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Choosing Wisely

Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their healthcare professionals.

Choosing Wisely UK was launched in 2016 by the Academy of Medical Royal Colleges as a way to identify tests, treatments and procedures of questionable value meaning that the appropriateness of their use should be discussed carefully with patients before being carried out. This work has since been superseded by other initiatives such as Evidence based Interventions and rethinking medicine.

Shared decision making

The focus of Choosing Wisely UK is now about shared decision making using BRAN to encourage patients get the best from conversations with their healthcare professionals by asking four questions.

What are the Benefits?
What are the Risks?
What are the Alternatives?
What if I do Nothing?

This is a collaborative process in which doctors and healthcare professionals work together with patients to select tests, treatments and care management or support packages, based on clinical evidence and patients’ informed preferences and values. It explicitly acknowledges the fact that there is usually more than one way to treat a problem, including ‘no treatment’ and patients may require help to weigh up the benefits and risks of the options to determine the best choice for them.

There is good evidence that shared decision making benefits patients, improving the quality and appropriateness of clinical decision making.