Morrisroe, K and Nakayama, A and Soon, J and Arnold, M and Barnsley, L and Barrett, C and Brooks, PM and Hall, S and Hanrahan, P and Hissaria, P and Jones, G and Katikireddi, VS and Keen, H and Laurent, R and Nikpour, M and Poulsen, K and Robinson, P and Soden, M and Wood, N and Cook, N and Hill, C and Buchbinder, R, EVOLVE: The Australian Rheumatology Association's 'top five' list of investigations and interventions doctors and patients should question, Internal Medicine Journal, 48, (2) pp. 135-143. ISSN 1444-0903 (2017) [Refereed Article]
Available from 28 February 2019
Copyright 2017 Internal Medicine Journal
Aims: To determine the Australian Rheumatology Association's (ARA's) 'top 5' list of low-value practices.
Methods: A working group comprising 19 rheumatologists and three trainees compiled a preliminary list. Items were retained if there was strong evidence of low-value and there was high or increasing clinical use and/or increasing cost. All ARA members (356 rheumatologists and 72 trainees) were invited to indicate their 'top 5' list from a list of 12 items via MonkeySurvey in December 2015 (reminder February 2016) .
Results: 179 rheumatologists (50.3%) and 19 trainees (26.4%) responded. The top 5 list (percent of rheumatologists including item in their top 5 list) was: Do not perform arthroscopy with lavage and/or debridement for symptomatic osteoarthritis of the knee nor partial meniscectomy for a degenerate meniscal tear (73.2%); Do not order ANA testing without symptoms and/or signs suggestive of a systemic rheumatic disease (56.4%); Do not undertake imaging for low back pain for patients without indications of an underlying serious condition (50.8%); Do not use ultrasound guidance to perform injections into the subacromial space as it provides no additional benefit in comparison to landmark-guided injection (50.3%); and Do not order anti dsDNA antibodies in ANA negative patients unless the clinical suspicion of SLE remains high (45.3%).
Conclusions: This list is intended to increase awareness among rheumatologists, other clinicians and patients about commonly used low-value practices that should be questioned.
|Item Type:||Refereed Article|
|Keywords:||EVOLVE, evidence-based practice, implementation, low-value care, rheumatology|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Rheumatology and Arthritis|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Skeletal System and Disorders (incl. Arthritis)|
|Author:||Jones, G (Professor Graeme Jones)|
|Deposited By:||Menzies Institute for Medical Research|
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