You May Not Need Antibiotics for Your Skin (for printer, small)
- Plain English: You May Not Need Antibiotics for Your Skin (for printer, large)
- Spanish: Usted podría no necesitar antibióticos para la piel
- Spanish: Usted podría no necesitar antibióticos para la piel (for printer, small)
- Spanish: Usted podría no necesitar antibióticos para la piel (for printer, large)
Antibiotic Treatment in the Hospital (SHEA)
The CDC is urging hospitals to cut back on the use of antibiotics when they are not needed. Here's what you should know.
Antibiotics (rack card)
Have a sore throat, cough, or runny nose? You probably don’t need antibiotics.
Antibiotics (rack card) (for children)
Does your child have a sore throat, cough, or runny nose? They probably don’t need antibiotics.
Antibiotics for Ear Infections in Children (AAFP)
In most cases of middle ear infection, antibiotics are not needed. Here's what to do instead.
Antibiotics for People With Catheters (AUA)
Almost all people who have catheters have some bacteria in their urine. But that doesn’t mean they all need antibiotics.
Antibiotics for Pink Eye (AAO)
Antibiotic eye drops or ointments don’t usually help with conjunctivitis. In fact, they can do more harm than good.
Antibiotics for Respiratory Illness in Adults (IDSA)
Antibiotics don’t help most respiratory infections. Here’s when you need antibiotics, and when you don't.
Antibiotics for Respiratory Illness in Children (AAP)
Most of the time, children don't need antibiotics for sore throat, cough or runny nose.
Antibiotics for Urinary Tract Infections in Older People (AGS)
Many older people get antibiotic treatment for urinary tract infections when they don't need it.
Antibiotics for Your Skin (AAD)
Some skin problems don’t stem from infections at all. So treating them with antibiotics can do more harm than good.
Antibiotics: When You Need Them and When You Don’t
When and how to use antibiotics to help you and your loved ones avoid drug resistance.
Antibiotics: Will They Help You or Hurt You?
Do you really need antibiotics? They can help you. But they also can harm you.
Antipsychotic Drugs for People with Dementia (AGS)
Powerful antipsychotic drugs should not be the first choice for people with dementia. Here's why.
Avoid Opioids for Most Long-Term Pain
In this guide you can read what the experts say about using opioids.
Cholesterol Drugs for People Over 75 (AMDA)
If you are age 75 or older and you haven’t had symptoms of heart disease, statins may be a bad idea.
Diabetes Tests and Treatments
If you have diabetes, when do you need to test your own glucose levels, and when do you need to take medication?
Dietary Supplements to Prevent Heart Disease or Cancer (ACPM)
Research shows that most people don't benefit from taking supplements to prevent heart disease or cancer.
Drugs for Migraine Headaches (AAN)
Think twice about treating migraine attacks with opioids or butalbital.
Drugs for Rheumatoid Arthritis (ACR)
The older, "non-biologic" drugs are a better first choice for treating rheumatoid arthritis.
Drugs to Prevent Infection During Chemotherapy (ASCO)
When do you need CSFs? When don't you need them?
Five Questions to Ask Your Doctor About Antibiotics (large posters, for children)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Five Questions to Ask Your Doctor About Antibiotics (small posters, for children)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Medicines to Relieve Chronic Pain (ASA)
Opioids (narcotics) usually are not the best way to treat long-term pain like arthritis, back pain or headaches.
Medicines to Treat Cancer (ASCO)
Drugs used to treat cancer can also cause harm, and some are very expensive. Here's what to discuss with your doctor.
Opioids for Pain (rack card)
Do you have ongoing pain that is not from cancer or a terminal illness? If so, you probably don't need an opioid pain reliever.
Oral Antibiotics for Ear Infections (AAO-HNSF)
Sometimes antibiotic eardrops are safer and more effective than oral antibiotics.
Painkiller Choices With Kidney or Heart Problems (ASN)
If you suffer from high blood pressure, heart failure, or kidney disease, steer clear of some pain relievers.
Preventing Seizures After an Ischemic Stroke (AANS, CNS)
Anti-seizure medicine is not usually necessary after an ischemic stroke.
Sleeping Pills for Children With Insomnia (AASM)
Sleep drugs aren’t made for children. There are no prescription drugs approved in the U.S. to treat childhood insomnia.
Sleeping Pills for Insomnia (AASM)
Sleeping pills are often not the best option for insomnia. Here's what you need to know.
Sleeping Pills for Insomnia and Anxiety in Older People (AGS)
Older adults usually should try other non-drug treatments first, for insomnia and anxiety.
Supplements for Osteoarthritis (AAOS)
The popular supplements glucosamine and chondroitin sulfate do not help relieve arthritic knees.
Taking Medicines Safely (ASHP)
It is more precise to measure medicines in milliliters, instead of using a kitchen spoon.
Testosterone for Erection Problems (AUA)
Unless you have other symptoms of low testosterone, you should think twice about the treatment. Here's why.
Think Your Child Needs Antibiotics?
Taking antibiotics when they aren’t needed can cause dangerous side effects.
Treating Heartburn and GERD (AGA)
In most cases of heartburn a PPI isn't necessary.
Treating Sinusitis (AAAAI)
Millions of people are prescribed antibiotics each year for sinusitis.
Treating Sinusitis (AAFP)
Millions of people are prescribed antibiotics each year for sinusitis.
Treating Sleep Problems (APA)
If you have insomnia, antipsychotic drugs should not be the first choice of treatment.
Using Opioids Safely After Surgery (AUA)
If you need opioids after surgery, it is important to talk to your doctor about how to use them safely.
You May Not Need Antibiotics for Your Skin (AAD)
You may not need antibiotics for some skin problems. Ask your doctor if there is another treatment you can try instead.
Procedures
Choosing Wisely helps doctors and patients together avoid needless and even harmful procedures.
Each PDF file may be read here, printed or downloaded to the user’s own device.
- Plain English: Advice for Caregivers: Treatments and Tests for Seniors
- Spanish: Consejos para los cuidadores
- Plain English: Artery and Vein Problems
- Spanish: Problemas de las arterias y las venas
- Plain English: Ask Your Doctor: Do I Need This Cancer Test or Treatment? (ASCO)
- Spanish: Pregúntele a su médico: ¿Necesito esta prueba o tratamiento para el cáncer?
- Plain English: Back Pain Tests and Treatments (AAPM&R;)
- Spanish: Pruebas y tratamientos para el dolor de espalda
- Plain English: Bed Rest for Lower-Back Pain (NASS)
- Spanish: Tratamiento del dolor en la parte baja de la espalda
- Plain English: Blood Transfusions for Anemia in the Hospital (ASH)
- Spanish: Transfusiones de sangre para la anemia en el hospital
- Plain English: Breast Biopsy
- Spanish: Biopsia del seno
- English: Cancer Tests and Treatments (ASCO)
- Plain English: Care at the End of Life for Advanced Cancer Patients (ASCO)
- Spanish: Cuidados al fin de la vida para pacientes con cáncer avanzado
- Plain English: Carotid Artery Surgery
- Spanish: Cirugía de la arteria carótida
- Plain English: Chiropractic Spinal Care for Lower-Back Pain
- Spanish: Atención quiropráctica de la columna vertebral para dolor en la zona lumbar
- Plain English: Colonoscopy
- Spanish: Colonoscopía
- Plain English: Dental Fillings That Contain Mercury
- Spanish: Empastes dentales que contienen mercurio
- Plain English: Do You Really Need That Medical Test or Treatment?
