Left ventricular non-compaction (LVNC) is a cardiomyopathy characterized by prominent and excessive trabeculation of the left ventricle. Both the clinical phenotype and genetics of LVNC in adults remain uncertain. This presents a major clinical challenge for the cardiologist as both the diagnosis and management [...]
Implantable cardioverter defibrillators (ICDs) are life-saving devices that prevent sudden cardiac death. Over a 12-year period, we have shown ICDs are being surgically inserted in patients at increasing rates at a cost of almost $155 million a year. We showed more than 75% of [...]
In this article, Tim Badgery-Parker, Sallie-Anne Pearson, Kelsey Chalmers, Adam G Elshaug and colleagues report the use of 27 low-value procedures in public hospitals in New South Wales. The study, a partnership between the University of Sydney, the NSW Ministry of Health, and the [...]
In recent years management practices for low-risk papillary thyroid cancer less than 1cm in size, also known as papillary microcarcinoma (PMC), has been changing as a result of an increased awareness of the potential for overdiagnosis and overtreatment. This study conducted interviews with patients [...]
The Ottawa Ankle and Midfoot Rules are simple clinical tests that are used to identify patients with an ankle sprain who have a low probability of fracture and so do not require imaging. Our diagnostic review confirmed that the rules are highly sensitive eg [...]
This editorial uses the example of managing low back pain to introduce physiotherapists to the concept of low value health care. While low-value care has received substantial attention in medicine, there has been little consideration of this issue in allied health. We chose to [...]
Clinical practice guidelines for spinal pain adopt the World Health Organization’s pain ladder, suggesting a stepped approach to analgesia, beginning with simple analgesics and progressing up the ladder if pain relief is insufficient. We used the BEACH database to study the analgesic medicines Australian [...]
This study was a secondary analysis of the Australian Care Track study that measured the appropriateness of health care in Australia for a range of considered across all settings about one quarter of the care for low back pain was not appropriate. The appropriateness [...]
Alerting features (red flags) such as unexplained weight loss are used to identify low back pain patients with a higher likelihood of cancer who require further diagnostic work-up. In this review we identified 15 red flags that have been endorsed to screen for malignancy [...]
Guidelines recommend that low back pain should be managed in primary care but increasingly patients with non-serious low back pain are presenting to emergency departments. This paper considers the problems of overdiagnosis and overtreatment that commonly occur in this setting and suggests strategies to [...]