Pediatric Testing and Care that Should be Discussed

American Academy of Pediatrics releases list of 10 things doctors and parents should question

(RxWiki News) With a constantly growing battery of medical tests available, it’s important for doctors to emphasize necessary care. The need is perhaps more pointed with vulnerable patient groups like children.

A new list designed for pediatric patients and physicians identified 10 points based on recommendations from physicians and healthcare networks around the country.

Patients and their families are encouraged to use the list to evaluate the importance of different procedures and tests.

The pointers urge discretion in prescription antibiotic use and questioned the benefit of cough and cold medicines for children under 4, among other items.

"Talk to your child’s doctor about the best available care."

James M. Perrin, MD, FAAP, president of the American Academy of Pediatrics, released this list on March 17.

The 10 items were developed through a three-stage process. After taking input from caregivers affiliated with the American Academy of Pediatrics (AAP), experts reviewed and evaluated the recommendations.

Finally, the AAP's Board of Directors picked 10 topics out of 100 based on criteria including evidenced clinical benefits and potential to cause harm.

To avoid antibiotic resistance, the AAP list discourages use of prescription antibiotics in treatment of viral respiratory illnesses.

Furthermore, in the treatment of respiratory illness, cough and cold medicines “offer little benefit to young children and can have potentially serious side effects,” the AAP wrote.

Regarding computed tomography (CT) scans, which use X-rays to make cross-section images of the body, the AAP makes three recommendations. CT scans are not necessary in the immediate evaluation of minor head injuries or for a child with “simple febrile seizure,” convulsions in small children brought on by fever.

“CT scans are not necessary in the routine evaluation of abdominal pain,” according to the AAP.

AAP doctors discourage use of high doses of dexamethasone, which is used to treat or prevent a lung condition in infants.

The list also has information on acid blockers, food allergy screening, urinary conditions and sudden infant death syndrome monitoring.

“Pediatricians want the best possible tests and treatments for their patients, and they want them to be used appropriately,” Dr. Perrin said.

“This is particularly important when treating children, because they are still growing and developing,” he said.

"There are both medical and financial benefits that result from encouraging clinicians and families to follow evidence-based best practices," said Adam Powell, PhD, health economist and President of Payer+Provider Syndicate.

"The American Academy of Pediatrics has been wise in its suggestion that clinicians and families 'question' rather than 'refuse' things, as there are always edge cases in which things are indicated. By offering a limited list, the American Academy of Pediatrics has made the information easy for people to recall," Dr. Powell told dailyRx News.

The list is part of an outreach initiative called Choosing Wisely, which is funded by the nonprofit American Board of Internal Medicine Foundation.

Review Date: 
March 18, 2014