- Plain English: Do You Really Need That Medical Test or Treatment? (for printer)
- Spanish: ¿Realmente necesitas esa prueba o tratamiento médico?
- Spanish: ¿Realmente necesitas esa prueba o tratamiento médico? (for printer)
- Plain English: Early Delivery (ACOG, AAFP)
- Spanish: Al dar a luz a su bebé
- Plain English: Feeding Tubes for People With Alzheimer’s (AGS, AAHPM)
- Spanish: Sondas de Alimentación para las personas con Alzheimer
- Plain English: Five Physical Therapy Treatments You Probably Don’t Need (APTA)
- Spanish: Terapia Física
- Plain English: Home apnea monitors for SIDs (AAP)
- Spanish: Monitores caseros para la apnea para el SIDS
- Plain English: Home Oxygen After a Hospital Stay (CHEST/ATS)
- Spanish: Oxígeno en casa después de una estadía en el hospital
- Plain English: Hospital Hazards (AAN)
- Spanish: Peligros en el hospital
- Plain English: Immunoglobulin Replacement Therapy
- Spanish: Terapia de reemplazo de IgG
- Plain English: Implanted Heart Devices at the End of Life (AAHPM)
- Spanish: Dispositivos cardíacos implantados al final de la vida
- Plain English: Kidney Disease (ASN)
- Spanish: Enfermedad Renal Crónica
- Plain English: Managing Side Effects of Cancer and its Treatments
- Spanish: Cómo controlar los efectos secundarios del cáncer y sus tratamientos
- Plain English: Monitoring Your Baby's Heartbeat During Labor (AAN)
- Spanish: Monitoreo del latido cardíaco del bebé durante el trabajo de parto
- Plain English: Overactive Bladder and Pelvic Organ Prolapse
- Spanish: Vejiga hiperactiva y prolapso de órganos pélvicos
- Plain English: Palliative Care (AAHPM)
- Spanish: Cuidados Paliativos
- Plain English: Pelvic Exams and Pap Tests Before Contraceptives (AAFP)
- Spanish: Exámenes pélvicos, exámenes de Papanicolau y anticonceptivos orales
- Plain English: Preventing Infections in the Hospital
- Spanish: Cómo prevenir las infecciones en el hospital
- Plain English: Questions to Ask Your Doctor About Radiation for Cancer (ASTRO)
- Spanish: Preguntas sobre la radiación para el cáncer
- Plain English: Radiation Therapy for Breast and Gynecologic Cancers (ASTRO)
- Spanish: La radioterapia para los cánceres ginecológicos y de seno
- Plain English: Radiation Therapy for Cancer (ASTRO)
- Spanish: La radioterapia para el cáncer
- Plain English: Sentinel Node Biopsy for Breast Cancer (CoC, NAPBC)
- Spanish: Tratamiento para el cáncer de seno
- Plain English: Stable Heart Disease (SCAI)
- Spanish: Enfermedad cardíaca estable
- Plain English: Tests and Treatments Employees May Not Need (ACOEM)
- Spanish: Pruebas y tratamientos que posiblemente sus empleados no necesiten
- Plain English: Tests and Treatments for Prostate Cancer
- Plain English: Tests and Treatments for Prostate Cancer (for printer)
- Plain English: Tests and Treatments for Prostate Cancer (for printer)
- Spanish: Exámenes y tratamientos para el cáncer de próstata
- Spanish: Exámenes y tratamientos para el cáncer de próstata )for printer)
- Plain English: Tests and Treatments for Women with Breast Cancer
- Spanish: Pruebas y tratamientos para mujeres con cáncer de seno
- Plain English: Treating Acute Blood Clots (ASH)
- Spanish: Tratamiento de coágulos sanguíneos agudos
- Plain English: Treating Blocked Leg Arteries (SVM)
- Spanish: Tratamiento de arterias obstruidas en las piernas
- Plain English: Treating Low-Risk Prostate Cancer (ASTRO)
- Spanish: Cáncer de próstata de bajo riesgo
- Plain English: Treating Plantar Fasciitis (AOFAS)
- Spanish: Tratamiento de la Fascitis Plantar
- Plain English: Treatments and Tests Your Baby May Not Need in the Hospital (AAP)
- Spanish: Tratamientos y pruebas que probablemente su bebé no necesite en el hospital
- Plain English: Unnecessary Treatments in the Emergency Room (ACEP)
- Spanish: Evite tratamientos innecesarios en la sala de emergencias
- Plain English: Vision Care for Children (AAPOS)
- Spanish: Cuidado de la vista para los niños
- Plain English: When It's Hard to Get Pregnant (ASRM)
- Spanish: Cuando es difícil embarazarse
- Plain English: Which Dental Treatments Are Right for You?
- Plain English: Which Dental Treatments Are Right for You? (for printer)
- Spanish: ¿Qué tratamientos dentales son los adecuados para usted?
- Spanish: ¿Qué tratamientos dentales son los adecuados para usted? (for printer)
Advice for Caregivers: Treatments and Tests for Seniors
Some tests and treatments won’t help older adults. They may even be harmful, especially near the end of life.
Artery and Vein Problems (SVS)
Vascular surgeons have listed four overused operations that are intended to treat vein and artery problems. If your doctor orders one of these, you should ask why.
Ask Your Doctor: Do I Need This Cancer Test or Treatment? (ASCO)
You may not need some common forms of imaging, screening tests, monitoring and drug therapy for cancer.
Back Pain Tests and Treatments (AAPM&R)
Some tests and treatments for back pain may not be right for you. That's why it is important to talk to your doctor.
Bed Rest for Lower-Back Pain (NASS)
Studies show that staying in bed longer than 48 hours won’t help with lower-back pain.
Blood Transfusions for Anemia in the Hospital (ASH)
Anemia is usually not urgent. Usually you don’t need a lot of blood. Or you may not need any blood at all.
Breast Biopsy (CoC)
In contrast with surgical or "open" biopsy, a needle biopsy is easier on the body.
Cancer Tests and Treatments (ASCO)
Some tests, treatments, and procedures are not only unnecessary, they can even prove harmful.
Care at the End of Life for Advanced Cancer Patients (ASCO)
Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.
Carotid Artery Surgery (AAN)
Having some blockage in a carotid artery doesn't automatically mean you should have artery-clearing surgery.
Chiropractic Spinal Care for Lower-Back Pain (ACA)
Most people with lower-back pain won’t need these: imaging tests; regular use of lumbar supports; or passive physical therapies.
Colonoscopy (AGA)
Even a very good test can be done too often.
Dental Fillings That Contain Mercury (ACMT, AACT)
It's not necessary to replace fillings that contain mercury.
Do You Really Need That Medical Test or Treatment? (rack card)
Sometimes doctors recommend things that aren’t needed. Sometimes they do it because their patients expect and ask for them. Before you get any medical test or treatment, ask your doctor these 5 questions.
Early Delivery (ACOG, AAFP)
To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.
Feeding Tubes for People With Alzheimer’s (AGS, AAHPM)
Feeding tubes sometimes do more harm than good. Here’s why.
