As part of the Choosing Wisely campaign, the American Academy of Pediatrics (AAP) has released a new list of 5 tests and procedures commonly ordered in pediatric emergency medicine that physicians and patients should question.

Choosing Wisely is an American Board of Internal Medicine (ABIM) Foundation initiative that aims to promote discussions between clinicians and patients to support evidence-based care. The new list of recommendations was compiled by the AAP Section of Emergency Medicine’s Choosing Wisely task force.

The 5 tests/procedures that physicians and patients should question include radiography in children with bronchiolitis, croup, asthma, or first-time wheezing; screening lab tests in the medical clearance process of children who require inpatient psychiatric admission (unless clinically indicated); lab tests or a CT scan of the head for children with an unprovoked, generalized seizure or a simple febrile seizure who have returned to baseline mental status; abdominal radiographs for suspected constipation; and comprehensive viral panel testing (panels simultaneously testing for 8-20+ viruses) for patients who have suspected respiratory viral illnesses.

“We encourage parents and providers to think again before asking for or ordering these blood tests, viral panels, X-rays, and CT scans,” said Shabnam Jain, MD, MPH, a professor of pediatrics and emergency medicine at Emory University School of Medicine and Children’s Healthcare of Atlanta. “The current crisis of emergency department overcrowding underscores more than ever the need to choose wisely and avoid tests that are not evidence-based and do not improve outcomes.”

References

Choosing Wisely: Five things physicians and patients should question in the practice of pediatric emergency medicine. News release. Accessed December 1, 2022. https://www.aap.org/en/news-room/news-releases/aap/2022/choosing-wisely-five-things-physicians-and-patients-should-question-in-the-practice-of-pediatric-emergency-medicine/