The American Academy of Neurology's Top Five Choosing Wisely recommendations
Objective:
To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician–patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports.
Methods:
A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations.
Results and recommendations:
The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).
Source: Neurology - Category: Neurology Authors: Langer-Gould, A. M., Anderson, W. E., Armstrong, M. J., Cohen, A. B., Eccher, M. A., Iverson, D. J., Potrebic, S. B., Becker, A., Larson, R., Gedan, A., Getchius, T. S. D., Gronseth, G. S. Tags: All Headache, Multiple sclerosis SPECIAL ARTICLE Source Type: research
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