Five Physical Therapy Treatments You Probably Don’t Need (APTA)
Five common physical therapy treatments can lead to harm, more tests, and greater costs.
Home Apnea Monitors for SIDs (AAP)
Home apnea monitors give little or no protection from Sudden Infant Death Syndrome.
Home Oxygen After a Hospital Stay (CHEST/ATS)
Many people who use long-term home oxygen therapy don’t need it.
Hospital Hazards (AAN)
The American Academy of Nursing has identified four hospital practices that are usually unnecessary and may harm you.
Immunoglobulin Replacement Therapy (AAAAI)
Some people receive the treatment even though they don’t need it.
Implanted Heart Devices at the End of Life (AAHPM)
An ICD helps the heart beat normally. But if you are near death, those shocks can make things worse.
Kidney Disease (ASN)
Here are four important tests and treatments you should carefully discuss with your family and doctor
Managing Side Effects of Cancer and its Treatments (AAN)
Some methods used to manage symptoms and side effects do not work. And some proven methods are often overlooked.
Monitoring Your Baby’s Heartbeat During Labor (AAN)
During labor and birth, the type of fetal heart rate monitoring called IA, for intermittent auscultation, is often the better choice.
Overactive Bladder and Pelvic Organ Prolapse (AUGS)
Here's what women should know about tests and treatments for these conditions.
Palliative Care (AAHPM)
With palliative care, you can get physical, emotional, and spiritual support at any stage of a serious illness.
Pelvic Exams and Pap Tests Before Contraceptives (AAFP)
You usually don’t need a Pap test and pelvic exam before getting birth control pills.
Preventing Infections in the Hospital (SHM)
Watch out for two overused hospital medical practices, urinary catheters and ulcer drugs.
Questions to Ask Your Doctor About Radiation for Cancer (ASTRO)
Radiation therapy can help treat cancer and the painful symptoms from tumors. But it's not always needed.
Radiation Therapy for Breast and Gynecologic Cancers (ASTRO)
When it comes to radiation therapy, sometimes less is more. Use this advice to start a conversation with your doctor about the benefits and risks.
Radiation Therapy for Cancer (ASTRO)
Here is advice for talking with your doctor about whether to use radiation as part of cancer treatment.
Sentinel Node Biopsy for Breast Cancer (CoC, NAPBC)
If you have breast cancer, there is a newer, simpler surgery to check your lymph nodes.
Stable Heart Disease (SCAI)
You may not need an angiogram if your heart disease is stable. Here's why.
Tests and Treatments Employees May Not Need (ACOEM)
Employers should consider these guidelines when sending workers or job candidates to the doctor.
Tests and Treatments for Prostate Cancer
It can be hard to know which tests and treatments to get for prostate cancer. This report pulls together the latest advice from experts.
Tests and Treatments for Women with Breast Cancer (ASBS)
If your doctor recommends one of these five procedures, ask if it’s really necessary. And ask about the risks and costs.
Treating Acute Blood Clots (ASH)
If you have a deep blood clot, you probably don't need a device called an IVC filter. They don't work better than blood-thinning drugs.
Treating Blocked Leg Arteries (SVM)
Most people with Peripheral Artery Disease won't benefit from surgery or angioplasty.
Treating Low-Risk Prostate Cancer (ASTRO)
If you have prostate cancer, but it poses a low risk to you, consider "watchful waiting."
Treating Plantar Fasciitis (AOFAS)
Some doctors recommend surgery. But that can lead to complications, and it doesn’t always work.
Treatments and Tests Your Baby May Not Need in the Hospital (AAP)
Here are some common tests and treatments a premature baby may not need.
Unnecessary Treatments in the Emergency Room (ACEP)
Three procedures commonly used in the emergency room are unnecessary in many cases.
Vision Care for Children (AAPOS)
There are several common vision tests and procedures that many children do not need.
When It’s Hard to Get Pregnant (ASRM)
Some fertility tests are not usually needed. For example, most couples don't need laparoscopies or post-coital tests.
Which Dental Treatments Are Right for You? (ADA)
Here are some facts about common dental treatments. Ask your dentist which treatments are best for you and your family.
Choosing Wisely in Kanawha County
Thanks to a generous grant from The Greater Kanawha Valley Foundation, West Virginians for Affordable Health Care has begun a pilot project called Choosing Wisely in Kanawha County.
Medical, nursing and health care organizations are invited to become Partner Organizations in the initiative, and promote participation by their members. Organizations interested in joining this quality improvement initiative can become a Partner Organization by clicking here and completing the form.
Individual clinical practitioners are invited to become Participating Providers. Participating Providers will be asked to help evaluate the Choosing Wisely process. Their input will aid in the further development of the Choosing Wisely in West Virginia initiative.
Participating Providers will:
- Receive Choosing Wisely material to engage patients in a dialogue about using health care appropriately to improve quality and contain cost.
- Be recognized as a Participating Provider in Choosing Wisely in Kanawha County’s printed materials, on the website, and, possibly, in the news media.
- Complete a short online survey about their experience with the initiative. This survey will be conducted three to six months after participation begins.
Our success depends on the participation of clinical providers in Kanawha County. Please consider becoming a Participating Provider and helping to evaluate the effectiveness of this process. If you are interested in becoming a Participating Provider, please click here and complete the Participating Provider Agreement form.
Completed Partner Organization agreements and Participating Provider agreements can be return to Nancy Tolliver at [email protected] or 830 Walters Road, Charleston, West Virginia 25314.
You can learn more about the Choosing Wisely in Kanawha County initiative by clicking on this PowerPoint.
Partner Organizations
Partner Organizations are those organizations that have agreed to collaborate with the Choosing Wisely in Kanawha County through encouraging their members working in Kanawha County to become Participating Providers. We thank these organizations for exhibiting leadership and becoming involved.
- Cabin Creek Health Systems
- Kanawha - Charleston Health Department
- Kanawha Medical Society
- Thomas Hospital System
- West Virginia Nurses Association
- West Virginia Partnership for Elder Living
- West Virginia Primary Care Association
- West Virginia State Medical Association
Participating Providers
Participating Providers are those individual physicians, advance practice registered nurses, or social workers who have agreed to implement Choosing Wisely in their practice and participate in an evaluation through an online survey. We thank these individuals for their participation.
