Welcome to the Choosing Wisely Campaign series! This is the fourth episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

Our third case-based episode presents a child with fever and cough. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely Hospital Medicine and Infectious Diseases lists to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Modified rMETRIQ Score: 14/15

Competencies:

AACN Essentials:

• 1: 1.1 g; 1.2 f; 1.3 d, e
• 2: 2.1 d, e; 2.2 g; 2.4 f, g; 2.5 h, i, j, k
• 7: 7.2 g, h, k
• 9: 9.1i, j; 9.2 i, j; 9.3 i, k

NONPF NP Core Competencies:

• 1: NP 1.1h; NP 1.2 k, m; NP 1.3 f, j, h
• 2: NP 2.1 j, g; NP 2.2 k, n; NP 2.4 h, i; NP 2.5 k, l, m, n, o
• 7: NP 7.2 m
• 9: NP 9.1 m, n; NP 9.2 n; NP 9.3 p

References

ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

American Academy of Pediatrics [AAP] Committee on Infectious Diseases & Pediatric Infectious Diseases Society. (2018). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWInfectiousDisease.pdf

de Benedictis, F. M., Kerem, E., Chang, A. B., Colin, A. A., Zar, H. J., & Bush, A. (2020). Complicated pneumonia in children. Lancet (London, England), 396(10253), 786–798. https://doi.org/10.1016/S0140-6736(20)31550-6

Kato, H. (2024) Antibiotic therapy for bacterial pneumonia. J Pharm Health Care Sci 10, 45. https://doi.org/10.1186/s40780-024-00367-5

Schlapbach, L. J., Watson, R. S., Sorce, L. R., Argent, A. C., Menon, K., Hall, M. W., Akech, S., Albers, D. J., Alpern, E. R., Balamuth, F., Bembea, M., Biban, P., Carrol, E. D., Chiotos, K., Chisti, M. J., DeWitt, P. E., Evans, I., Flauzino de Oliveira, C., Horvat, C. M., Inwald, D., … Society of Critical Care Medicine Pediatric Sepsis Definition Task Force (2024). International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA, 331(8), 665–674. https://doi.org/10.1001/jama.2024.0179

Smith, D. K., Kuckel, D. P., & Recidoro, A. M. (2021). Community-Acquired Pneumonia in Children: Rapid Evidence Review. American family physician, 104(6), 618–625.

Society of Hospital Medicine, AAP, & Academic Pediatric Association. (2021). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWHospitalmedicine.pdf

Yun K. W. (2024). Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment. Clinical and experimental pediatrics, 67(2), 80–89. https://doi.org/10.3345/cep.2022.01452

Welcome to the Choosing Wisely Campaign series! This is the third episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

Our second case-based episode presents an infant with diarrhea and diaper dermatitis. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely dermatology and gastroenterology, hepatology, and nutrition lists to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Modified rMETRIQ Score: 15/15

Competencies:

AACN Essentials:

• 1: 1.1 g, 1.2f, 1.3de
• 2: 2.1 de, 2.2g, 2.4fg, 2.5 hijk
• 7: 7.2 ghk
• 9: 9.1ij, 9.2ij, 9.3ik

NONPF NP Core Competencies:

• 1: NP1.1h, NP 1.2km, NP 1.3fjh
• 2: NP2.1jg, NP2.2kn, NP 2.4hi, NP2.5 klmno
• 7: NP7.2m
• 9: NP9.1mn, NP9.2n, NP9.3p

References

ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

AAP Section on Dermatology. (2021). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWDermatology.pdf

AAP Section on Gastroenterology, Hepatology, and Nutrition. (2023). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWGastroenterology.pdf

Harriet Lane Service (Johns Hopkins Hospital), Anderson, C. C., Kapoor, S., & Mark, T. E. (2024). The Harriet Lane handbook: a manual for pediatric house officers (23rd ed.). Elsevier.

Jauregui, J., Nelson, D., Choo, E., Stearns, B., Levine, A. C., Liebmann, O., & Shah, S. P. (2014). External validation and comparison of three pediatric clinical dehydration scales. PloS one, 9(5), e95739. https://doi.org/10.1371/journal.pone.0095739

Johnson, H., & Yu, J. (2022). Current and Emerging Therapies in Pediatric Atopic Dermatitis. Dermatology and therapy, 12(12), 2691–2703. https://doi.org/10.1007/s13555-022-00829-4

Semon, A. K., Keenan, O., & Zackular, J. P. (2021). Clostridioides difficile and the Microbiota Early in Life. Journal of the Pediatric Infectious Diseases Society, 10(Supplement_3), S3–S7. https://doi.org/10.1093/jpids/piab063

Welcome to the Choosing Wisely Campaign series! This is the second episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

The first of our case-based episodes presents a school age child with syncope. After a clear discussion of the case and thoughtful consideration of an acute care differential, we use the AAP’s Choosing Wisely cardiac list to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Competencies:

AACN Essentials:

• 1: 1.1 g, 1.2f
• 2: 2.1 de, 2.2g, 2.5 ij
• 6: 6.1 i
• 7: 7.2 ghk
• 9: 9.1ij, 9.2ij, 9.3ik

NONPF NP Core Competencies:

• 1: NP1.1h, NP 1.2km
• 2: NP2.1jg, NP2.2kn, NP2.5 lo
• 6: NP6.1o
• 7: NP7.2m
• 9: NP9.1mn, NP9.2n, NP9.3p

References:

AAP Section on Cardiology and Cardiac Surgery. (2020). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWCardio.pdf

Gilpin, K., & Goode, Z. (2024). Syncope. Pediatrics in review, 45(10), 606–608. https://doi.org/10.1542/pir.2023-006053