Choosing Wisely Canada-Top Five List in Hepatology: Official Position Statement of the Canadian Association for the Study of the Liver (CASL) and Choosing Wisely Canada (CWC) – Annals of Hepatology (free)

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada

1 – Don’t order serum ammonia to diagnose or manage hepatic encephalopathy (HE).

2 – Don’t routinely transfuse fresh frozen plasma, platelets or give Vitamin K to reverse abnormal tests of coagulation in patients with cirrhosis prior to abdominal paracentesis, endoscopic variceal band ligation, or any other minor invasive procedures.

3 – Don’t order HFE genotyping based on serum ferritin values alone to diagnose hereditary hemochromatosis.

4 – Don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (ex. focal nodal hyperplasia, hemangioma).

5 – Don’t repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.

(Under a Creative Commons license)


Current Concepts in Acute Liver Failure

22 May, 2019 | 06:00h | UTC

Review: Chronic Constipation

2 May, 2019 | 04:31h | UTC

Chronic Constipation – Mayo Clinic Proceedings (free)

Related: Indian Consensus on Chronic Constipation in Adults (free guidelines and reviews on the subject)


Colorectal Cancer Screening – JAMA (free for a limited period)

Related: Colorectal Cancer Screening for Average‐risk Adults (guidelines from other organizations)


Review: Hepatorenal Syndrome

24 Apr, 2019 | 06:21h | UTC

Review: Clostridium Difficile Infection

21 Apr, 2019 | 21:16h | UTC

Ilececum: A Comprehensive Review

20 Apr, 2019 | 13:34h | UTC

Grand Round: Autoimmune Hepatitis

15 Apr, 2019 | 02:20h | UTC

EASL Clinical Practice Guidelines: Drug-induced liver injury – Journal of Hepatology (free)

Related Review: Drug-induced liver injury: recent advances in diagnosis and risk assessment – Gut (free)


Related Commentary on Twitter


Review article: treatment options for functional dyspepsia – Alimentary Pharmacology and Therapeutics (free)

“None of the available therapies is effective in the majority of patients without being associated with major side effects.”


Are Probiotics Money Down the Toilet? Or Worse? – JAMA (free for a limited period)

Related: Randomized Trials: Probiotics Ineffective Against Gastroenteritis (link to abstract and commentaries) AND Perspective: The Problem with Probiotics (free commentaries) AND Probiotics: Does the Evidence Match the Hype? (link to abstract and commentaries) AND Systematic Review: Harms Reporting in Trials with Probiotics (link to abstract and commentaries)


Thailand Dyspepsia Guidelines

27 Jan, 2019 | 20:11h | UTC

Accelerating the elimination of viral hepatitis – Commissions from the Lancet journals (free articles – registration required)


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Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies – Osteoporosis International (link to abstract – $ for full-text)

Commentary: PPIs up risk for hip fracture in large meta-analysis – Univadis (free registration required)


Related Commentary on Twitter

Guideline: Autoimmune Hepatitis

4 Jan, 2019 | 20:09h | UTC

Review: Hepatic Echinococcosis

20 Nov, 2018 | 15:11h | UTC

Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU – New England Journal of Medicine (free for a limited period)

Editorial: Proton-Pump Inhibitor Prophylaxis in the ICU — Benefits Worth the Risks? (free for a limited period)

“Proton pump inhibitors are minimally effective to reduce GI bleeding among the critically ill folks at high risk for stress ulcers. Takeaways: no role for routine PPI for any patients on the WARDS, and shouldn’t be considered ‘routine’ in the ICU” (via @AnilMakam see Tweet)


Review: Diabetic Gastroparesis

16 Oct, 2018 | 21:45h | UTC

Review: Sclerosing Mesenteritis

16 Oct, 2018 | 21:35h | UTC

Report: Global Burden of Diarrhea

21 Sep, 2018 | 02:06h | UTC

Probiotic Safety—No Guarantees – JAMA Internal Medicine (free for a limited period)

Related: Probiotics: Does the Evidence Match the Hype? (free articles and commentaries) AND Systematic Review: Harms Reporting in Trials with Probiotics (link to abstract and commentaries)


NICE Guideline: Pancreatitis

14 Sep, 2018 | 01:30h | UTC

Guideline: Intestinal Failure in Adults

31 Aug, 2018 | 01:41h | UTC

Rotavirus Vaccination and the Global Burden of Rotavirus Diarrhea Among Children Younger Than 5 Years – JAMA Pediatrics (free)

“Rotavirus-associated mortality has decreased by 48.2% in children under 5 between 1990 and 2016” (via @IHME_UW see Tweet with infographics)


Guideline: Primary Biliary Cholangitis

11 Aug, 2018 | 02:23h | UTC

Review: Elevation of Liver Enzymes

11 Aug, 2018 | 02:17h | UTC