- Aila Accad, RN, MSN
- Traci Boyd Acklin, MD, Montgomery Pediatricians
- Bonnie Bailey, MD, New Century Emergency Physicians of WV
- Mary J. Bailey, MD, FamilyCare
- Elizabeth Baldwin, APRN, PNP, BC
- Sven Berg, MD, MPH, CPE, West Virginia Medical Institute
- Anne Berry, MD, Family and Maternity Care
- April R. Cartwright, LPN, Public Health Nurse
- Amber Coll, RN, CLC
- Sandra Cotton, DNP, APRN, ANP-BC
- Christy A. Estep, DO, FamilyCare
- Bethany Ferris, RN, BSN
- Lissa Gonzalez, APRN, FNP-BC
- Dawn L. Grigsby, APRN FNP-BC
- Zeina N. Haidar, MD, FamilyCare
- Yalanda Hylselan, RNC
- Rachele N. Jeffries, Pa-C, FamilyCare
- Mary B. Jenkins, MD, FamilyCare
- Amanda S. Keeney-Carte, PA-C, FamilyCare
- Linda Kessinger, MD, FamilyCare
- Sarah D. Knight, APRN, FP-BC, FamilyCare
- Lester Labus, MD
- Qamar Maimoore, MD, FAAP, FamilyCare
- Laure Marino, APRN, FNP, GNP
- Jessica McColley, DO, Maternal Child Health
- Susan Morgan, RN
- Holly R. Murriner, PA-C, FamilyCare
- Angelita Nixon, CNM
- Jamie Peden, RN, IBCLC
- Kelly Priddy, RNC-OB
- Asni Samples, RN
- Virginia Selanik, APRN, FNP, RN
- Samantha Smith, RNC–OB
- Amber Torman, MSN, RNC-OB
- Lauren A. Trozzi, MSN, FNP-BC
- Tracy A. Underwood, FNP-BC
- Kimberly K. Yow, RN3
En español
La mayoría de nuestros informes sobre fármacos, pruebas y tratamientos están disponibles en español. Hemos reunido a todos los informes en un solo sitio.
- Spanish: Consejos para los cuidadores
- Spanish: Pruebas para Alergias
- Spanish: Pruebas para la enfermedad de Alzheimer
- Spanish: Tratamiento antibiótico en el hospital
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos (for printer)
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos
- Spanish: 5 preguntas para hacer a tu médico antes de tomar antibióticos (for printer)
- Spanish: Antibióticos para infecciones del oído en niños
- Spanish: Antibióticos para personas con sondas
- Spanish: Antibióticos para la conjuntivitis
- Spanish: Resfriados, influenza y otras enfermedades respiratorias en adultos
- Spanish: Antibióticos para garganta irritada, tos o nariz tapada
- Spanish: Antibióticos para las infecciones de las vías urinarias en personas mayores
- Spanish: Antibióticos para la piel
- Spanish: Antibióticos para la piel (for printer)
- Spanish: Antibióticos: Cuándo se necesitan y cuándo no
- Spanish: Antibióticos: ¿Te ayudarán o te harán daño?
- Spanish: Antibióticos: ¿Te ayudarán o te harán daño? (For offset printing)
- Spanish: Tratamiento del comportamiento problemático en personas con demencia
- Spanish: Problemas de las arterias y las venas
- Spanish: Pregúntele a su médico: ¿Necesito esta prueba o tratamiento para el cáncer?
- Spanish: Evite los opioides contra casi todos los dolores de larga duración
- Spanish: Evite los opioides contra casi todos los dolores de larga duración (for printer)
- Spanish: Pruebas y tratamientos para el dolor de espalda
- Spanish: Tratamiento del dolor en la parte baja de la espalda
- Spanish: Pruebas de sangre para mostrar el riesgo de un aborto espontáneo
- Spanish: Pruebas de sangre cuando usted está en el hospital
- Spanish: Transfusiones de sangre para la anemia en el hospital
- Spanish: Pruebas de Densidad de los Huesos
- Spanish: Las tomografías del cerebro para las lesiones de la cabeza
- Spanish: Biopsia del seno
- Spanish: Pruebas de esfuerzo con imágenes
- Spanish: Cuidados al fin de la vida para pacientes con cáncer avanzado
- Spanish: Cirugía de la arteria carótida
- Spanish: Prueba de detección de cáncer cervical
- Spanish: Radiografía del tórax antes de una cirugía
- Spanish: Atención quiropráctica de la columna vertebral para dolor en la zona lumbar
- Spanish: Medicamentos para el colesterol para personas mayores de 75 años
- Spanish: Arterias del cuello obstruidas
- Spanish: Pruebas de CMR para el dolor de pecho y examen cardíaco
- Spanish: Colonoscopía
- Spanish: Tomografías (CT scans) para niños con lesiones en la cabeza
- Spanish: CT scans en el departamento de emergencias
- Spanish: CT scans en el departamento de emergencias (for printer)
- Spanish: Tomografías (CT scans) para detectar cáncer de pulmón en fumadores
- Spanish: Empastes dentales que contienen mercurio
- Spanish: Pruebas y tratamientos para la diabetes
- Spanish: Pruebas y tratamientos para la diabetes (for printer)
- Spanish: Suplementos dietéticos para prevenir la enfermedad cardíaca o el cáncer
- Spanish: ¿Necesita una tomografía computarizada (CT scan) por una lesión en la cabeza?
- Spanish: ¿Necesita una tomografía computarizada (CT scan) por una lesión en la cabeza? (for printer)
- Spanish: ¿Realmente necesitas esa prueba o tratamiento médico?
- Spanish: ¿Realmente necesitas esa prueba o tratamiento médico? (for printer)
- Spanish: Tratamiento de migrañas
- Spanish: Cómo tratar la artritis reumatoide
- Spanish: Medicamentos para aumentar los glóbulos blancos en pacientes con cáncer que reciben quimioterapia
- Spanish: Al dar a luz a su bebé
- Spanish: Un ecocardiograma antes de una cirugía
- Spanish: Un ecocardiograma después de una cirugía para reemplazar una válvula cardíaca
- Spanish: Ecocardiografía para valvulopatías cardíacas
- Spanish: Los electrocardiogramas (ECG) (EKG) y las pruebas de esfuerzo durante el ejercicio
- Spanish: Sondas de Alimentación para las personas con Alzheimer
- Spanish: Terapia Física
- Spanish: Small Poster in Spanish
- Spanish: Small Poster in Spanish for Printing
- Spanish: Large Poster in Spanish
- Spanish: Large Poster in Spanish for Printing
- Spanish: 5 Preguntas Para Hacerle a Su Médico
- Spanish: 5 Preguntas Para Hacerle a Su Médico (lower literacy version)
- Spanish: Aquí hay 5 preguntas
- Spanish: Aquí hay 5 preguntas (for printing)
- Spanish: 5 Preguntas Para Hacerle a Su Médico
- Spanish: 5 Preguntas Para Hacerle a Su Médico (lower literacy version)
- Spanish: 5 preguntas para hacerle a su médico
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos
- Spanish: 5 preguntas para hacerle al doctor antes de tomar antibióticos (For Printer)
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente (for printer)
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente
- Spanish: 5 maneras de manejar el dolor de la espalda baja sabiamente (for printer)
- Spanish: 5 maneras de ser inteligente en cuanto al cáncer de ovario se refiere
- Spanish: 5 maneras de ser inteligente en cuanto al cáncer de ovario se refiere (for printer)
- Spanish: Cómo recibir la atención adecuada para que sus hijos se mantengan sanos
- Spanish: Cómo recibir la atención adecuada para que sus hijos se mantengan sanos (for printer)
- Spanish: Cómo tener los cuidados adecuados para mantenerse saludable conforme envejece
- Spanish: Cómo tener los cuidados adecuados para mantenerse saludable conforme envejece (for printer)
- Spanish: Exámenes médicos
- Spanish: 5 pruebas de salud y vacunas que la mayoría de las personas debería tener conforme envejecen
- Spanish: 5 pruebas de salud y vacunas que la mayoría de las personas debería tener conforme envejecen (for printer)
- Spanish: Pruebas de imágenes del corazón antes de una cirugía
- Spanish: Pruebas de imágenes del corazón antes de una cirugía
- Spanish: Pruebas de esfuerzo del corazón antes de una cirugía de tórax
- Spanish: Virus de inmunodeficiencia humana (HIV)
- Spanish: Monitores caseros para la apnea para el SIDS
- Spanish: Oxígeno en casa después de una estadía en el hospital
- Spanish: Peligros en el hospital
- Spanish: Pruebas de marcadores tumorales y de imágenes para el cáncer de seno
- Spanish: Pruebas de imagen por dolores de cabeza
- Spanish: Pruebas de imagen por dolores de cabeza (for printer)
- Spanish: Problemas auditivos
- Spanish: Pruebas de imágenes después de un procedimiento cardíaco
- Spanish: Pruebas radiológicas debido a dolor en la parte baja de la espalda
- Spanish: Pruebas de imágenes para el cáncer colorrectal
- Spanish: Pruebas de imágenes para el cáncer de próstata en su etapa temprana
- Spanish: Pruebas de imágenes para dolores de cabeza
- Spanish: Pruebas de Imágenes para la enfermedad cardíaca
- Spanish: Pruebas radiológicas debido a dolor en la parte baja de la espalda
- Spanish: Pruebas de imágenes para el melanoma
- Spanish: Pruebas de imágenes para quistes ováricos
- Spanish: Terapia de reemplazo de IgG
- Spanish: Dispositivos cardíacos implantados al final de la vida
- Spanish: Enfermedad Renal Crónica
- Spanish: Pruebas de laboratorio antes de una cirugía
- Spanish: ¿Le duele la parte baja de la espalda?
