Choosing Wisely: The Canadian Rheumatology Association Pediatric Committee’s List of Items Physicians and Patients Should Question

• DOI: 10.3899/jrheum.2023-0043
• Publication Date: 2023-08-01T12:21:03Z
• Authors: Lillian Lim; Tara McMillan; Gaëlle Chédeville; Piya Lahiry; Jennifer J.Y. Lee; Liane D. Heale; Andrea L. Human; Tara R. McGrath; Sue E. MacQueen; Elizabeth Stringer; Mehul P. Jariwala; Kate M. Neufeld; Gordon S. Soon; Lynn R. Spiegel; Nadia J.C. Luca
• Keywords: Delphi Method; Rheumatism

To develop a list of tests or treatments frequently used in pediatric rheumatology practice that may be unnecessary based on existing evidence.A Choosing Wisely (CW) working group composed 16 rheumatologists, 1 allied health professional, parent, and patient the Delphi method to generate, rank, refine harmful. The items with highest content agreement perceived impact were presented survey all Canadian Rheumatology Association (CRA) physicians who rheumatology. Respondents asked rate their impact, rank items. Five composite scores 2 additional selected by CW put forward for literature review.The initial procedure generated 80 After 3 rounds, was narrowed 13 completed 41/81 (51%) CRA members across Canada. Respondent characteristics similar those membership self-reported gender, geographical location, career stage. score antinuclear antibody testing, drug toxicity monitoring, HLA-B27 rheumatoid factor/anticyclic citrullinated peptide Lyme serology testing. Two (numerous repeated intraarticular corticosteroid injections, autoinflammatory diseases genetic testing) also selected. Literature review performed these 7 priority items.We have identified areas quality improvement evaluation treatment rheumatic children.