AAFP issues top five 'choosing wisely' recommendations

The AAFP examined evidence-based items in primary care practice that would lead to significant health benefits, reduce risk and harms, and decrease costs. After developing an initial list, the literature was reviewed to provide evidence to support or refute the activities. The AAFP identified the Top Five Recommendations and also a set of five additional recommendations for the second phase of the Choosing Wisely Campaign.

The Top Five Recommendations issued by the AAFP are: (1) imaging should not be performed for low-back pain within the first six weeks, unless red flags indicate serious conditions; (2) antibiotics should not be routinely prescribed for acute mild-to-moderate sinusitis; (3) dual-energy X-ray absorptiometry screening for osteoporosis is not recommended for women younger than 65 years or men younger than 70 years without risk factors; (4) annual electrocardiograms or other cardiac screening should not be ordered for low-risk asymptomatic patients; and (5) women younger than 21 or those who have had a non-cancer-related hysterectomy should not undergo Papanicolaou testing. The second set of recommendations include guidelines for avoiding elective induction of labor and screening guidelines for carotid artery stenosis and cervical cancer.

"The goal was to identify items common in primary care practice, strongly supported by the evidence and literature, that would lead to significant health benefits, reduce risks and harm, and reduce costs," the authors write.

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