EH 2_2015

THE EUROPEAN FORUM FOR THOSE IN THE BUSINESS OF MAKING HEALTHCARE WORK CONTENTS NEWS & MANAGEMENT 1-6 CARDIOLOGY 7-8 LABORATORY 9-20 RADIOLOGY 21-24 ULTRASOUND 25 IT & TELEMED 26-28 www.healthcare-in-europe.com V O L 2 4 I S S U E 2 / 1 5 • A P R I L / M AY 2 0 1 5 Report: Bettina Döbereiner Prescribing antibiotics for a viral infec- tion with fever, a cold and a cough? There is no point! This is the best- known example of over-use in medi- cine. There are also numerous exam- ples of diagnostic procedures and therapies that are pointless, yet still being doled out in surgeries and hospitals – sometimes even harm- ing a patient. This is set to change, according to the German Society of Internal Medicine (DGIM), which has launched ‘Klug entscheiden’, modelled on the USA’s campaign ‘Choosing Wisely’. That country is not alone. Worldwide, Canada’s campaign runs alongside the USA’s version, and the Swiss, Dutch and Italians have also adopted the concept. A Choosing Wisely campaign is also planned for by Great Britain, Australia, New Zealand and Japan. The German campaign consists of 3-5-point checklists per specialist medical discipline, aimed at alerting doctors and patients to typical exam- ples of over-use. The attraction of the campaign: ‘First, the doctors are encouraged to compile these check- points with patients and patients’ representatives. Second, the lists are meant to be written in such a way that patients can also understand them,’ explained Emeritus Professor Ulrich Fölsch, DGIM General Secretary and former Director of the Department of Internal Medicine I, at the Schleswig- Holstein University Medical Centre, when introducing the campaign in Berlin this February. The model for the DGIM campaign was initiated as Choosing Wisely in 2012 by the American Board Editor’s note:The effects of such a campaign on volumes of laboratory, pharmaceutical, imaging and usage of a multitude of other medical supplies is inestimable, at this stage. In addition, ethical questions must be addressed and debated regarding what is or is not really essential – for example, dip into the debate on cancer treatments at http://consumerhealthchoices. org/wp-content/uploads/2012/10/ ChoosingWiselyCancerASCO.pdf of Internal Medicine (ABIM), with which 60 specialist medical socie- ties are currently involved. In line with the campaign’s US motto – Five things physicians and patients should question – The North American Spine Society, for example, begins its checklist with the statement: ‘Don’t recommend advanced imaging (i.e. MRI) of the spine within the first six weeks in patients with non-specific acute low back pain in the absence of red flags.’ Red flags signify, among other things, the presence of trauma history, unintentional weight loss or immunosuppression. However, the above-mentioned example does not fall within the field of internal medi- cine represented by the DGIM. The German campaign is also still in its infancy. As recently as the beginning of 2015, Prof. Fölsch asked all eleven DGIM member societies represent- ing, for example, cardiology, pulmo- nology and intensive care, to name three to five examples of over-use, but also under-use in their specific medical disciplines. This will be fur- ther discussed and consented in a conference prepared for early May this year. The fact that so-called under-use will also be addressed is one of two differences between the German campaign and American trailblazer. The second, more important differ- ence concerns scientific safeguarding. Feedback from the different medical societies is to be checked for sci- entific verifiability based on exist- ing, evidence-based directives before publication. The first German organisation to engage with the Choosing Wisely theme, and discuss the relevance and methodical challenges in spe- cific workshops, was the German Network Evidence Based Medicine (DNEbM). Daniel Strech, Member of the Board at the DNEbM, values the DGIM initiative as well as similar campaigns currently being initiated by other organisations. He appeals for the implementation of the cam- paign in a patient-oriented and sci- ence-based manner. Professor David Klemperer, from the Regensburg University of Applied Sciences, and member of a work- ing group within the Association of the Scientific Medical Societies in Germany (AWMF), which is focusing on the implementation of a Choosing Wisely campaign under the patron- age of the AWMF, also hopes for good cooperation with the DGIM. Klemperer assumes that, in coming weeks, it will be possible to inte- grate the DGIM initiative into the efforts of the AWMF and to develop a joint campaign that all 168 special- ist societies within the AWMF can join. ‘Such comprehensive implemen- tation of the campaign would be very significant, also in comparison with the American and Canadian Choosing Wisely campaigns,’ says Klemperer, who is also a member of the 2014 established Choosing Wisely International Working Group. Cut prescriptions and choose treatments wisely!The USA’s cautionary campaign is hitting the global psyche Source:Shutterstock-Gajus Source:DGIM LABORATORY 9-20 • Obama’s billion-$ war on drug resistant microbes • ECCMID’s 25th anniversary event • Are medical apps a waste of time? RADIOLOGY 21-24 • AB-MRI ideal for screening? • Bonding radiology and NUC • Eliminating barriers in patient communication Emeritus Professor Ulrich R Fölsch, General Secretary of the German Society of Internal Medicine (DGIM), based in Wiesbaden, Germany V O L 24 I S S U E 2 / 15 • A P R I L / M AY 2015

EH 2_2015

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