Launch of new lists

New Choosing Wisely recommendations were launched recently, from:

  • New Zealand College of Midwives

  • New Zealand College of Public Health Medicine

  • New Zealand Committee Royal New Zealand and Australian College of Obstetricians and Gynaecologists

  • New Zealand Rheumatology Association

  • Australasian Faculty of Occupational and Environmental Medicine

  • Australia and New Zealand Child Neurology Society

The New Zealand College of Midwives and the New Zealand Committee Royal New Zealand and Australian College of Obstetricians and Gynaecologists both caution against too many ultrasound scans in healthy pregnant women. The College of Midwives also says it is not necessary to continuously monitor a baby’s heart rate during normal labour, and that the umbilical cord should not be cut straight away. Unless the baby requires resuscitation at birth, cord clamping should be delayed for at least three minutes or until the cord has stopped pulsating (whichever is longer).

The New Zealand College of Public Health Medicine and the New Zealand Committee Royal New Zealand and Australian College of Obstetricians and Gynaecologists both say that population screening, unless strict criteria are met, can do more harm than good.  Population screening for ovarian cancer for example, is not recommended according to College of Obstetrics and Gynaecology.  The New Zealand Rheumatology Association also cautions against screening patients at low risk of osteoporosis with bone density scanning more frequently than every five years.

When communicating health risks, harms and benefits, the New Zealand College of Public Health Medicine recommends that absolute risk is used ahead of relative risk.  For example, a treatment that gives a relative reduction in deaths of 50 percent can sound misleadingly good, but the absolute risk of dying from a condition may only decrease by a very small amount.

Many New Zealanders are undergoing tests such as x-rays and CT scans that they do not need, and these can be harmful, for example, because they increase a person’s risk of cancer.  The Australasian Faculty of Occupational and Environmental Medicine advises against any imaging for low back pain.  CT scans are also not needed to investigate first-time headache or fainting in children, according to the Australia and New Zealand Child Neurology Society.

The event received worthwhile media attention:

Radio NZ interview with NZCOM Deputy Chief Executive Alison Eddy.

Newshub report on the launch.

NZ Doctor article.

Health Central post.

Dr Rebecca Grainger NZRA NZCOM launch