Abstract
Choosing Wisely (CW) is an initiative that aims to advance the dialogue between physicians and patients about low-value health interventions. Given that thyroid conditions are frequent in clinical practice, we aimed to develop an evidence-based list of thyroid CW recommendations. The Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) named a Task Force to conduct the initiative. The Task Force work was based on an electronic Delphi approach. The 10 recommendations that received the highest scores by the Task Force were submitted for voting by all SBEM associates. The 5 recommendations that received the highest scores by SBEM associates are presented herein. The Task Force was composed of 14 thyroidologists from 10 tertiary-care, teaching-based Brazilian institutions. The brainstorming/ideation phase resulted in 69 recommendations. After the removal of duplicates and recommendations that did not adhere to the initiative's scope, 35 remained. Then the Task Force voted to attribute a grade (0 [lowest agreement] to 10 [highest agreement]) for each recommendation. The 10 recommendations that received the highest scores by the Task Force were submitted to all SBEM associates. A total of 683 associates voted electronically, attributing a grade (0 to 10) for each recommendation. The 5 recommendations that received the highest scores by the SBEM associates compose our final list. A set of recommendations to avoid unnecessary medical tests, treatments, or procedures for thyroid conditions are offered with a transparent methodology. This initiative aims to foster productive interactions between physicians and patients, stimulating shared decision-making.
Highlights
The overuse of low-value interventions is a global problem
Given that thyroid conditions are widespread and that low-value interventions for these conditions are frequent in clinical practice, we aimed to develop a list of recommendations of measures not to be done when approaching patients with thyroid conditions
In 2017 the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Choosing Wisely Brasil agreed to work towards the development of a list of Choosing Wisely recommendations for thyroid conditions
Summary
The overuse of low-value interventions is a global problem. A growing body of knowledge highlights that it leads to a waste of precious health care resources and poses patients at risk of harm [1].Choosing Wisely is a worldwide health care professional-led initiative that aims to advance the dialogue between physicians and patients about low-value health interventions, avoiding wasteful or unnecessary medical tests, treatments, and procedures [2,3].The Choosing Wisely initiative started in the United States in 2012 led by the American Board of Internal Medicine (ABIM) and is present in many countries, involving more than one hundred medical associations/societies, hospitals, and universities.Given that thyroid conditions are widespread and that low-value interventions for these conditions are frequent in clinical practice, we aimed to develop a list of recommendations of measures not to be done when approaching patients with thyroid conditions.This article aims to summarize the top five recommendations in the list developed by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) for the Choosing Wisely project. Choosing Wisely is a worldwide health care professional-led initiative that aims to advance the dialogue between physicians and patients about low-value health interventions, avoiding wasteful or unnecessary medical tests, treatments, and procedures [2,3]. The Choosing Wisely initiative started in the United States in 2012 led by the American Board of Internal Medicine (ABIM) and is present in many countries, involving more than one hundred medical associations/societies, hospitals, and universities. Given that thyroid conditions are widespread and that low-value interventions for these conditions are frequent in clinical practice, we aimed to develop a list of recommendations of measures not to be done when approaching patients with thyroid conditions. This article aims to summarize the top five recommendations in the list developed by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) for the Choosing Wisely project
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