Callaghan Brian C, De Lott Lindsey B, Kerber Kevin A, Burke James F, Skolarus Lesli E
Health Services Research Program (BCC, LDL, KAK, JFB, LES), Department of Neurology, University of Michigan; and VA Center for Clinical Management Research (BCC, JFB), Ann Arbor, MI.
Neurol Clin Pract. 2015 Oct;5(5):439-447. doi: 10.1212/CPJ.0000000000000189.
To increase neurologist awareness and inform future efficiency efforts, we identified all neurology-related Choosing Wisely items. Items were categorized by neurologic specialty, disease/symptom, and test/treatment. Of 370 items provided by 65 medical societies, 74 (20%) items were relevant to neurologists. Twelve were duplicated by multiple societies. Items pertaining to 10 neurologic subspecialties were identified, but none for movement disorders and neuromuscular disease. While many recommendations question the use of imaging, few address other high-cost neurologic tests such as EMG/nerve conduction studies and EEG. A rapidly growing number of neurology-related Choosing Wisely recommendations exist including areas of consensus and areas with few recommendations despite high costs. Consensus items should be prioritized for near-term interventions, while areas with few recommendations represent opportunities for future research.
为提高神经科医生的认识并为未来的效率提升工作提供信息，我们确定了所有与神经科相关的明智选择项目。这些项目按神经科专业、疾病/症状以及检查/治疗进行分类。在65个医学协会提供的370个项目中，74个（20%）项目与神经科医生相关。有12个项目被多个协会重复提及。确定了与10个神经科亚专业相关的项目，但未涉及运动障碍和神经肌肉疾病方面的项目。虽然许多建议对影像学检查的使用提出质疑，但很少有建议涉及其他高成本的神经科检查，如肌电图/神经传导研究和脑电图。与神经科相关的明智选择建议数量正在迅速增加，包括达成共识的领域以及尽管成本高昂但建议较少的领域。对于近期干预措施，应优先考虑达成共识的项目，而建议较少的领域则为未来研究提供了机会。
