Top five unnecessary medical procedures for newborns

Timothy Ho, MD, from the Beth Israel Deaconess Medical Center in Boston, and colleagues identified candidate unnecessary tests and treatments in a national survey. Over three rounds of a modified Delphi process, an expert panel comprising 51 individuals representing 28 perinatal care organizations narrowed the list.

The researchers found that the 1,047 survey respondents suggested 1,648 candidate tests and 1,222 treatments. Consensus was achieved on the top five items after three Delphi rounds.

These included: (1) avoiding routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux disease or apnea and desaturation treatment in preterm infants;

(2) for treatment of initially asymptomatic infants without evidence of bacterial infection, routine continuation of antibiotics beyond 48 hours should be avoided;

(3) routine pneumograms for predischarge assessment of ongoing/prolonged apnea of prematurity should be avoided;

(4) in the absence of indication, daily chest radiographs should be avoided for intubated infants; and

(5) in preterm infants, routine screening term-equivalent or discharge brain magnetic resonance imaging should be avoided.

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