{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:25:24Z","timestamp":1787358324696,"version":"build-2736575974"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Overuse in medicine refers to the provision of medical services that exceed what is necessary to meet patient needs and therefore result in more harm than benefit. Up to 30% of provided services can be classified as overuse. In several countries worldwide, including Canada, \u201cChoosing Wisely\u201d committees exist that issue recommendations to reduce overuse. In Germany, there are currently no recommendations for avoiding overuse in gynecology and obstetrics, which is why we adapted the recommendations of the Canadian \u201cChoosing Wisely\u201d initiative and discussed them in the context of the guidelines and directives applicable in Germany. Our article provides 13 concrete recommendations as well as practice-oriented suggestions for reducing overdiagnosis and overtreatment in gynaecology and obstetrics, thereby supporting the continuous and sustainable optimisation of patient care. Furthermore, reducing overuse in our field can help improve working conditions in healthcare professions and lower the ecological and economic costs of our healthcare system.<\/jats:p>","DOI":"10.1055\/a-2854-8087","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T22:33:22Z","timestamp":1784154802000},"page":"630-637","source":"Crossref","is-referenced-by-count":0,"title":["Avoiding Overuse in German Gynaecology and Obstetrics \u2013 Adaptation of the Canadian \u201cChoosing Wisely\u201d Recommendations"],"prefix":"10.1055","volume":"86","author":[{"given":"Nikolaus","family":"Mezger","sequence":"first","affiliation":[{"name":"Arbeitsgruppe Globale und Planetare Gesundheit, Martin-Luther-Universit\u00e4t Halle-Wittenberg, Halle (Saale), Germany"},{"name":"Karolinska Institutet, Stockholm, Sweden"},{"name":"Ersta Hospital, Stockholm, Sweden"},{"name":"Deutsche Allianz Klimawandel und Gesundheit (KLUG) e.\u200aV., Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Hasenburg","sequence":"first","affiliation":[{"name":"Arbeitsgemeinschaft Nachhaltigkeit der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Mainz, Germany"},{"name":"Universit\u00e4tsklinikum, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Scharli","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Mannheim, Mannheim, Germany"},{"name":"St.\u00a0Josefskrankenhaus, Heidelberg, Germany"},{"name":"Arbeitsgemeinschaft Nachhaltigkeit der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Sch\u00fcler-Toprak","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft Nachhaltigkeit der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Mainz, Germany"},{"name":"Klinik f\u00fcr Frauenheilkunde und Geburtshilfe, Lehrstuhl der Universit\u00e4t Regensburg am Caritas Krankenhaus St.\u00a0Josef, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Ebner","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft Nachhaltigkeit der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Mainz, Germany"},{"name":"Alb-Donau-Klinikum, Ehingen, Germany"},{"name":"Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Goeckenjan","sequence":"additional","affiliation":[{"name":"Arbeitsgemeinschaft Nachhaltigkeit der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Mainz, Germany"},{"name":"Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Francoeur","sequence":"additional","affiliation":[{"name":"Society of Obstetricians and Gynaecologists, Ottawa, Kanada"},{"name":"Universit\u00e4t Montr\u00e9al, Montr\u00e9al, Kanada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the working group for sustainability of the German Society for Gynaecology and Obstetrics","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","volume-title":"\u00dcberversorgung \u2013 eine Spurensuche","author":"M Grote Westrick","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.zeko_sn_PlanetaryHealth2026","article-title":"Stellungnahme der Zentralen Kommission zur Wahrung ethischer Grunds\u00e4tze in der Medizin und ihren Grenzgebieten (Zentrale Ethikkommission, ZEKO) bei der Bundes\u00e4rztekammer \u201ePlanetary Health und \u00e4rztliche Verantwortung\u201c","author":"Zentrale Ethikkommission der Bundes\u00e4rztekammer","year":"2026","journal-title":"Deutsches \u00c4rzteblatt"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1055\/a-2723-9436","article-title":"Klimaschonendes Arbeiten in der klinischen Gyn\u00e4kologie und Geburtshilfe","volume":"85","author":"P Scharli","year":"2025","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"h4534","DOI":"10.1136\/bmj.h4534","article-title":"Setting a research agenda for medical overuse","volume":"351","author":"D J Morgan","year":"2015","journal-title":"BMJ"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/S0140-6736(16)32585-5","article-title":"Evidence for overuse of medical services around the world","volume":"390","author":"S Brownlee","year":"2017","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s12916-020-01563-4","article-title":"The three numbers you need to know about healthcare: the 60-30-10 Challenge","volume":"18","author":"J Braithwaite","year":"2020","journal-title":"BMC Med"},{"issue":"02","key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006066.pub3","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour","volume":"2","author":"Z Alfirevic","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001450.pub4","article-title":"Fetal and umbilical Doppler ultrasound in normal pregnancy","volume":"2015","author":"Z Alfirevic","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"06","key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007529.pub4","article-title":"Fetal and umbilical Doppler ultrasound in high-risk pregnancies","volume":"6","author":"Z Alfirevic","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.jogc.2016.04.093","article-title":"Management of Spontaneous Labour at Term in Healthy Women","volume":"38","author":"L Lee","year":"2016","journal-title":"J Obstet Gynaecol Can"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.ajog.2014.01.026","article-title":"Safe prevention of the primary cesarean delivery","volume":"210","author":"A B