- Spanish: ¿Le duele la parte baja de la espalda? (For printer)
- Spanish: Pruebas para la Enfermedad de Lyme
- Spanish: Cómo tomar decisiones inteligentes sobre las pruebas genéticas
- Spanish: Cómo controlar los efectos secundarios del cáncer y sus tratamientos
- Spanish: Pruebas médicas antes de una cirugía de ojo
- Spanish: Pruebas médicas antes de una cirugía
- Spanish: Medicinas para aliviar el dolor crónico
- Spanish: Medicinas para tratar el cáncer
- Spanish: Monitoreo del latido cardíaco del bebé durante el trabajo de parto
- Spanish: Dolor de cuello y espalda
- Spanish: ¿Tienes dolor constante que no es por cáncer o una enfermedad terminal?
- Spanish: ¿Tienes dolor constante que no es por cáncer o una enfermedad terminal? (for printer)
- Spanish: Antibióticos orales para las infecciones del oído
- Spanish: Vejiga hiperactiva y prolapso de órganos pélvicos
- Spanish: Medicinas para el dolor
- Spanish: Cuidados Paliativos
- Spanish: Pruebas de Papanicolaou
- Spanish: Exámenes pélvicos, exámenes de Papanicolau y anticonceptivos orales
- Spanish: Tomografías (PET scans) después del tratamiento contra el cáncer
- Spanish: Cómo prevenir las infecciones en el hospital
- Spanish: Prevención de convulsiones después de un ataque cerebral isquémico
- Spanish: La prueba de sangre PSA para detectar cáncer de próstata
- Spanish: Las pruebas de sangre del antígeno prostático específico o PSA para el cáncer de próstata
- Spanish: Preguntas sobre la radiación para el cáncer
- Spanish: La radioterapia para los cánceres ginecológicos y de seno
- Spanish: La radioterapia para el cáncer
- Spanish: Pruebas de detección para aneurismas cerebrales
- Spanish: Exámenes de detección para el cáncer de ovario
- Spanish: Pruebas de detección
- Spanish: Tratamiento para el cáncer de seno
- Spanish: Evite dar somníferos a los niños con insomnio
- Spanish: Las pastillas para dormir para el insomnio
- Spanish: Insomnio y ansiedad en personas mayores
- Spanish: Espirometría para el asma
- Spanish: Enfermedad cardíaca estable
- Spanish: Pruebas de esfuerzo después de un procedimiento de endoprótesis o colocación de stent
- Spanish: Pruebas de esfuerzo del corazón antes de una cirugía
- Spanish: Pruebas de esfuerzo para el dolor de pecho
- Spanish: El tratamiento de la osteoartritis de la rodilla
- Spanish: Cómo tomar medicinas de forma segura
- Spanish: Pruebas después de procedimientos cardíacos
- Spanish: Tratamiento para los problemas de erección
- Spanish: Pruebas y tratamientos que posiblemente sus empleados no necesiten
- Spanish: Exámenes y tratamientos para el cáncer de próstata
- Spanish: Exámenes y tratamientos para el cáncer de próstata )for printer)
- Spanish: Pruebas y tratamientos para mujeres con cáncer de seno
- Spanish: Pruebas antes de una cirugía del corazón
- Spanish: ¿Crees que tu hijo necesita antibióticos?
- Spanish: ¿Crees que tu hijo necesita antibióticos? (For printing)
- Spanish: Tratamiento de coágulos sanguíneos agudos
- Spanish: Tratamiento de arterias obstruidas en las piernas
- Spanish: Cómo tratar las agruras y la enfermedad de reflujo gastroesofágico
- Spanish: Cáncer de próstata de bajo riesgo
- Spanish: Tratamiento de la Fascitis Plantar
- Spanish: Cómo tratar la sinusitis
- Spanish: Cómo tratar la sinusitis
- Spanish: Tratamiento de problemas del sueño
- Spanish: Tratamientos y pruebas que probablemente su bebé no necesite en el hospital
- Spanish: Evite tratamientos innecesarios en la sala de emergencias
- Spanish: Pruebas y tratamientos para infecciones de las vías urinarias (UTI) en personas mayores
- Spanish: El uso seguro de los opioides después de una cirugía
- Spanish: Cuidado de la vista para los niños
- Spanish: Pruebas de Vitamina D
- Spanish: Cuando es difícil embarazarse
- Spanish: Cuándo necesita una CT scan para saber si tiene un coágulo en los pulmones
- Spanish: Cuándo necesita una CT scan para saber si tiene un coágulo en los pulmones (for printer)
- Spanish: ¿Qué tratamientos dentales son los adecuados para usted?
- Spanish: ¿Qué tratamientos dentales son los adecuados para usted? (for printer)
- Spanish: Tomografías de todo el cuerpo para detectar cáncer
- Spanish: Por qué el médico podría decidir no hacerle una CT scan para saber si tiene piedras en el riñón
- Spanish: Por qué el médico podría decidir no hacerle una CT scan para saber si tiene piedras en el riñón (for printer)
- Spanish: Usted podría no necesitar antibióticos para la piel
- Spanish: Usted podría no necesitar antibióticos para la piel (for printer, small)
- Spanish: Usted podría no necesitar antibióticos para la piel (for printer, large)
Advice for Caregivers: Treatments and Tests for Seniors
Some tests and treatments won’t help older adults. They may even be harmful, especially near the end of life.
Allergy Tests (AAAAI)
If you don’t have symptoms or a medical evaluation that points to allergy, think twice about skin or blood tests.
Alzheimer’s Disease Testing (SNMMI)
If you're having memory problems, your doctor should look for other causes before ordering a brain scan.
Antibiotic Treatment in the Hospital (SHEA)
The CDC is urging hospitals to cut back on the use of antibiotics when they are not needed. Here's what you should know.
