Choosing Wisely

Five Things Physicians and Patients Should Question

1.

For pharmacological treatment of patients with gastroesophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals.

 
 
2.

Do not repeat colorectal cancer screening (by any method) for 10 years after a high-quality colonoscopy is negative in average-risk individuals.

View the patient report.

 
3.

Do not repeat colonoscopy for at least five years for patients who have one or two small (< 1 cm) adenomatous polyps, without high-grade dysplasia, completely removed via a high-quality colonoscopy.

View the patient report.

 
4.

For a patient who is diagnosed with Barrett’s esophagus, who has undergone a second endoscopy that confirms the absence of dysplasia on biopsy, a follow-up surveillance examination should not be performed in less than three years as per published guidelines.

 
5.

For a patient with functional abdominal pain syndrome (as per ROME III criteria) computed tomography (CT) scans should not be repeated unless there is a major change in clinical findings or symptoms.

 

Download the full list, accompanying evidentiary statements and sources.

Video Modules

The AGA has coordinated with the ABIM Foundation, Drexel University College of Medicine and, in the instance of section five on functional abdominal pain DrossmanCare, to develop video modules to present evidence-based, efficient communication strategies for you, a busy practitioner, to support your implementation of the Choosing Wisely recommendations in your practice. These treatment decisions may be different from what some patients have come to expect, or even demand. We offer this module, which includes evidence based text and video examples, as an approach to explain these choices to patients in a way that is time efficient and creates greater, mutual satisfaction. 

View the modules