Caughey","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/S0140-6736(18)32274-8","article-title":"Zhang\u02bcs guideline to assess labour progression","volume":"393","author":"S Grylka-Baeschlin","year":"2019","journal-title":"Lancet"},{"key":"ref26","first-page":"45","article-title":"Primary cervical cancer truly negative for high-risk human papillomavirus is a rare but distinct entity that can affect virgins and young adolescents","volume":"30","author":"C Liebrich","year":"2009","journal-title":"Eur J Gynaecol Oncol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/1471-2407-13-379","article-title":"Annual Papanicolaou screening for 5 years among human papillomavirus-negative women","volume":"13","author":"K U Petry","year":"2013","journal-title":"BMC Cancer"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1210\/jc.2011-3362","article-title":"Executive Summary of the Stages of Reproductive Aging Workshop +\u200910: Addressing the Unfinished Agenda of Staging Reproductive Aging","volume":"97","author":"S D Harlow","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1080\/13697137.2025.2585487","article-title":"International Menopause Society (IMS) recommendations and key messages on women\u02bcs midlife health and menopause","volume":"28","author":"N Panay","year":"2025","journal-title":"Climacteric"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/S0140-6736(15)01224-6","article-title":"Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial","volume":"387","author":"I J Jacobs","year":"2016","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1001\/jama.2011.766","article-title":"Effect of Screening on Ovarian Cancer Mortality: The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial","volume":"305","author":"S S Buys","year":"2011","journal-title":"JAMA"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.maturitas.2012.01.021","article-title":"Incidence of uterine leiomyosarcoma and endometrial stromal sarcoma in Nordic countries: Results from NORDCAN and NOCCA databases","volume":"72","author":"R Koivisto-Korander","year":"2012","journal-title":"Maturitas"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1016\/j.fertnstert.2011.03.079","article-title":"The FIGO classification of causes of abnormal uterine bleeding in the reproductive years","volume":"95","author":"M G Munro","year":"2011","journal-title":"Fertil Steril"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2362244","DOI":"10.1080\/09513590.2024.2362244","article-title":"Unmet needs in abnormal uterine bleeding due to ovulatory dysfunction","volume":"40","author":"T Simoncini","year":"2024","journal-title":"Gynecol Endocrinol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1111\/1471-0528.17843","article-title":"Examining the association of hysterectomy with and without oophorectomy on cardiovascular disease and all-cause, cardiovascular or cancer mortality: A systematic review and meta-analysis","volume":"131","author":"Y Chen","year":"2024","journal-title":"BJOG"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.ihj.2025.08.001","article-title":"Cardiovascular outcomes of bilateral oophorectomy: A systematic review and meta-analysis","volume":"77","author":"T Attachaipanich","year":"2025","journal-title":"Indian Heart J"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.ajog.2023.06.043","article-title":"Long-term outcomes of hysterectomy with bilateral salpingo-oophorectomy: a systematic review and meta-analysis","volume":"230","author":"H Hassan","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12905-014-0150-5","article-title":"Risk-reducing salpingo-oophorectomy: a meta-analysis on impact on ovarian cancer risk and all cause mortality in BRCA 1 and BRCA 2 mutation carriers","volume":"14","author":"C Marchetti","year":"2014","journal-title":"BMC Womens Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1007\/s00404-025-07974-z","article-title":"Intergroup statement: opportunistic salpingectomy\u2013molecular pathology, clinical outcomes and implications for practice (German Ovarian Cancer Commission, the North-Eastern German Society of Gynecologic Oncology (NOGGO), AGO Austria and AGO Swiss)","volume":"311","author":"M P\u00f6lcher","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2600","DOI":"10.1245\/s10434-012-2299-1","article-title":"Comparison of Patient Characteristics and Outcomes of Contralateral Prophylactic Mastectomy and Unilateral Total Mastectomy in Breast Cancer Patients","volume":"19","author":"A Chung","year":"2012","journal-title":"Ann Surg Oncol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ejca.2022.11.036","article-title":"EBCC-13 manifesto: Balancing pros and cons for contralateral prophylactic mastectomy","volume":"181","author":"M K Schmidt","year":"2023","journal-title":"Eur J Cancer"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1097\/SLA.0000000000002309","article-title":"Indications for Contralateral Prophylactic Mastectomy: A Consensus Statement Using Modified Delphi Methodology","volume":"267","author":"F C Wright","year":"2018","journal-title":"Ann Surg"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1055\/a-2311-9934","article-title":"Ultraschall- und CTG Kontrollen in der Schwangerschaft: Vorgaben in den Mutterschafts-Richtlinien und Versorgungswirklichkeit","volume":"30","author":"R Sch\u00e4fers","year":"2025","journal-title":"Gesundheits\u00f6konomie Qual"},{"key":"ref54","volume-title":"Versorgungskompass: Geburtshilfe und Hebammenversorgung Teil 3 \u2013 H\u00e4ufigkeiten von Risikofaktoren und von CTG- und Ultraschalluntersuchungen in der Schwangerschaft","author":"D Hertle","year":"2024"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1136\/bmjqs-2019-010060","article-title":"De-implementing wisely: developing the evidence base to reduce low-value care","volume":"29","author":"J M Grimshaw","year":"2020","journal-title":"BMJ Qual Saf"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2854-8087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T23:55:52Z","timestamp":1787356552000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2854-8087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":32,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2854-8087","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}