{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:10:53Z","timestamp":1765728653440,"version":"3.37.3"},"reference-count":65,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The EVOLVE (evaluating evidence, enhancing efficiencies) initiative aims to drive safer, higher\u2010quality patient care through identifying and reducing low\u2010value practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the Australian Rheumatology Association\u2019s (ARA) \u2018top five\u2019 list of low\u2010value practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A working group comprising 19 rheumatologists and three trainees compiled a preliminary list. Items were retained if there was strong evidence of low value and there was high or increasing clinical use and\/or increasing cost. All ARA members (356 rheumatologists and 72 trainees) were invited to indicate their \u2018top five\u2019 list from a list of 12\u2010items through SurveyMonkey in December 2015 (reminder February 2016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 179 rheumatologists (50.3%) and 19 trainees (26.4%) responded. The top five list (percentage of rheumatologists, including item in their top five list) was: Do not perform arthroscopy with lavage and\/or debridement for symptomatic osteoarthritis of the knee nor partial meniscectomy for a degenerate meniscal tear (73.2%); Do not order anti\u2010nuclear antibody (ANA) testing without symptoms and\/or signs suggestive of a systemic rheumatic disease (56.4%); Do not undertake imaging for low back pain for patients without indications of an underlying serious condition (50.8%); Do not use ultrasound guidance to perform injections into the subacromial space as it provides no additional benefit in comparison to landmark\u2010guided injection (50.3%) and Do not order anti\u2010double\u2010stranded DNA antibodies in ANA negative patients unless the clinical suspicion of systemic lupus erythematosus remains high (45.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This list is intended to increase awareness among rheumatologists, other clinicians and patients about commonly used low\u2010value practices that should be questioned.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13654","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T07:42:38Z","timestamp":1509176558000},"page":"135-143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["EVOLVE: The Australian Rheumatology Association\u2019s \u2018top five\u2019 list of investigations and interventions doctors and patients should question"],"prefix":"10.1111","volume":"48","author":[{"given":"Kathleen","family":"Morrisroe","sequence":"first","affiliation":[{"name":"Department of Rheumatology St Vincent\u2019s Hospital  Sydney New South Wales Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria 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