Bobbio Marco, Vernero Sandra
General Secretary Slow Medicine, Turin.
Monaldi Arch Chest Dis. 2019 Jun 12;89(2). doi: 10.4081/monaldi.2019.1104.
The philosophy and the history of the International Choosing Wisely movement, launched in the U.S. in 2012, are described. It grew and spread beyond what it was anticipated at the beginning because there is a rising concern of the medical community regarding the appropriate use of procedures and treatments placed into the market before an adequate evaluation of risks and benefits. Not only healthcare providers, but also patients, citizens and politicians, are becoming aware of the consequences of inappropriate decisions and behaviors since inappropriateness has economic (waste of resources), clinical (risks), but also ethical implications. In Italy the movement was launched and still is coordinated by the Slow Medicine organization, that created the campaign Doing more does not mean doing better - Choosing Wisely Italy, which aimed to improve clinical appropriateness through the reduction of unnecessary tests and treatments and the dialogue between physicians and patients. Currently, 44 societies of physicians, nurses, pharmacists and physiotherapists identified 230 recommendations about tests, treatments and procedures commonly used in Italy's clinical practice that do not provide any benefit to most patients but may cause harm.
本文介绍了2012年在美国发起的“明智选择”国际运动的理念和历史。该运动的发展和传播超出了最初的预期，因为医学界日益关注在对风险和益处进行充分评估之前就推向市场的程序和治疗方法的合理使用。不仅医疗服务提供者，而且患者、公民和政治家都开始意识到不当决策和行为的后果，因为不当行为不仅会产生经济后果（资源浪费）、临床后果（风险），还会带来伦理影响。在意大利，该运动由“慢医学”组织发起并仍由其协调，该组织开展了“做得更多并不意味着做得更好——意大利明智选择”运动，旨在通过减少不必要的检查和治疗以及医生与患者之间的对话来提高临床合理性。目前，44个医生、护士、药剂师和物理治疗师协会确定了230条关于意大利临床实践中常用检查、治疗和程序的建议，这些建议对大多数患者没有任何益处，反而可能造成伤害。