Antibiotics (rack card)
Have a sore throat, cough, or runny nose? You probably don’t need antibiotics.
Antibiotics (rack card) (for children)
Does your child have a sore throat, cough, or runny nose? They probably don’t need antibiotics.
Antibiotics for Ear Infections in Children (AAFP)
In most cases of middle ear infection, antibiotics are not needed. Here's what to do instead.
Antibiotics for People With Catheters (AUA)
Almost all people who have catheters have some bacteria in their urine. But that doesn’t mean they all need antibiotics.
Antibiotics for Pink Eye (AAO)
Antibiotic eye drops or ointments don’t usually help with conjunctivitis. In fact, they can do more harm than good.
Antibiotics for Respiratory Illness in Adults (IDSA)
Antibiotics don’t help most respiratory infections. Here’s when you need antibiotics, and when you don't.
Antibiotics for Respiratory Illness in Children (AAP)
Most of the time, children don't need antibiotics for sore throat, cough or runny nose.
Antibiotics for Urinary Tract Infections in Older People (AGS)
Many older people get antibiotic treatment for urinary tract infections when they don't need it.
Antibiotics for Your Skin (AAD)
Some skin problems don’t stem from infections at all. So treating them with antibiotics can do more harm than good.
Antibiotics: When You Need Them and When You Don’t
When and how to use antibiotics to help you and your loved ones avoid drug resistance.
Antibiotics: Will They Help You or Hurt You?
Do you really need antibiotics? They can help you. But they also can harm you.
Antipsychotic Drugs for People with Dementia (AGS)
Powerful antipsychotic drugs should not be the first choice for people with dementia. Here's why.
Artery and Vein Problems (SVS)
Vascular surgeons have listed four overused operations that are intended to treat vein and artery problems. If your doctor orders one of these, you should ask why.
Ask Your Doctor: Do I Need This Cancer Test or Treatment? (ASCO)
You may not need some common forms of imaging, screening tests, monitoring and drug therapy for cancer.
Avoid Opioids for Most Long-Term Pain
In this guide you can read what the experts say about using opioids.
Back Pain Tests and Treatments (AAPM&R)
Some tests and treatments for back pain may not be right for you. That's why it is important to talk to your doctor.
Bed Rest for Lower-Back Pain (NASS)
Studies show that staying in bed longer than 48 hours won’t help with lower-back pain.
Blood Tests for Miscarriage Risk (SMFM)
Blood tests for thrombophilia often are not needed, even if you have had a pregnancy problem.
Blood Tests in the Hospital (SHM)
In the hospital, if your blood test results stay the same after a day or two, you may not need them again.
Blood Transfusions for Anemia in the Hospital (ASH)
Anemia is usually not urgent. Usually you don’t need a lot of blood. Or you may not need any blood at all.
Bone-Density Tests (AAFP)
If you’re not at higher risk for weak bones, you should think twice about the bone-density test. Here’s why.
Brain Scans for Head Injuries (AMSSM)
Brain scans are usually not helpful for a concussion.
Breast Biopsy (CoC)
In contrast with surgical or "open" biopsy, a needle biopsy is easier on the body.
Cardiac Imaging Stress Tests (ASNC)
In some cases, especially in healthy people without chest pain, you should be cautious about the tests.
Care at the End of Life for Advanced Cancer Patients (ASCO)
Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.
Carotid Artery Surgery (AAN)
Having some blockage in a carotid artery doesn't automatically mean you should have artery-clearing surgery.
Cervical Cancer Screening (ASCCP)
Young women with an abnormal Pap test don’t always need to be treated right away.
Chest X-rays Before Surgery (ACR)
If you don’t have signs or symptoms of heart or lung disease, think twice about having a pre-operative X-ray.
Chiropractic Spinal Care for Lower-Back Pain (ACA)
Most people with lower-back pain won’t need these: imaging tests; regular use of lumbar supports; or passive physical therapies.
Cholesterol Drugs for People Over 75 (AMDA)
If you are age 75 or older and you haven’t had symptoms of heart disease, statins may be a bad idea.
Clogged Neck Arteries (AAFP)
Do you need a screening test for clogged neck arteries?
CMR Tests for Chest Pain and Cardiac Screening (SCMR)
CMR is an imaging test for heart disease. But it may not be the best test for you.
Colonoscopy (AGA)
Even a very good test can be done too often.
CT Scans for Children With Head Injuries (AAP)
For children with head injuries, a CT scan often is not needed.
CT Scans in the Emergency Department (ACEP)
They may not be needed as often as you think.
CT Scans to Find Lung Cancer in Smokers (CHEST/ATS)
The CT scan, used to look for early signs of lung cancer, is not useful for many smokers.
Dental Fillings That Contain Mercury (ACMT, AACT)
It's not necessary to replace fillings that contain mercury.
Diabetes Tests and Treatments
If you have diabetes, when do you need to test your own glucose levels, and when do you need to take medication?
Dietary Supplements to Prevent Heart Disease or Cancer (ACPM)
Research shows that most people don't benefit from taking supplements to prevent heart disease or cancer.
Do You Need a CT Scan for a Head Injury? (ACEP)
A health history and physical exam can help the doctor decide if you need a Computerized Tomography (CT) scan.
Do You Really Need That Medical Test or Treatment? (rack card)
Sometimes doctors recommend things that aren’t needed. Sometimes they do it because their patients expect and ask for them. Before you get any medical test or treatment, ask your doctor these 5 questions.
Drugs for Migraine Headaches (AAN)
Think twice about treating migraine attacks with opioids or butalbital.
Drugs for Rheumatoid Arthritis (ACR)
The older, "non-biologic" drugs are a better first choice for treating rheumatoid arthritis.
Drugs to Prevent Infection During Chemotherapy (ASCO)
When do you need CSFs? When don't you need them?
Early Delivery (ACOG, AAFP)
To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.
Echocardiogram Before Surgery (ASE)
If you’re having surgery, you may wonder if you need an echocardiogram first.
Echocardiography After Valve Surgery (STS)
Sometimes the echocardiogram imaging test is done very soon after heart valve surgery, while you are still in the hospital. Usually that's not useful.
Echocardiography for Heart Valve Disease (ACC)
When do you need an echocardiogram?
EKGs and Exercise Stress Tests (AAFP)
EKGs or exercise stress tests usually aren't necessary for people without symptoms.
Feeding Tubes for People With Alzheimer’s (AGS, AAHPM)
Feeding tubes sometimes do more harm than good. Here’s why.
Five Physical Therapy Treatments You Probably Don’t Need (APTA)
Five common physical therapy treatments can lead to harm, more tests, and greater costs.
Five Questions to Ask About Medical Tests Before Surgery (posters)
Talk to your doctor to make sure you end up with the right pre-op tests.
Five Questions to Ask Your Doctor (large posters)
This poster offers five questions that patients should ask their doctor before agreeing to any medical test or procedure.
Five Questions to Ask Your Doctor (rack cards)
Here's a rack card designed for waiting rooms and exam rooms: Don't know what to ask your health care provider? Here are five questions.
Five Questions to Ask Your Doctor (small posters)
This poster offers five questions that patients should ask their doctor before agreeing to any medical test or procedure.
Five Questions to Ask Your Doctor (wallet card)
A handy wallet card, suitable for tucking behind your health insurance card, that reminds you of five questions to ask your doctor.
