Clinical Decisions Made Before and After Choosing Wisely
Clinical Decisions Made Before and After Choosing Wisely
Before the intervention, rates of clinical decisions adhering to Choosing Wisely recommendations ranged from 45% (sinusitis treatment) to 99% (ECG and Papanicolaou tests). After the intervention, rates ranged from 88% (back pain imaging) to 100% (sinusitis treatment) (Table 1). Two recommendations had significantly increased rates of adherence: DEXA screening (66.7% appropriate before the intervention and 90.0% appropriate after the intervention; P = .049) and sinusitis treatment (45.4% appropriate before the intervention and 100% appropriate after the intervention; P < .000). Rates of appropriate use of Papanicolaou test screening, ECG testing, and back pain imaging were unchanged. For all 5 recommendations the rate of appropriate clinical decisions significantly increased from 93.2% to 96.5%.
Results
Before the intervention, rates of clinical decisions adhering to Choosing Wisely recommendations ranged from 45% (sinusitis treatment) to 99% (ECG and Papanicolaou tests). After the intervention, rates ranged from 88% (back pain imaging) to 100% (sinusitis treatment) (Table 1). Two recommendations had significantly increased rates of adherence: DEXA screening (66.7% appropriate before the intervention and 90.0% appropriate after the intervention; P = .049) and sinusitis treatment (45.4% appropriate before the intervention and 100% appropriate after the intervention; P < .000). Rates of appropriate use of Papanicolaou test screening, ECG testing, and back pain imaging were unchanged. For all 5 recommendations the rate of appropriate clinical decisions significantly increased from 93.2% to 96.5%.
