JOURNAL OF THE CZECH PEDIATRIC SOCIETY AND THE SLOVAK PEDIATRIC SOCIETY

Čes-slov Pediat 2026, 81(1):13-16 | DOI: 10.55095/CSPediatrie2026/001

Choosing Wisely: An initiative promoting rational and high-value care based on the recommendations of the European Academy of Paediatrics (EAP)

Sabina Dzurická1, Veronika Pokorná2
1 Klinika pediatrie a dědičných poruch metabolismu, 1. lékařská fakulta, Univerzita Karlova, Všeobecná fakultní nemocnice v Praze
2 Dětská klinika, Fakultní nemocnice Hradec Králové, Lékařská fakulta v Hradci Králové, Univerzita Karlova

Choosing Wisely initiative, launched in 2012, is an international physician-led movement promoting rational, safe, and patient-centred healthcare. Its aim is to reduce the overuse of diagnostic tests, procedures, and treatments that often do not lead to better outcomes and may be burdensome or even harmful. Current data suggest that approximately 20-30% of healthcare provides no real benefit to patients. The call to reconsider certain routine practices has also extended to paediatrics, where this philosophy carries particular importance given the vulnerability of the paediatric population. This article presents the development of the initiative with an emphasis on the pa ediatric field and illustrates how the early American and Canadian lists gradually shaped the emerging European agenda. Following the finding that more than 80% of European paediatricians perceive overuse of care as a significant problem, the European Academy of Paediatrics (EAP) published the first European set of paediatric recommendations in 2 023 (the Choosing Wisely Top 10 List). Four of the ten recommendations address the overuse of antibiotics, while others highlight, for example, the inappropriate treatment of cough in children or gastroesophageal reflux in infants. This publication opens a series of expert communications that will discuss individual recommendations from the Choosing Wisely Top 10 List and their relevance for Czech paediatrics.

Keywords: Choosing Wisely, paediatrics, quality of care, overtreatment, patient-centred care, EAP

Accepted: December 4, 2025; Published: January 30, 2026  Show citation

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Dzurická S, Pokorná V. Choosing Wisely: An initiative promoting rational and high-value care based on the recommendations of the European Academy of Paediatrics (EAP). Ces-slov Pediat. 2026;81(1):13-16. doi: 10.55095/CSPediatrie2026/001.
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    References

    1. . Cassel CK, Guest JA. Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA 2012; 307(17): 1801-1802. Go to original source...
    2. . Weinberger SE. Providing high-value, cost-conscious care: a critical seventh general competency for physicians. Ann Intern Med 2011; 155(6): 386-388. Go to original source...
    3. . Trapani S, Montemaggi A, Indolfi G. Choosing wisely in pediatric healthcare: a narrative review. Front Pediatr 2022; 10: 1071088. Go to original source...
    4. . Sipila R, Makela M, Komulainen J. Highlighting the need for de-implementation - choosing wisely recommendations based on clinical practice guidelines. BMC Health Serv Res 2019; 19(1): 638. Go to original source...
    5. . European Academy of Paediatrics. Choosing Wisely. 2025. Dostupné z: https://eapaediatrics.eu/choose-wisely/
    6. . OECD. Tackling Wasteful Spending on Health. Paris: OECD Publishing 2017.
    7. . Brody H. Medicine's ethical responsibility for health care reform - the top five list. N Engl J Med 2010; 362(4): 283-285. Go to original source...
    8. . American Board of Internal Medicine Foundation. Choosing Wisely. 2025. Dostupné z: https://www.choosingwisely.org/
    9. . Quinonez RA, Garber MD, Schroeder AR, et al. Choosing wisely in pediatric hospital medicine: five opportunities for improved healthcare value. J Hosp Med 2013; 8(9): 479-485. Go to original source...
    10. . Friedman JN. Saying yes to the less: making it easier to choose wisely. J Pediatr 2017; 184: 4-5.e1. Go to original source...
    11. . Bobbio M, Vernero S, Colimberti D, Gardini A. Slow medicine and choosing wisely: a synergistic alliance. J Evid Based Healthc 2022; 4: e4222. Go to original source...
    12. . Den norske legeforening. Gjør kloke valg. 2025. Dostupné z: https://www.legeforeningen.no/kloke-valg/
    13. . Bogler O, Roth D, Feinstein J, et al. Choosing medications wisely: is it time to address paediatric polypharmacy? Paediatr Child Health 2019; 24(5): 303-305. Go to original source...
    14. . McDonough M, Hathi K, Corsten G, et al. Choosing Wisely Canada - pediatric otolaryngology recommendations. J Otolaryngol Head Neck Surg 2021; 50(1): 61. Go to original source...
    15. . Royal Australasian College of Physicians. RACP Choosing Wisely list. Dostupné z: https://www.choosingwisely.org.au/recommendations/racp
    16. . American Academy of Family Physicians. Avoid referring most children with umbilical hernias to a pediatric surgeon until around age four to five years. Dostupné z: https://www.aafp.org/pubs/afp/collections/choosing-wisely/417.html
    17. . Admon AJ, Gupta A, Williams M, et al. Appraising the evidence supporting Choosing Wisely® recommendations. J Hosp Med 2018; 13(10): 688-691. Go to original source...
    18. . Lin KW, Yancey JR. Evaluating the evidence for Choosing Wisely™ in primary care using the strength of recommendation taxonomy (SORT). J Am Board Fam Med 2016; 29(4): 512-515. Go to original source...
    19. . Stordal K, Wyder C, Trobisch A, et al. Overtesting and overtreatment - statement from the European Academy of Paediatrics (EAP). Eur J Pediatr 2019; 178(12): 1923-1927. Go to original source...
    20. . Jankauskaite L, Grechukha Y, Kjaer KA, et al. Overuse of medical care in paediatrics: a survey from five countries in the European Academy of Pediatrics. Front Pediatr 2022; 10: 945540. Go to original source...
    21. . Jankauskaite L, Wyder C, Del Torso S, et al. Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society. Front Pediatr 2024; 12: 1333239. Go to original source...
    22. . Mahant S, Friedman JN. Choosing Wisely® in pediatric hospital medicine: time to celebrate? J Hosp Med 2020; 15(2): 124-125. Go to original source...
    23. . Friedman JN, Whitney L, Jones M, Ostrow O. Resource stewardship and choosing wisely in a children's hospital. Paediatr Child Health 2023; 28(3): 151-157. Go to original source...
    24. . Reyes MA, Etinger V, Hall M, et al. Impact of the Choosing Wisely® campaign recommendations for hospitalized children on clinical practice: trends from 2008 to 2017. J Hosp Med 2020; 15(2): 68-74. Go to original source...

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