The Joint Commission and the American Medical Association-Convened Physician Consortium for Performance Improvement released a paper yesterday indentifying five overused medical treatments and proposals to prevent their overuse, which the report defines as use of a treatment that confers zero or negative benefits to a patient.
1. Antibiotics for viral upper respiratory infections. Develop clinical definitions for upper respiratory infections, streamline current national guidelines and partner with the CDC for a national education campaign on antibiotic overuse.
2. Over-transfusion of red blood cells. Develop an educational tool kit for physicians, expand education on alternatives to transfusion and create a separate process for informed consent for transfusions that clearly communicates both risks and benefits to patients.
3. Tympanostomy tubes for middle ear effusion of brief duration. Develop performance measures for tube use, determine rates of inappropriate tube implantation and focus national research on tympanostomy tube procedures.
4. Early-term non-medically indicated elective delivery. Standardize gestational age calculations, improve clinical practice through a comprehensive early elective delivery indication and exclusion list and educate physicians and patients more thoroughly on non-medically indicated elective deliveries.
5. Elective percutaneous coronary intervention. Encourage standardized reporting for catheterization and interventional procedures, encourage standardized analysis of non-invasive ischemia tests, improve tools for informed consent by advancing patient understanding of elective percutaneous coronary intervention risks and provide more professional and public education on the procedure.
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