Top POEMs of 2017 Consistent with Principles of the Choosing Wisely Campaign

Dr Roland Grad is back again with another persuasive publication regarding POEMs that align with principles of the Choosing Wisely campaign.

I find that infoPOEMs are a quick way to learn about new developments in practice and many of the topics align well with my interest in avoiding unnecessary and harmful care. Drs Grad and Bell have reviewed last year's POEMs with that lens, and their paper offers a great source of input for Choosing Wisely recommendations, as well as a launching point for changing your own practice.

Dr Grad will be presenting the poster at the Preventing Overdiagnosis 2018 conference in Copenhagen.

A POEM is a synopsis of a research study that reports patient-oriented outcomes, such as improvement in symptoms, quality of life, or mortality; is free of important methodologic bias; and recommends a change in practice for many physicians. We selected these POEMs through a crowdsourcing strategy of the daily POEMs information service for physician-members of the Canadian Medical Association. . . . The recommendations cover musculoskeletal conditions (e.g., avoid arthroscopy for initial treatment of a meniscal tear), respiratory disease (e.g., avoid screening for lung cancer without informing your patient of the risk of a false-positive test result), infections (e.g., do not routinely add trimethoprim/sulfamethoxazole to cephalexin for nonpurulent uncomplicated cellulitis), and cardiovascular disease (e.g., do not prescribe niacin, alone or in combination with a statin, to prevent cardiovascular disease). These POEMs describe interventions whose benefits are not superior to other options, are sometimes more expensive, or put patients at increased risk of harm. Knowing more about these POEMs and their connection with the Choosing Wisely campaign will help clinicians and their patients engage in conversations that are better informed by high-quality evidence.

You can read the full publication here, in AFP.

Previous contribution from Dr Grad and colleagues to this blog can be found here:

 

Update: POEMs help identify clinical practices for the Choosing Wisely Campaign

Update: Grad et al's paper is now published! View the full text: Patient-Oriented Evidence that Matters (POEMs) Suggest Potential Clinical Topics for the Choosing WiselyCampaign in JABFM.

[this blog post below was originally published Nov 24, 2014]


It can be challenging to cultivate topics for the Choosing Wisely Campaign; Montréal family physician and researcher Dr. Roland Grad (bio) and his group have found a unique way to harness an existing tool to do so easily.

Dr Grad presented a poster at the Family Medicine Forum (FMF) indicating one way forward could employ physician ratings of Patient-Oriented Evidence that Matters (POEMs).

POEMs are short summaries of relevant and valid information for clinicians. These are free for Canadian Medical Association (CMA) members (login to cma.ca, click on your name, and go to the Manage Newsletters section) and are basically quick reads with commentary on recent clinical trials, systematic reviews, etc. [Non-CMA members can go to Essential Evidence Plus]

Grad, Pluye, Shulha and Tang focused on one item on the validated questionnaire used by physicians to evaluate POEMs, which asked whether the POEM helped the practitioner in ‘avoiding an unnecessary diagnostic test or treatment’.

They identified the top 20 POEMs in each of two years most commonly associated with helping avoid unnecessary tests or treatment. Interestingly, only 11 of the 40 POEMs had a corresponding item on the Choosing Wisely master list.

[short version: there's a huge collection of already identified practice-changing recommendations just ripe for the adding to a campaign like Choosing Wisely!]

Their process provides an easy way to gather possible topics for future Choosing Wisely lists and could aid in the expert panel approach.

The group's paper is now in the Journal of the American Board of Family Medicine.