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Walk the evidence base by book and chapter — the raw source passages that ground Ask, Differential, and the rest.
6 passages
Don't do imaging for low back pain within the first six weeks unless red flags are present. Setting: acute low back pain of less than 6 weeks with no red flags (major trauma, neurological deficit, history of cancer, unexplained weight loss, fever/infection, IV drug use) Why: Imaging of the low back before six weeks does not improve outcomes but exposes patients to unnecessary cost, radiation, and incidental findings that prompt further low-value testing. Consider instead: conservative management with reassessment; image only if red flags emerge or symptoms persist beyond 6 weeks Source: American Academy of Family Physicians (Choosing Wisely, US, 2012).
Don't routinely prescribe antibiotics for uncomplicated upper respiratory infections or mild acute rhinosinusitis. Setting: uncomplicated viral upper respiratory infection, or acute rhinosinusitis with mild-to-moderate symptoms of less than 7 days Why: Most acute URIs and sinusitis are viral and self-limited; antibiotics do not speed recovery and drive resistance and adverse effects. Consider instead: symptomatic treatment; reserve antibiotics for persistent (>10 days), severe, or worsening ('double-sickening') presentations Source: American Academy of Family Physicians (Choosing Wisely, US, 2012).
Don't screen for prostate cancer using a PSA test without a discussion of the risks and benefits. Setting: asymptomatic average-risk man, particularly under 55 or over 69 years, without shared decision-making Why: PSA screening without informed discussion leads to over-diagnosis and over-treatment of indolent disease with significant harms. Consider instead: shared decision-making before any PSA testing Source: American Academy of Family Physicians (Choosing Wisely, US, 2012).
Don't perform DEXA (bone density) screening for osteoporosis in women younger than 65 or men younger than 70 with no risk factors. Setting: woman under 65 or man under 70 with no osteoporosis risk factors Why: Bone-density screening in younger low-risk adults has low yield and can lead to unnecessary treatment. Consider instead: screen at the guideline age, or earlier only if risk factors are present Source: American Academy of Family Physicians (Choosing Wisely, US, 2012).
Don't prescribe antibiotics for acute bronchitis in otherwise healthy adults without evidence of pneumonia. Setting: acute bronchitis or acute cough illness in an otherwise healthy adult with no clinical or radiographic evidence of pneumonia (no consolidation) Why: Acute bronchitis is overwhelmingly viral; antibiotics (including respiratory fluoroquinolones) do not shorten the illness and add adverse effects and resistance. Consider instead: symptomatic treatment and safety-netting; reassess for pneumonia if focal chest findings, hypoxia, or deterioration Source: American Academy of Family Physicians (Choosing Wisely, US, 2012).
Don't prescribe antibiotics for acute bronchitis in otherwise healthy adults without evidence of pneumonia. Setting: acute bronchitis or acute cough illness in an otherwise healthy adult with no clinical or radiographic evidence of pneumonia (no consolidation) Why: Acute bronchitis is overwhelmingly viral; antibiotics (including respiratory fluoroquinolones) do not shorten the illness and add adverse effects and resistance. Consider instead: symptomatic treatment and safety-netting; reassess for pneumonia if focal chest findings, hypoxia, or deterioration Source: American Academy of Family Physicians (Choosing Wisely, US, 2016).