How Neurologists Can Choose (Even More) Wisely

Callaghan, Brian C.; Burke, James F.; Feldman, Eva L.

doi:10.1001/jama.2014.1021

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…benefit/cost). 28 In their analysis, Callaghan et al evaluate relative values of neuroimaging and electroencephalograms for headaches. They suggest that neuroimaging for headaches should generally be avoided because it provides only slightly more benefit than electroencephalograms at a much higher cost.…”

Section: Discussionmentioning

confidence: 99%

Choosing Wisely

2015

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Multiple national initiatives seek to curb spending in order to address increasing health care costs in the United States. The Choosing Wisely® initiative is one popular initiative that focuses on reducing health care spending by setting guidelines to limit tests and procedures requested by patients and ordered by physicians. To reduce spending on neuroimaging, the Choosing Wisely® initiative and other organizations have offered guidelines to limit neuroimaging for headaches. Although the intentions are laudable, these guidelines are inconsistent with the neurosurgeon’s experience with brain tumor patients. If adopted by governing or funding organizations, these guidelines threaten to negatively impact the care and outcomes of patients with brain tumors, who frequently present with minimal symptoms or isolated headaches syndromes. As we grapple with the difficult conflict between evidence-based cost-cutting guidelines and individualized patient-tailored medicine, a physician must carefully balance the costs and benefits of discretionary services such as neuroimaging for headaches. By participating in the development of validated clinical decision rules on neuroimaging for headaches, neurosurgeons can advocate for their patients and improve their patients’ outcomes.

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Section: Discussionmentioning

confidence: 99%

Choosing Wisely

2015

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“…Callaghan et al 2 in another Viewpoint draw attention to the great challenge of increasing health costs in the United States and the need to define the overall value of many of these expenditures. The authors endorse the Choosing Wisely campaign, which encourages dialogue between physicians and patients about the necessity of tests, procedures, and medications.…”

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confidence: 99%