Choosing Wisely

A video on talking to parents about comprehensive respiratory viral panels

By Brad Sobolewski, MD, MEd|2023-09-20T14:37:52-04:00September 29th, 2023|Choosing Wisely, Infectious Diseases|

Did you know that there are comprehensive respiratory viral panels that will test for dozens of viruses all at once? Did you know that these tests are very expensive, and that they rarely alter management? Did you know that Choosing Wisely recommends that we do not routinely obtain them for respiratory viral illnesses? Of course you did, but that doesn't mean you shouldn't watch this entertaining video that I made with Dr. Tanner Heckle, a Pediatric Emergency Medicine Fellow from Cincinnati Children's which depicts a conversation between a provider and a parent of a child with a respiratory infection.

You don’t need to order comprehensive viral panels for most patients

By Brad Sobolewski, MD, MEd|2023-09-20T14:08:23-04:00September 27th, 2023|Choosing Wisely, Infectious Diseases|

Did you know that there are lab panels that can test for more than a dozen viruses on a single swab, but that these panels are very expensive and don't actually change the clinical trajectory of our patients all that often?

My son made me a video about whether or not X-Rays are needed in constipation

By Brad Sobolewski, MD, MEd|2023-09-19T22:01:48-04:00September 22nd, 2023|Choosing Wisely, Radiology|

For most children with children with constipation an abdominal X-Ray will not assist in making the diagnosis or quantifying the exact stool burden. @WilltheThrill2 made a special video that helps to answer the question. And yes, he's my son. Enjoy!

You don’t need X-Rays to tell if a child is constipated

By Brad Sobolewski, MD, MEd|2023-09-14T20:31:18-04:00September 20th, 2023|Choosing Wisely, Gastroenterology, Radiology|

X-Rays are generally not necessary for making the diagnosis of constipation or assessing the stool burden. In fact, they may obscure another diagnosis.

Talking to families about why we don’t need tests after febrile seizures or first-time seizures

By Brad Sobolewski, MD, MEd|2023-09-11T16:16:44-04:00September 15th, 2023|Choosing Wisely, Neurology|

This video features Dr. Archit Sahai who conducts a simulated discussion with a parent of a child following a seizure, and reviews why we don't need labs or CT scans.

You don’t need labs or CT scans in children who have recovered after a simple febrile or first time seizure

By Brad Sobolewski, MD, MEd|2023-09-06T15:04:55-04:00September 13th, 2023|Choosing Wisely, Neurology, Radiology|

Labs or CT scans are not necessary to provide additional diagnostic information or reassurance for most children who recover completely following simple febrile seizures or unprovoked first time generalized seizures. The rate of abnormalities on these studies is very low, and the cost and downsides are too high to justify ordering them on a regular basis.

The conversations we have about labs when trying to admit psych patients

By Brad Sobolewski, MD, MEd|2023-09-08T06:59:03-04:00September 8th, 2023|Choosing Wisely, Psychiatry|

This video discusses why we don't need labs for most children and adolescents who are being admitted to an inpatient mental health facility via an admittedly silly (but representative) conversation.

You don’t need labs to medically clear a psych patient

By Brad Sobolewski, MD, MEd|2023-08-23T22:06:56-04:00September 6th, 2023|Choosing Wisely, Psychiatry|

You do not need to obtain screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission unless clinically indicated. Read more about why - and how you can impact the systems you work in.

A classic educational video about the dangers of Repetitive Read Syndrome

By Brad Sobolewski, MD, MEd|2023-08-29T10:56:32-04:00September 1st, 2023|Choosing Wisely, Radiology|

Repetitive Read Syndrome is affecting Radiologists across the globe. Symptoms include dictations including the same phrasing and suggesting clinical correlation repeatedly. We can help our Radiology colleagues by avoiding unnecessary chest X-ray orders for most children with respiratory problems such as bronchiolitis, asthma exacerbations, croup, or first-time wheezing.

A video that teaches you how to talk about why we don’t need chest X-Rays in respiratory illnesses

By Brad Sobolewski, MD, MEd|2023-08-27T10:18:24-04:00September 1st, 2023|Choosing Wisely, Infectious Diseases, Radiology|

Did you know that chest X-Rays are not recommended for most children with respiratory problems such as bronchiolitis, asthma exacerbations, croup, or first-time wheezing. Choosing Wisely recommends that doctors and all medical providers have detailed conversations with patients and their families about why X-Rays are unlikely to give new information or provide any additional reassurance. They also expose young children to unnecessary radiation. This video features Dr. Vincent Alexander who conducts a simulated discussion with a parent of a child with a respiratory illness.