Choosing Wisely to prevent overtreatment

I’ve been a fan of the healthcare consumer group, Choosing Wisely, for several years.

Collaborating with Consumer Reports, Choosing Wisely brings evidence-based healthcare information to patients. Their goal is to educate patients and physicians, and support informed decision making.

Shared decision making not only prevents patient harm from overtreating, but brings down escalating healthcare costs by eliminating unnecessary diagnostic tests and procedures. (Healthcare waste accounts for billions of dollars every year!)

Now it’s even easier to get access to their information.

The healthcare app, iTriage, has added 160 of Choosing Wisely’s recommendations to its content.

About the iTriage app

I’ve had the iTriage app on my phone since it came out a few years ago. It was started by a couple of ER doctors, and the healthcare information is reviewed by Harvard Medical School.

The app is free, although you’ll need to sign up for an account if you want to use all the options.

It has a symptom checker (not my favorite one, though) and can help you find a nearby physician or emergency room if you need one.

Related post: Apps for the cyberchondriac

It also has information about prescription and over-the-counter drugs, health conditions and common tests and procedures.

If you make an account, you can keep use the app to store your healthcare records, insurance information and contact information for your care providers, as well as track appointments and prescriptions.

Do I Need This Test?

Choosing Wisely’s recommendations are found under “Procedures.”

For example, I typed in “PSA” and that brought up “Prostate specific antigen, PSA, prostate cancer screening blood test.”

Then I clicked on “Do I Need This Test?” It told me:

Don’t routinely screen for prostate cancer using a prostate specific antigen (PSA) test or digital rectal exam.

There is convincing evidence that PSA-based screening leads to substantial over-diagnosis of prostate tumors. Many tumors will not harm patients, while the risks of treatment are significant.

I also typed in “carotid ultrasound,” which showed me “Carotid ultrasound exam, neck artery imaging.”

Do I need this test?

Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.

There is good evidence that for adult patients with no evidence of carotid artery stenosis, the harms of screening outweigh the benefits. Screening could lead to non-indicated surgeries that result in serious harms, including death, stroke and myocardial infarction [heart attack].

Overall, I found the updated app really easy to use, and I think it would be helpful to have this information literally at your fingertips when talking to your physician.

Download the Android version here.

Download the iOS version here.

For more information about Choosing Wisely and preventing overtreatment, check out these previous posts:

• Choosing Wisely: 5 questions to ask your doctor
• Choosing Wisely—Use less healthcare
• Don’t be a victim of too much medical care
• Don’t reach for Life Line screenings
• “The Treatment Trap”
• Atul Gwande—Overtreatment, “Overkill”

Sláinte,

Frugal Nurse