Five Questions to Ask Your Doctor About Antibiotics (large posters, for adults)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Five Questions to Ask Your Doctor About Antibiotics (large posters, for children)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Five Questions to Ask Your Doctor About Antibiotics (small posters, for adults)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Five Questions to Ask Your Doctor About Antibiotics (small posters, for children)
Use these five questions to talk to your doctor about when you need antibiotics -- and when you don’t.
Five Ways to be Smart About Back Pain (large poster)
Don’t rush to MRIs, CT scans or X-rays for back pain.
Five Ways to be Smart About Back Pain (small poster)
Don’t rush to MRIs, CT scans or X-rays for back pain.
Five Ways to be Smart About Ovarian Cancer (posters)
What you need to know about ovarian cancer prevention, risks, symptoms and testing.
Getting the Right Care to Keep Your Children Healthy
Parents have more choices than ever about medical tests and treatments for their kids. But which ones are right for your child—and which ones might do more harm than good?
Getting the Right Care to Stay Healthy as You Age
Here’s a quick guide to some of the most common tests and treatments for older adults. It’s based on advice from medical experts and Consumer Reports.
Health Checkups (SGIM)
You probably don't need that yearly checkup. In fact, it can do more harm than good.
Healthy Aging (rack card)
Here are five health tests and vaccines most people should get as they age.
Heart Imaging Before Surgery (ACC)
If you’re having surgery, you may wonder if you need a heart imaging test first to make sure it is safe.
Heart Imaging Tests Before Surgery (ASNC)
If you don't have heart problems, you probably don't need a heart test before an operation.
Heart Stress Tests Before Chest Surgery (STS)
Stress tests usually aren’t helpful if you don’t have heart problems.
HIV: When You Need CD4 Tests (HIVMA)
If your treatment for HIV is working well, you usually need the CD4 count less often, if at all. Here’s why.
Home Apnea Monitors for SIDs (AAP)
Home apnea monitors give little or no protection from Sudden Infant Death Syndrome.
Home Oxygen After a Hospital Stay (CHEST/ATS)
Many people who use long-term home oxygen therapy don’t need it.
Hospital Hazards (AAN)
The American Academy of Nursing has identified four hospital practices that are usually unnecessary and may harm you.
Imaging and Blood Tests in Early Breast Cancer (ASCO)
When do cancer experts recommend imaging tests and tumor marker tests?
Imaging for Headaches (rack card)
Imaging tests usually don’t show why you’re having headaches, and they won’t ease your pain.
Imaging for Hearing Problems (AAO-HNSF)
For tinnitus or sudden hearing loss, imaging tests such as CT scans or MRIs can be unnecessary, costly, or even harmful.
Imaging Tests After a Heart Procedure (ACC)
If you’ve had bypass surgery or a stent inserted to open a blocked artery, do you need regular imaging tests?
Imaging Tests for Back Pain (AAFP)
It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.
Imaging Tests for Colorectal Cancer (SSO)
Imaging tests for colorectal cancer use radiation, may be costly, and may not change how you are treated. Your doctor should only order tests if they are needed.
Imaging Tests for Early Prostate Cancer (ASCO)
It's not always a good idea to get all the tests that are available. You may not need them.
Imaging Tests for Headaches (ACR)
Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.
Imaging Tests for Heart Disease (ACC)
If you are a healthy person without symptoms, you should think twice about having these tests.
Imaging Tests for Lower-Back Pain (NASS)
You may think you need an X-ray, MRI or CT scan to find out what is causing your back pain. But these imaging tests usually don’t help.
Imaging Tests for Melanoma (SSO)
Imaging tests usually don’t help if you have early-stage skin cancer. Here’s why.
Imaging Tests for Ovarian Cysts (ACR)
Repetitive ultrasound exams may not be necessary.
Immunoglobulin Replacement Therapy (AAAAI)
Some people receive the treatment even though they don’t need it.
Implanted Heart Devices at the End of Life (AAHPM)
An ICD helps the heart beat normally. But if you are near death, those shocks can make things worse.
Kidney Disease (ASN)
Here are four important tests and treatments you should carefully discuss with your family and doctor
Lab Tests Before Surgery (ASCP)
Most healthy people don't need blood or urine tests done before surgery, especially low-risk surgery. Here's why.
Lower Back Pain (rack card)
Does your lower back hurt? You probably don’t need an MRI, CT scan, or X-ray.
Lyme Disease Tests (ACR)
There are two blood tests for Lyme disease, but usually you don't need them. Here's why.
Making Smart Decisions About Genetic Testing (ACMG)
Sometimes a genetic test is not the best way to find an inherited condition or disease risk.
Managing Side Effects of Cancer and its Treatments (AAN)
Some methods used to manage symptoms and side effects do not work. And some proven methods are often overlooked.
Medical Tests Before Eye Surgery (AAO)
Most people don't need to have their blood tested or their heart checked before they have eye surgery. Here's why.
Medical Tests Before Surgery
Often, pre-operative tests are not necessary. It is not a good idea to get them just because you’re having surgery.
Medicines to Relieve Chronic Pain (ASA)
Opioids (narcotics) usually are not the best way to treat long-term pain like arthritis, back pain or headaches.
Medicines to Treat Cancer (ASCO)
Drugs used to treat cancer can also cause harm, and some are very expensive. Here's what to discuss with your doctor.
Monitoring Your Baby’s Heartbeat During Labor (AAN)
During labor and birth, the type of fetal heart rate monitoring called IA, for intermittent auscultation, is often the better choice.
Neck and Back Pain: When You Need Tests (AANEM)
If the symptoms are severe or continue for a while, you may need an electrodiagnostic test.
Opioids for Pain (rack card)
Do you have ongoing pain that is not from cancer or a terminal illness? If so, you probably don't need an opioid pain reliever.
Oral Antibiotics for Ear Infections (AAO-HNSF)
Sometimes antibiotic eardrops are safer and more effective than oral antibiotics.
Overactive Bladder and Pelvic Organ Prolapse (AUGS)
Here's what women should know about tests and treatments for these conditions.
Painkiller Choices With Kidney or Heart Problems (ASN)
If you suffer from high blood pressure, heart failure, or kidney disease, steer clear of some pain relievers.
Palliative Care (AAHPM)
With palliative care, you can get physical, emotional, and spiritual support at any stage of a serious illness.
Pap Tests (AAFP)
Many teenage girls and some women have the test when they don’t need it. Here’s why.
Pelvic Exams and Pap Tests Before Contraceptives (AAFP)
You usually don’t need a Pap test and pelvic exam before getting birth control pills.
PET Scans After Cancer Treatment (ASCO)
If you've been treated for cancer, you may not need PET scans to check for a return of the cancer.
Preventing Infections in the Hospital (SHM)
Watch out for two overused hospital medical practices, urinary catheters and ulcer drugs.
Preventing Seizures After an Ischemic Stroke (AANS, CNS)
Anti-seizure medicine is not usually necessary after an ischemic stroke.
PSA Test for Prostate Cancer (AAFP)
The PSA screening test is widely used, but often is not needed.
PSA Tests for Prostate Cancer (AUA)
The PSA test is the only available screening test for prostate cancer, but it can have serious risks.
