title: The American Academy of Neurology's top five choosing wisely recommendations.
abstract: OBJECTIVE
  To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports.
  
  
  METHODS
  A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations.
  
  
  CONCLUSIONS
  The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).
authors: From the Neurology Department, Los Angeles Medical Center (A.M.L.-G.), Southern California Kaiser Permanente Medical Group (S.B.P.), Los Angeles; Department of Research & Evaluation (A.M.L.-G.), Kaiser Permanente Southern California, Pasadena; California Pacific Neurosciences Institute (W.E.A.), San Francisco; Department of Neurology (M.J.A.), University of Maryland School of Medicine, Baltimore; Massachusetts General Hospital (A.B.C.), Harvard Medical School, Cambridge; Geisinger Medical Center (M.A.E.), Danville, PA; Humboldt Neurological Medical Group, Inc. (D.J.I.), Eureka, CA; American Academy of Neurology (A.B., R.L., A.G., T.G.), Minneapolis, MN; and University of Kansas Medical Center (G.S.G.), Kansas City.
authors: Annette M
authors: AM
authors: Langer-Gould
authors: Wayne E
authors: WE
authors: Anderson
authors: Melissa J
authors: MJ
authors: Armstrong
authors: Adam B
authors: AB
authors: Cohen
authors: Matthew A
authors: MA
authors: Eccher
authors: Donald J
authors: DJ
authors: Iverson
authors: Sonja B
authors: SB
authors: Potrebic
authors: Amanda
authors: A
authors: Becker
authors: Rod
authors: R
authors: Larson
authors: Alicia
authors: A
authors: Gedan
authors: Thomas S D
authors: TS
authors: Getchius
authors: Gary S
authors: GS
authors: Gronseth
mesh_terms: D019468:Disease Management; D006801:Humans; D059065:Medication Reconciliation / Q000592:standards*; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000628:therapy*; D009462:Neurology / Q000458:organization & administration / Q000592:standards*; D012955:Societies, Medical / Q000458:organization & administration / Q000592:standards; D014481:United States