Unidade de Tireoide do Hospital de Clínicas de Porto Alegre e Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil,
Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2021 Nov 1;65(2):248-252. doi: 10.20945/2359-3997000000323. Epub 2021 Feb 15.
Choosing Wisely (CW) is an initiative that aims to advance the dialogue between physicians and patients about low-value health interventions. Given that thyroid conditions are frequent in clinical practice, we aimed to develop an evidence-based list of thyroid CW recommendations.
The Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) named a Task Force to conduct the initiative. The Task Force work was based on an electronic Delphi approach. The 10 recommendations that received the highest scores by the Task Force were submitted for voting by all SBEM associates. The 5 recommendations that received the highest scores by SBEM associates are presented herein.
The Task Force was composed of 14 thyroidologists from 10 tertiary-care, teaching-based Brazilian institutions. The brainstorming/ideation phase resulted in 69 recommendations. After the removal of duplicates and recommendations that did not adhere to the initiative's scope, 35 remained. Then the Task Force voted to attribute a grade (0 [lowest agreement] to 10 [highest agreement]) for each recommendation. The 10 recommendations that received the highest scores by the Task Force were submitted to all SBEM associates. A total of 683 associates voted electronically, attributing a grade (0 to 10) for each recommendation. The 5 recommendations that received the highest scores by the SBEM associates compose our final list.
A set of recommendations to avoid unnecessary medical tests, treatments, or procedures for thyroid conditions are offered with a transparent methodology. This initiative aims to foster productive interactions between physicians and patients, stimulating shared decision-making.
选择明智（Choosing Wisely，CW）是一项旨在促进医生与患者就低价值医疗干预措施进行对话的倡议。鉴于甲状腺疾病在临床实践中较为常见，我们旨在制定一份基于证据的甲状腺 CW 推荐清单。
巴西内分泌代谢学会（SBEM）甲状腺科任命了一个工作组来开展这项倡议。工作组的工作基于电子德尔菲法。收到工作组评分最高的 10 条建议提交给所有 SBEM 会员进行投票。现将 SBEM 会员评分最高的 5 条建议呈现如下。
工作组由来自巴西 10 家三级教学医院的 14 名甲状腺专家组成。头脑风暴/构思阶段产生了 69 条建议。去除重复和不符合倡议范围的建议后，还剩 35 条。然后，工作组投票为每条建议分配一个等级（0[最低一致]至 10[最高一致]）。收到工作组评分最高的 10 条建议提交给所有 SBEM 会员。共有 683 名会员通过电子方式投票，为每条建议分配一个等级（0 至 10）。获得 SBEM 会员评分最高的 5 条建议构成了我们的最终清单。
提供了一组避免甲状腺疾病不必要的医学检查、治疗或程序的建议，并采用了透明的方法。这项倡议旨在促进医生与患者之间的富有成效的互动，促进共同决策。
