Selected Choosing WiselyTM Recommendations with Strength of Recommendation Taxonomy Ratings and Rationale
| Recommendation | Organization | SORT Rating | Rationale |
|---|---|---|---|
| Do not perform screening panels for food allergies without previous consideration of medical history. | AAP | C | AAP guideline based on disease-oriented evidence |
| Do not perform stress cardiac imaging or advanced noninvasive imaging during the initial evaluation of patients without cardiac symptoms unless high-risk markers are present. | ACC | C | ACC/AHA guideline based on expert consensus |
| Do not medicate to achieve tight glycemic control in older adults. | American Geriatrics Society | A | Multiple RCTs show harms, including higher mortality, with tight glycemic control |
| Do not screen for ovarian cancer in asymptomatic women at average risk. | American College of Obstetricians and Gynecologists | B | Single RCT showing no benefit from screening, USPSTF grade D recommendation |
| Do not prescribe opioid analgesics as first-line therapy to treat chronic, noncancer pain. | American Society of Anesthesiologists-Pain Medicine | C | Expert consensus |
| Do not perform imaging for low-back pain within the first 6 weeks unless red flags are present. | American Academy of Family Physicians and American College of Physicians | A | Systematic review of multiple RCTs with consistent results |
| Do not continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort. | Critical Care Societies Collaborative–Critical Care | C | Expert consensus, seems self-evident |
AAP, American Academy of Pediatrics; ACC, American College of Cardiology; AHA, American Heart Association; RCT, randomized controlled trial; SORT, Strength of Recommendation Taxonomy; USPSTF, US Preventive Services Task Force.