Questions to Ask Your Doctor About Radiation for Cancer (ASTRO)
Radiation therapy can help treat cancer and the painful symptoms from tumors. But it's not always needed.
Radiation Therapy for Breast and Gynecologic Cancers (ASTRO)
When it comes to radiation therapy, sometimes less is more. Use this advice to start a conversation with your doctor about the benefits and risks.
Radiation Therapy for Cancer (ASTRO)
Here is advice for talking with your doctor about whether to use radiation as part of cancer treatment.
Screening Tests for Brain Aneurysms (AANS)
Screening healthy people for weak areas in the brain's blood vessels can do more harm than good.
Screening Tests for Ovarian Cancer (SGO)
Ultrasound and the CA-125 blood test are not useful for screening low-risk women for ovarian cancer.
Screening Tests: When You Need Them, When You Don’t
It’s important to know which tests you need, and how often you need them.
Sentinel Node Biopsy for Breast Cancer (CoC, NAPBC)
If you have breast cancer, there is a newer, simpler surgery to check your lymph nodes.
Sleeping Pills for Children With Insomnia (AASM)
Sleep drugs aren’t made for children. There are no prescription drugs approved in the U.S. to treat childhood insomnia.
Sleeping Pills for Insomnia (AASM)
Sleeping pills are often not the best option for insomnia. Here's what you need to know.
Sleeping Pills for Insomnia and Anxiety in Older People (AGS)
Older adults usually should try other non-drug treatments first, for insomnia and anxiety.
Spirometry for Asthma (AAAAI)
Many people who need the test don’t receive it.
Stable Heart Disease (SCAI)
You may not need an angiogram if your heart disease is stable. Here's why.
Stress Tests After a Stent Procedure (SCAI)
Stress tests usually aren’t helpful after a stent procedure, unless you have symptoms of heart disease.
Stress Tests Before Surgery (SVM)
If you’re having surgery, you will probably not need a heart stress test beforehand if you are healthy, active, and feeling well, or if you’re having minor surgery.
Stress Tests for Chest Pain (ASNC)
If you’re at low risk for having a heart problem, even if you have symptoms, you usually don’t need this imaging test.
Supplements for Osteoarthritis (AAOS)
The popular supplements glucosamine and chondroitin sulfate do not help relieve arthritic knees.
Taking Medicines Safely (ASHP)
It is more precise to measure medicines in milliliters, instead of using a kitchen spoon.
Testing After Heart Procedures (ASNC)
Unless you're experiencing symptoms, this test usually isn't helpful in the first few years after heart bypass surgery or a stent procedure.
Testosterone for Erection Problems (AUA)
Unless you have other symptoms of low testosterone, you should think twice about the treatment. Here's why.
Tests and Treatments Employees May Not Need (ACOEM)
Employers should consider these guidelines when sending workers or job candidates to the doctor.
Tests and Treatments for Prostate Cancer
It can be hard to know which tests and treatments to get for prostate cancer. This report pulls together the latest advice from experts.
Tests and Treatments for Women with Breast Cancer (ASBS)
If your doctor recommends one of these five procedures, ask if it’s really necessary. And ask about the risks and costs.
Tests Before Heart Surgery (STS)
Before heart surgery, you probably don't need a breathing test or carotid ultrasound test, unless you have breathing problems or symptoms.
Think Your Child Needs Antibiotics?
Taking antibiotics when they aren’t needed can cause dangerous side effects.
Treating Acute Blood Clots (ASH)
If you have a deep blood clot, you probably don't need a device called an IVC filter. They don't work better than blood-thinning drugs.
Treating Blocked Leg Arteries (SVM)
Most people with Peripheral Artery Disease won't benefit from surgery or angioplasty.
Treating Heartburn and GERD (AGA)
In most cases of heartburn a PPI isn't necessary.
Treating Low-Risk Prostate Cancer (ASTRO)
If you have prostate cancer, but it poses a low risk to you, consider "watchful waiting."
Treating Plantar Fasciitis (AOFAS)
Some doctors recommend surgery. But that can lead to complications, and it doesn’t always work.
Treating Sinusitis (AAAAI)
Millions of people are prescribed antibiotics each year for sinusitis.
Treating Sinusitis (AAFP)
Millions of people are prescribed antibiotics each year for sinusitis.
Treating Sleep Problems (APA)
If you have insomnia, antipsychotic drugs should not be the first choice of treatment.
Treatments and Tests Your Baby May Not Need in the Hospital (AAP)
Here are some common tests and treatments a premature baby may not need.
Unnecessary Treatments in the Emergency Room (ACEP)
Three procedures commonly used in the emergency room are unnecessary in many cases.
Urinary Tract Infections in Older People (AGS, AMDA)
Older adults are often tested for UTIs. But if you don’t have symptoms, the tests are not very useful.
Using Opioids Safely After Surgery (AUA)
If you need opioids after surgery, it is important to talk to your doctor about how to use them safely.
Vision Care for Children (AAPOS)
There are several common vision tests and procedures that many children do not need.
Vitamin D Tests (ASCP)
Doctors often order a blood test to measure your vitamin D, but the results are unlikely to change their advice.
When It’s Hard to Get Pregnant (ASRM)
Some fertility tests are not usually needed. For example, most couples don't need laparoscopies or post-coital tests.
When You Need a CT Scan to Check for a Blood Clot in Your Lungs (ACEP)
If you have most of the signs and risk factors for a blood clot in your lungs, it may be wise to have a CT scan. If not, you may receive a D-dimer blood test first.
Which Dental Treatments Are Right for You? (ADA)
Here are some facts about common dental treatments. Ask your dentist which treatments are best for you and your family.
Whole-Body Scans to Screen for Cancer (ACPM)
No medical society recommends whole-body scans. There is no evidence that they are a good screening tool.
Why the Doctor May Not Order a CT Scan for Kidney Stones (ACEP)
For most people, a urine test, blood test and health history are all that's needed to diagnose kidney stones.
You May Not Need Antibiotics for Your Skin (AAD)
You may not need antibiotics for some skin problems. Ask your doctor if there is another treatment you can try instead.
Videos
Our video collection reinforces the messages from Choosing Wisely. You can watch them here, share them, or view the entire collection.
Quality Improvement Conference
West Virginians for Affordable Health Care organized “Choosing Wisely Quality Improvement,” a conference held in May 2015.
Patrick Conway
Experts from around the country discussed how physicians can best use the Choosing Wisely recommendations to help their patients.
Their presentations are attached below.
Keynote Address:
Patrick Conway, MD, MSc, CMS Chief Medical Officer
Featured Speakers:
Dominic J. Lorusso, Director, Health Partnerships, Consumer Reports
Jeff Borenstein, MD, MPH, FACP, VP, Clinical Content, Stanson Health.
Barbara Daiker, PhD, RN, Quality Improvement Manager, Minnesota Medical Association
Elisabeth Fowlie Mock, MD, MPH, FAAFP, Adult Hospitalist, Bangor, Maine
Jeffrey H. Coben, MD, director, West Virginia University ICRC
Jeremiah Samples, MLS, West Virginia Department of Health and Human Services
Alan Ducatman, MD, MSc, professor, West Virginia University School of Public Health
Jeremy T. Powers, MD, CAMC Physicians Group
Nancy J. Tolliver, RN, MSIR